For the third time since the start of the COVID-19 pandemic, Ontario students are getting ready for another new school year. After seven waves and countless variants, there are also immunocompromised children returning to in-person learning for the first time since the pandemic began in March of 2020. Since then, families of children with weakened immune systems due to medical conditions or certain medications have had to choose between going back to school or protecting their health for several years. For others, this difficult decision was made to protect a sibling or family member with a suppressed immune system.

Although children who are immunocompromised do have higher rates of severe illness with COVID-19, at this point in the pandemic, the risk is generally considered to be similar to other common viruses like influenza. And this risk is even lower in children than adults. Remote learning is still an option for those who wish to continue with online classes, but many families now feel that the benefits of in-person learning significantly outweigh the risks.

For a Smooth and Safe Return to School for an Immunocompromised Child

Without mask mandates or vaccination requirements in place, the return to school for a child with a weakened immune system or medical complexity can be overwhelming. If your child’s health team has okayed in-person learning, here are some strategies to prepare for this transition and help your child stay as safe as possible:

• Lead the way. Kids look to the adults in their life for how to respond to stressful events. Even if you are feeling anxious, try your best to stay calm and positive. To build some enthusiasm around going back to school, bring your child with you to choose a new backpack, buy supplies and pick out their first day outfit. After a long time away, it can also be helpful to walk by their school, play with a classmate in the schoolyard, or make a card for their new teacher to help remove some of the uncertainty around going back to school.
• Return to routine. Depending on how your child’s remote learning or homeschooling was structured, getting into the school year rhythm may be difficult. It’s often easier to make gradual changes instead of just waiting for the first day. Start now with consistent wake up, bedtimes and mealtimes, post a family calendar with the school start date highlighted and write out the new school year schedule to help your child better prepare for what’s to come.
• Remind and practice. If your child will wear a mask to school, talk about the benefits of mask-wearing often. This includes reducing their risk of getting sick or passing the virus onto others, and masks also discourage face and mouth touching. You may want to give your child some possible responses to classmates’ questions about why they are still wearing a mask. For example, ‘COVID could make me really sick, so I’m wearing a mask to stay healthy,’ or ‘That’s okay if you don’t want to wear a mask, I’m going to keep mine on, though.’ Also regularly remind your child about the importance of washing their hands, covering coughs and sneezes properly and not touching their face, nose or mouth. The good news is that children with weakened immune systems are more likely to follow health measures and usually well aware of their importance, so hopefully their good habits will translate to their time at school.
• Connect with teachers. For peace of mind and your child’s safety, it may be reasonable to ask the teacher to send a note to parents communicating that there is an immunocompromised child in the class. This reminder may encourage families to keep children home when they are sick and to be more diligent with testing and symptom monitoring. Talk to their new teacher about your child’s specific medical concerns and the extra steps you are taking to stay safe so they can hopefully support these efforts in the classroom. Teachers can also provide support to your child should they struggle with questions from other students.
• Regularly check in. After years of remote learning, your child may be overwhelmed in social situations, struggle academically, or just feel a little lost. It can be difficult for kids to manage big emotions or identify problems, so don’t expect them to reach out. Ask your child what they are looking forward to and what they are concerned about, validate their feelings and encourage problem solving. Try, ‘I can see why you might be feeling (insert feeling – worried, nervous, left out), ‘What worries you the most?’ or ‘Tell me more about that’. If you notice any concerning symptoms like stomach aches, headaches, sleeping problems or obsessive behaviours—unrelated to their health condition—your child may benefit from some additional support.
• Keep assessing. As we’ve seen throughout the pandemic, community risk can vary from week to week and changes can occur quickly. Regularly consider your child’s immune status and the number of COVID-19 cases in your area to help you continue to make decisions that are best for your family. Stay up to date on booster recommendations and the pre-emptive and antiviral treatments your child may qualify for if they contract COVID. Always speak to a doctor, but children ages 5 to 11 who are considered moderately to severely immunocompromised are typically recommended to get a third dose of the COVID-19 vaccine—especially before returning to school.

The past few years have been more challenging for parents than we ever thought possible and even more so for parents of children who are immunocompromised. During this stressful transition, try to pay attention to taking care of yourself so you can also take care of the people in your life. And try to focus on the positive – the benefits of your child’s return to school, the fact that we are hopefully on the other side of things with the pandemic and all the gains that have been made since the start of the last school year.

If you enjoyed this article, you may also like to read:

• Navigating Back-to-School During a Pandemic
• Back-to-School for the Second Time During a Pandemic