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At what age should children wear a mask at school, depending on the country?

Text updated on 2020-10-27


In this time of the COVID-19 epidemic, the wearing of masks has become compulsory at schools for many pupils, from the age of 3 to 12, depending on the country.

In many countries, children are required to put on a mask from kindergarten, primary, or secondary school.

Here are the ages at which the mask is mandatory for different countries:

A few countries have not made masks compulsory for children at school (as of October 10, 2020): Denmark, New Zealand, Norway, Sweden. In Japan, there is no obligation to wear masks in schools but during COVID-19, children generally all wear masks from an early age and there has been some discussion about wearing masks under the age of 2. In Taiwan, masks are compulsory at school when distances cannot be kept and masks specially designed for children under 4 years of age are available in stores.

The World Health Organization (WHO) and UNICEF recommend that children aged 12 years and older wear masks under the same conditions as adults, especially when they cannot guarantee a distance of at least one meter from others and if transmission is widespread in the area concerned. In addition, when intense transmission exists in the area where the child resides, or when children are likely to interact with people at high risk, WHO and UNICEF recommend that masks be worn from the age of 6 years. The American Academy of Pediatrics and the US CDC even go so far as to recommend wearing the mask from the age of 2.

Why are there so many variations between countries? Because although it is now known that children develop less severe forms of the COVID-19 disease and that they can transmit the SARS-CoV-2 coronavirus to other children and adults, there is not yet scientific consensus on the importance of contagiousness of children and their role in the dynamics of the pandemic, depending on whether they are symptomatic or not. Different parameters also need to be taken into account: most studies have been carried out during school closures (confinement, holidays), in countries where the mix of pupils may be different, as well as the density of pupils per class or the rate at which masks are worn. See the question Do children transmit less coronavirus than adults? (in progress).

WHO and UNICEF recommend ensuring that the child knows how to "use a mask correctly and safely", is supervised by an adult, is well instructed on how to wear it, and has the opportunity to change or wash it. Consideration should also be given to the "potential impact of mask use on the child's learning and psychosocial development".

In addition to the mask, other measures are important in schools to limit the spread of the virus: washing hands, avoiding close contact, airing, keeping the mask in the toilet, always being in the same small group in the cafeteria, and during other activities that require the removal of the mask.


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Sources

October 2020 report comparing school-related measures taken by different countries.

COVID-19 Literature Report Team, Washington State Department of Health. Summary of Evidence Related to Schools During the COVID-19 Pandemic. Report of October 19 2020.

WHO and UNICEF advice on the age at which children should wear masks.

Questions and answers on masks and children in the context of COVID-19. WHO. Accessed on 24 October 2020.

The American Academy of Pediatrics recommends wearing masks from the age of 2 years.

Cloth Face Covering. American Academy of Pediatrics. Accessed 24 October 2020.

The American CDC recommends that the mask be worn from the age of 2 years.

Help Stop the Spread of COVID-19 in Children. Centers for Disease Control and Prevention. Accessed 24 October 2020.

A study of 10,524 elementary school children in the town of Matsumoto in Japan in February 2015 showed that 52% of the children wore a mask and that wearing a mask decreased the likelihood of catching influenza, with a slightly stronger protective effect of masks on 9-12 year olds than on 6-9 year olds.

Uchida, M., Kaneko, M., Hidaka, Y., Yamamoto, H., Honda, T., Takeuchi, S., ... & Kawa, S. (2017). Effectiveness of vaccination and wearing masks on seasonal influenza in Matsumoto City, Japan, in the 2014/2015 season: An observational study among all elementary schoolchildren. Preventive medicine reports, 5, 86-91.

Press release from the Stop Postillons collective of October 8, 2020, which calls for masks to be worn by schoolchildren from the age of 6 in France.

Press release from the Stop Postillons collective of October 8, 2020.

COVID-19 epidemic at a youth camp in Georgia, U.S.A. in June 2020. A teenager began to have symptoms of COVID-19 on the sixth day of camp and tested positive the next day. Of the 344 camp participants tested, 76% (260) tested positive. The overall attack rate was 51% in 6-10 year olds, 44% in 11-17 year olds and 33% in 18-21 year olds. The longer the length of stay in the camp, the higher the attack rates. Wearing a mask was not required for camp participants.

Szablewski, C. M., Chang, K. T., Brown, M. M., Chu, V. T., Yousaf, A. R., Anyalechi, N., ... & McDaniel, C. J. (2020). SARS-CoV-2 transmission and infection among attendees of an overnight camp-Georgia, June 2020. Morbidity and Mortality Weekly Report, 69(31), 1023.

In Israel, a junior high school and a high school experienced COVID-19 epidemics which began on May 26-27, 2020, ten days after their reopening. 153 students and 25 staff members contracted COVID-19. This represents 13% of students and 17% of staff. The percentage of COVID-19 cases was higher in the 7-9 year olds (20-30%) than in the 10-12 year olds (1-6%). Factors that may have contributed to the spread of the virus included the large number of students per class (35-38 students), a distance of about 1 meter between desks, and particularly a temporary removal of masks during a heat wave (May 19-21). 87 COVID-19 cases confirmed were recorded among the close contacts of the pupils of the first school. These included siblings attending other schools, friends and participants in afternoon sports and dance classes, parents of pupils, and family members of school staff.

Stein-Zamir, C., Abramson, N., Shoob, H., Libal, E., Bitan, M., Cardash, T., ... & Miskin, I. (2020). A large COVID-19 outbreak in a high school 10 days after schools' reopening, Israel, May 2020. Eurosurveillance, 25(29), 2001352.

Further reading

Can children be infected with the SARS-CoV-2 coronavirus?

Can my child transmit COVID-19 ?

What are the symptoms of COVID-19 in children?

How do I explain COVID-19 to children?

Why put on a mask?

COVID: Can a surgical mask be used more than once?

What are the different types of masks?

Why put on a mask?

What is a superspreader event for COVID-19 ?

What are the key points for understanding the dynamics of the COVID epidemic?

Children's role during the COVID-19 epidemic: what do we know?