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Prevention Strategies to Reduce Transmission of SARS-CoV-2 in Schools

CDC recommends that all teachers, staff, and eligible students be vaccinated as soon as possible. However, schools have a mixed population of both people who are fully vaccinated and people who are not fully vaccinated. This requires K-12 administrators to make decisions about the use of COVID-19 prevention strategies in their schools and is why CDC recommends universal indoor masking regardless of vaccination status at all levels of community transmission.

Together with local public health officials, school administrators should consider multiple factors when they make decisions about implementing layered prevention strategies against COVID-19. Since schools typically serve their surrounding communities, decisions should be based on the school population, families and students served, as well as their communities. The primary factors to consider include:

  • Level of community transmission of COVID-19

  • COVID-19 vaccination coverage in the community and among students, teachers, and staff

  • Strain on health system capacity within the community

  • Accessibility of SARS-CoV-2 testing resources for students, teachers, and staff

  • Use of a SARS-CoV-2 screening testing program for students, teachers, and staff. Testing provides an important layer of prevention, particularly in areas with substantial to high community transmission levels

  • COVID-19 outbreaks or increasing trends in the school or surrounding community

  • Ages of children served by K-12 schools and the associated social and behavioral factors that may affect risk of transmission and the feasibility of different prevention strategies

CDC recommends universal indoor masking, physical distancing to the extent possible, and additional prevention strategies to protect students, teachers, and staff. Schools should not exclude students from in-person learning to keep a minimum distance requirement; layering multiple prevention strategies is essential when physical distancing of at least 3 feet is not possible at all times.

1. Promoting Vaccination

COVID-19 vaccination among all eligible students as well as teachers, staff, and their respective household members is the most critical strategy to help schools safely resume full operations.

Vaccination is the leading public health prevention strategy to end the COVID-19 pandemic. A growing body of evidence suggests that people who have completed the primary series (and a booster when eligible) are at substantially reduced risk of severe illness and death from COVID-19 compared with unvaccinated people.

When infections occur among vaccinated people, they tend to be milder than among those who are unvaccinated. Even vaccinated people who are infected can be infectious and can spread the virus to others. To reduce the risk of becoming infected with SARS-CoV-2 and spreading the virus to others, students, teachers, and school staff should continue to use layered prevention strategies.

Schools can promote vaccinations among teachers, staff, families, and eligible students by providing information about COVID-19 vaccination, encouraging vaccine trust and confidence, and establishing supportive policies and practices that make getting vaccinated as easy and convenient as possible.

When promoting COVID-19 vaccination, consider that certain communities and groups have been disproportionately affected by COVID-19 illness and severe outcomes, and some communities might have experiences that affect their trust and confidence in the healthcare system. Teachers, staff, students, and their families may differ in their level of vaccine confidence. School administrators can adjust their messages to the needs of their families and community and involve trusted community messengers as appropriate, including those on social media, to promote COVID-19 vaccination among people who may be hesitant to receive it.

To promote vaccination, schools can:

  • Visit to find out where teachers, staff, students, and their families can get vaccinated against COVID-19 in the community and promote COVID-19 vaccination locations near schools.

  • Encourage teachers, staff, and families, including extended family members that have frequent contact with students, to get vaccinated as soon as they can.

  • Consider partnering with state or local public health authorities to serve as COVID-19 vaccination sites, and work with local healthcare providers and organizations, including school-based health centers. Offering vaccines on-site before, during, and after the school day and during summer months can potentially decrease barriers to getting vaccinated against COVID-19. Identify other potential barriers that may be unique to the workforce and implement policies and practices to address them. The Workplace Vaccination Program has information for employers on recommended policies and practices for encouraging COVID-19 vaccination uptake among workers.

  • Find ways to adapt key messages to help families, teachers, and staff become more confident about the vaccine by using the language, tone, and format that fits the needs of the community and is responsive to concerns.

  • Use CDC COVID-19 Vaccination Toolkits to educate members of the school community and promote COVID-19 vaccination. CDC’s Workers COVID-19 Vaccine Toolkit is also available to help employers educate their workers about COVID-19 vaccines, raise awareness about vaccination benefits, and address common questions and concerns. HHS also has an On-site Vaccination Clinic Toolkit to help community groups, employers, and other host organizations work directly with vaccine providers to set up vaccination clinics in locations that people know and trust.

  • Host information sessions to connect parents and guardians with information about the COVID-19 vaccine. Teachers, staff, and health professionals can be trusted sources to explain the safety, efficacy, and benefits of COVID-19 vaccines and answer frequently asked questions.

  • Offer flexible, supportive sick leave options (e.g., paid sick leave) for employees to get vaccinated or who have side effects after vaccination. See CDC’s Post-vaccination Considerations for Workplaces.

  • Promote vaccination information for parents and guardians, siblings who are eligible for vaccines, and other household members as part of kindergarten transition and enrollment in summer activities for families entering the school system.

  • Provide students and families flexible options for excused absences to receive a COVID-19 vaccination and for possible side effects after vaccination.

  • Work with local partners to offer COVID-19 vaccination for eligible students and eligible family members during pre-sport/extracurricular activity summer physicals.

2. Consistent and Correct Mask Use

When teachers, staff, and students consistently and correctly wear a mask, they protect others as well as themselves. Consistent and correct mask use is especially important indoors and in crowded settings, when physical distancing cannot be maintained.

  • Indoors: CDC recommends indoor masking for all* individuals ages 2 years and older, including students, teachers, staff, and visitors, regardless of vaccination status.

  • Outdoors: In general, people do not need to wear masks when outdoors. CDC recommends that people who are not fully vaccinated wear a mask in crowded outdoor settings or during activities that involve sustained close contact with other people. Fully vaccinated people might choose to wear a mask in crowded outdoor settings, especially if they or someone in their household is immunocompromised.

