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Column originally published Dec 6, 2022

Masks and Vaccines Are Important In Preventing Spread of Respiratory Infections

Question: Our younger son is eight months old, he was born with a hole in his heart. He will need surgery to repair it, most likely in the next few months. He is still quite healthy; we are waiting for him to grow bigger to make surgery easier. Our family has been very careful since he was born. His three-year-old sister wears a mask everywhere, including daycare, because she wants to protect her little brother. We are really proud of her, she never complained when we explained to her the importance of wearing mask. Both of us have received the Covid-19 vaccine and booster. Our son and daughter had their first dose recently. We have done everything that we can. However, we have heard that children’s hospitals are full of sick children with Covid-19, influenza, and RSV infections. We are afraid that our son will catch one of these, and won’t be able to fight them. We also worry that he may not be able to get his surgery on time. Please tell your readers that they need to get vaccinated to help others, like our son.


I am very glad to hear all the things that your family has done to protect your son. Bless her heart, your daughter deserves credit for wearing her mask in daycare. Your son can also wear a mask indoors, this can give him an extra layer of protection. Many children, even under one year of age, can be taught to keep a mask on for their protection. You have to explain to him, and show him that you are wearing one also. Do that at home to practise; with encouragement and persistence, it can be done. It is still important to reduce exposure to large crowds indoor, where transmission of viruses is more likely.

When I was still practicing as a paediatrician, I have looked after many sick children in hospital with virus infections. They had difficulty breathing because of mucus congesting their lungs and bronchial tubes, as well as the nose. Very young children mainly breathe through their nose; they breathe through their mouth when they cry. As a result, they struggled to breathe and needed oxygen support; some had to be put on ventilators. Not infrequently, we found multiple viruses attacking them all at once.

In fall, winter, and spring, we have many respiratory viruses circulating in the community. The most serious ones used to be influenza and Respiratory Syncytial Virus (RSV). Now, we have to add Covid-19 virus, and they are coming much sooner than before. This is likely because of all the pandemic precautions; many children were not exposed to them for several years. Relaxation of pandemic precautions allow more travelling and indoor gatherings. Respiratory viruses spread easily with close contacts.

You have done very well in getting Covid-19 vaccine. The first dose that your children received would not provide protection for them; it gives their immune system something to recognize. When they get their next dose, their immune system will start to produce protective antibodies. Therefore, your children are still very susceptible to Covid-19 infection now. Furthermore, both of you may be eligible for the next booster dose. The new bivalent Covid-19 vaccine can provide better protection for you against the new variants.

In addition to Covid-19, all of you should be immunized with influenza vaccine. Influenza can be just as dangerous to your son because of his heart condition. The vaccine is safe and effective for children over 6 months of age, as well as for adults and seniors.

Many infectious disease specialists across the country, as well as myself, are strongly encouraging everyone to wear masks indoors. This is the most effective way to reduce the spread of respiratory viruses, including influenza, RSV, and Covid-19 that are causing major problems for emergency rooms and hospitals. As a result, many life-saving surgeries have to be cancelled or delayed because of these viruses. All of us have the responsibility to protect those who are vulnerable, like your son.

If anyone asks why your little baby is wearing a mask, you should explain to them about his heart condition, and the importance of wearing masks and getting vaccinated. You can do this to advocate for him.