The Cribsiders podcast

Bonus! Back to School Special: 2021 Edition

September 6, 2021 | By


We were all hoping for an uneventful start to the school year, but the Delta variant of SARS-CoV2 had other plans. Join the Cribsiders with pediatrician and public health expert, Dr. Josh Sharfstein, to break down the situation we are in, what we need to do to keep kids safe, and how to advocate for children’s health on both an individual and societal level.



  • Writer and Producer: Edward Corty, MD MPH
  • Executive Producer: Max Cruz, MD
  • Infographic: Edward Corty, MD MPH
  • Cover Art: Chris Chiu MD
  • Hosts: Jessica Hane MD and Chris Chiu MD
  • Editor: Justin Berk MD; Clair Morgan of
  • Guest(s): Josh Sharfstein, MD

COVID Back to School Pearls

  1. Schools have more resources than ever to make their environment safe.
  2. Vaccinating all adults in schools would be a great start to ensuring safety among children.
  3. Although many more children are now becoming sick with COVID-19, the rate of hospitalization has not changed from around 1%.
  4. All children are behind their expected education levels, but the learning loss is inequitable. 
  5. Explain to parents that we don’t yet have a vaccine for young children because it is being studied so intensely.
  6. Myocarditis is an identified adverse effect of the COVID vaccine, primarily in young boys, but it is still far more likely to get myocarditis from COVID infection than the vaccine.



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Back to School: 2021 Edition Notes 

Current state

AAP Report as of 8/26/21


Total children in the US

~75 million

Total COVID cases among children

4.8 million

Change in cases

9% (380,000 cases) increase over prior 2 weeks.

Hospitalization rate

Still rare (0.9%) but greater total number infected means hospitals filling up.


Very rare (0 to 0.03%) in states reporting.


Preparing for school

  • Schools need resources for ventilation, spacing, PPE, class sizes, and extra staff.
  • Mitigation measures have largely worked, especially in states that have taken them seriously.
  • States now have more resources including $140 billion for K-12 schools through the American Rescue Plan.

Changes this year

Social inequities 

  • Kids are behind in school and it’s not equal-NWEA and McKinsey found that Latino and Black third graders are 15-17% behind where expected. Meanwhile, White children are 9% behind expected. 
  • Future investments need to focus on education and beyond, such as child food insecurity and mental health.
  • The major expansion in child tax credit is a HUGE start and is estimated to cut child poverty by 45%.

Responding to anti-science policies

  • Clinicians should express their views.
  • “The mission of serving children has got to prevail.”
  • Advocacy matters and works.


Children under 12

  • Trials will be submitted to FDA but the timeline is not public.
  • Dr. Sharfstein has said publicly that the FDA should be more transparent to prevent conjecture about the approval process.

Children 12 and over

  • Emergency use has been expanded to children 12 and over, under the emergency use authorization (EUA), which simply means that benefits outweigh the risks.
  • Licensure is based on longer follow-up for safety and there are a set of standards that need to be met.
  • Companies have not submitted data for full licensure.

Preparing parents of young children

  • Explain to parents that we don’t yet have a vaccine for young children because it is being studied so intensely. You could say, “I don’t know whether or not I will recommend the vaccine until I know what the data show.” 
  • Myocarditis has been identified an adverse effect of vaccination, but COVID-19 can also cause myocarditis, and at much higher rates than the vaccine.


  • People’s hesitancy is often rooted in anecdotal stories from friends or family members, not necessarily true Covid data
  • Dr. Sharfstein recommends asking patients, “Who would you get vaccinated for?” and then having a conversation about their loved ones or influential people in their life. 

Check out Public Health on Call Podcast


Dr. Sharfstein reports no relevant financial disclosures. The Cribsiders report no relevant financial disclosures. 


Corty EW, Sharfstein JM, Hane J, Masur S, Cruz M, Chiu C, Berk J. “Bonus! Back to School Special: 2021 Edition” The Cribsiders: Pediatric Podcast. 6 September 2021.


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The Cribsiders are partnering with VCU Health Continuing Education to offer FREE continuing education credits for physicians and other healthcare professionals. Visit and search for this episode to claim credit.

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