*Exceptions can be made for the following categories of people:

  • A person who cannot wear a mask, or cannot safely wear a mask, because of a disability as defined by the Americans with Disabilities Act (ADA) (42 U.S.C. 12101 et seq.). Discuss the possibility of reasonable accommodation with workers who are unable to wear or have difficulty wearing certain types of masks because of a disability.

  • A person for whom wearing a mask would create a risk to workplace health, safety, or job duty as determined by the relevant workplace safety guidelines or federal regulations.

Masks should meet one of the following criteria:

During school transportation: CDC’s Order applies to all public transportation conveyances including school buses. Passengers and drivers must wear a mask on school buses, including on buses operated by public and private school systems, regardless of vaccination status, subject to the exclusions and exemptions in CDC’s Order. Learn more about CDC’s Requirements for Face Masks on Public Transportation Conveyances and at Transportation Hubs.

Schools should provide masks to those students who need them (including on buses), such as for students who forgot to bring their mask or whose families are unable to afford them. No disciplinary action should be taken against a student who does not have a mask, as described in the U.S. Department of Education COVID-19 Handbook, Volume 1.

3. Physical Distancing

Because of the importance of in-person learning, schools should implement physical distancing to the extent possible within their structures but should not exclude students from in-person learning to keep a minimum distance requirement. In general, CDC recommends people who are not fully vaccinated maintain physical distance of at least 6 feet from other people who are not in their household. However, several studies from the 2020-2021 school year show low COVID-19 transmission levels among students in schools that had less than 6 feet of physical distance when the school implemented and layered other prevention strategies, such as the use of masks.

Based on studies from the 2020-2021 school year, CDC recommends schools maintain at least 3 feet of physical distance between students within classrooms, combined with indoor mask wearing to reduce transmission risk. When it is not possible to maintain a physical distance of at least 3 feet, such as when schools cannot fully re-open while maintaining these distances, it is especially important to layer multiple other prevention strategies, such as screening testing, cohorting, improved ventilation, handwashing and covering coughs and sneezes, staying home when sick with symptoms of infectious illness including COVID-19, and regular cleaning to help reduce transmission risk. A distance of at least 6 feet is recommended between students and teachers/staff, and between teachers/staff who are not fully vaccinated. Correct and consistent mask use by all* students, teachers, staff, and visitors is particularly important when physical distance cannot be maintained.

Cohorting: Cohorting means keeping people together in a small group and having each group stay together throughout an entire day. Cohorting can be used to limit the number of students, teachers, and staff who come in contact with each other, especially when it is challenging to maintain physical distancing, such as among young children, and particularly in areas of moderate-to-high transmission levels. The use of cohorting can limit the spread of COVID-19 between cohorts but should not replace other prevention measures within each group. Cohorting people who are fully vaccinated and people who are not fully vaccinated into separate cohorts is not recommended. It is a school’s responsibility to ensure that cohorting is done in an equitable manner that does not perpetuate academic, racial, or other tracking, as described in the U.S. Department of Education COVID-19 Handbook, Volume 1.

4. Screening Testing

Screening testing identifies infected people, including those with or without symptoms (or before development of symptoms) who may be contagious, so that measures can be taken to prevent further transmission. In K-12 schools, screening testing can help promptly identify and isolate cases, initiate quarantine, and identify clusters to help reduce the risk to in-person education. Decisions regarding screening testing may be made at the state or local level. Screening testing may be most valuable in areas with substantial or high community transmission levels, in areas with low vaccination coverage, and in schools where other prevention strategies are not implemented. More frequent testing can increase effectiveness, but feasibility of increased testing in schools needs to be considered. Screening testing should be done in a way that ensures the ability to maintain confidentiality of results and protect student, teacher, and staff privacy. Consistent with state legal requirements and Family Educational Rights and Privacy Act (FERPA), K-12 schools should obtain parental consent for minor students and assent/consent for students themselves.

Screening testing can be used to help evaluate and adjust prevention strategies and provide added protection for schools that are not able to provide optimal physical distance between students. At a minimum, screening testing should be offered to students who have not been fully vaccinated when community transmission is at moderate, substantial, or high levels (Table 1). At any level of community transmission, screening testing should, at a minimum, be offered to all teachers and staff who have not been fully vaccinated. To be most effective, the screening program should test at least once per week, and rapidly (within 24 hours) report results. Screening testing more than once a week might be more effective at interrupting transmission. Schools may consider multiple screening testing strategies such as conducting pooled testing of cohorts. Testing in low-prevalence settings might produce false positive results, but testing can provide an important prevention strategy and safety net to support in-person education.

To facilitate safe participation in sports, extracurricular activities, and other activities with elevated risk (such as activities that involve singing or shouting, band participation, and vigorous exercise that could lead to forceful or increased exhalation), schools should consider implementing screening testing for participants. Schools can routinely test student athletes, participants, coaches, trainers, and other people (such as adult volunteers) who could come into close contact with others during these activities. Schools should consider implementing screening testing of participants up to 24 hours before sporting, competition, or extracurricular events. Schools can use different screening testing strategies for lower-risk sports. High-risk sports and extracurricular activities should be virtual or canceled in areas of high community transmission unless all participants are fully vaccinated.

Funding provided through the Epidemiology Laboratory Capacity (ELC) Reopening Schools award is primarily focused on providing needed resources to implement screening testing programs in schools aligned with CDC recommendations. Learn more at ELC Reopening Schools: Support for Screening Testing to Reopen & Keep Schools Operating Safely Guidance. Resources are available to support school testing – see Appendix 2: Testing Strategies for COVID-19 Prevention in K-12 Schools.

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