Masks for Kids (and everyone else!)

Let’s talk about masks.  I wrote this with kids in mind - especially for those under age 12 who haven't been eligible for the COVID vaccines yet - but the links below have information that anyone can use. Even if you are vaccinated, right now you need to mask up when indoors in public, so the following advice applies to everyone.

School is starting soon, which means that if you have an unvaccinated child, they will be spending several hours a day indoors, with other unvaccinated classmates. While you can’t make the FDA move faster on vaccines, you can protect your family from COVID-19, right now, with a simple face mask.   Masks really work, this is well established.  Click here if you want to understand how, or click here if you want to read about the many studies that show their effectiveness in the real world.

However, not only is it hard to find a mask that fits a child well (as you can see from this photo), the best mask is useless if your kid won't wear it. So it's crucial to find one that's effective, and that they will use all day long. OK, let's pick a mask!

There are a number of rating systems out there, and I don't want to get too deep into the details, but the three main ones that confirm excellent filtration and protection are N95, KF94 and KN95. At this point, with manufacturing ramped up, and more comfortable designs on the market, there is no reason to use anything less effective, like bandanas or cloth masks (although cloth masks with filter inserts can work well). And please don’t use those masks with exhalation valves built in. They are meant for protecting you from dust, they don’t stop the spread of viruses.

N95 is a NIOSH rating, and NIOSH is the US National Institute for Occupational Safety and Health. Since it's an OCCUPATIONAL regulatory agency, there are no pediatric standards. Also, they tend to be a bit less comfortable for long term use, and more expensive, so they are more commonly used in a health care setting. To get an N95 rating, fit testing is not required by the US government, although most hospitals do fit testing for their employees. The government actively enforces these standards with manufacturers, looks for counterfeits, etc..

KF94 is a rating by the South Korean Ministry of Food and Drug Safety (their equivalent of the FDA) which does an excellent job in both certification AND enforcement of these standards with the manufacturers. They also watch for counterfeits. By some measures, the KF94 standard exceeds the N95 standard, and includes fit testing. Korea has been doing this for a long time out of necessity - viral outbreaks earlier in the 21st century resulted in the government developing ways of effectively masking their entire population. Unlike the N95 standard, which is only for the workplace, the KF94 standard reflects the need to stop the spread in the whole community, which means adults AND children.

KN95 is a certification by the Chinese government. Given China’s vast manufacturing capabilities, these became very popular in the past year due to cost and availability. However, compared to the N95 and KF94 standards, it’s not clear if the KN95 standard is as effectively enforced, which can be a critical issue. Most of these masks are probably fine, but there is some evidence that the KF94 masks may fit and filter better than KN95.

So which mask should you pick for your child? It needs to be effective, and it needs to be comfortable enough for them to wear it all day. There are a lot of them out there, so I’m going to direct you to two resources that will help you choose.

The first one is a guy named Aaron Collins, who is a mechanical engineer, and who has made a mission of doing extensive mask testing in real world usage. He has a number of videos, including one recently made specifically for kids under 12. Here is his data sheet for a large number of brands, and this is a sheet with masks that are good for kids.

The second resource is by two PhDs in civil and environmental engineering from Virginia Tech - Aaron Prussin and Linsey Marr. This has an excellent summary of what to look for in a mask, and another list of specific brands.

As I mentioned above and wrote about previously, masking indoors in public has once again become necessary, even for vaccinated people like myself, due to the Delta variant and breakthrough cases. This does NOT mean that the vaccines don’t work. They are still AMAZINGLY effective in preventing hospitalization and death, and they also reduce the likelihood of asymptomatic cases and spread. This means they can keep new variants from developing, which is crucial. Watch for news in the near future about full FDA approval, emergency use authorization for kids under 12, and boosters.

We can win this war if we understand that new developments require new actions on our part. Don’t be complacent, don’t be cynical, don’t despair, and don’t give up!