Top 5 Takeaways

1. Mask Requirements Impact: Counties with school mask requirements had significantly lower increases in pediatric COVID-19 case rates compared to those without mask mandates.
2. Statistical Significance: The difference in case rates between counties with and without mask mandates was statistically significant (p<0.001).
3. Average Case Rate Change: Counties with mask mandates saw an average increase of 16.32 cases per 100,000 children per day, while those without saw an increase of 34.85 cases per 100,000 per day.
4. Controlled Analysis: Even after adjusting for various covariates, mask requirements were associated with lower daily case rates (β = −1.31; 95% CI = −1.51 to −1.11).
5. Study Limitations: The study’s limitations include its ecologic design, lack of control for teacher vaccination rates and school testing data, and a small sample size which may affect generalizability.

Original Article Author and Citation

Corresponding Author

Samantha E. Budzyn, oqi0@cdc.gov

Suggested Citation

Budzyn SE, Panaggio MJ, Parks SE, et al. Pediatric COVID-19 Cases in Counties With and Without School Mask Requirements — United States, July 1–September 4, 2021. MMWR Morb Mortal Wkly Rep 2021;70:1377–1378. DOI: http://dx.doi.org/10.15585/mmwr.mm7039e3

Summary

This study assessed the impact of school mask requirements on pediatric COVID-19 case rates in U.S. counties from July 1 to September 4, 2021. The analysis revealed that counties with school mask mandates experienced smaller increases in COVID-19 cases among children compared to counties without such mandates. The findings support the effectiveness of mask requirements in reducing COVID-19 transmission in school settings.

Methods

The study included counties with known school mask requirements and valid school start dates. Data from the CDC’s COVID Data Tracker was used to calculate pediatric COVID-19 rates. Statistical analyses, including one-sided t-tests and multiple linear regression, were conducted to compare case rates and assess the association between mask requirements and COVID-19 incidence, adjusting for various demographic and socioeconomic factors.

Discussion

The analysis demonstrated that school mask mandates are associated with lower increases in pediatric COVID-19 case rates. Despite the study’s limitations, such as its ecologic design and small sample size, the findings highlight the importance of mask requirements in schools as part of a comprehensive strategy to mitigate COVID-19 spread.

Conclusion

The study concludes that school mask requirements, along with other preventive measures like vaccination, are crucial in reducing COVID-19 transmission among children. Future analyses should consider additional factors such as teacher vaccination rates and school testing data to further validate these findings.

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