https://adc.bmj.com/content/early/2023/12/06/archdischild-2023-326215

https://archive.is/fZ2SK

https://adc.bmj.com/content/archdischild/early/2023/12/06/archdischild-2023-326215.full.pdf?with-ds=yes

Archives of Disease in Childhood: Child mask mandates for COVID-19: a systematic review

Received August 17th, 2023

Published December 2nd, 2023

Abstract

Background:

Mask mandates for children during the COVID-19 pandemic varied in different locations. A risk-benefit analysis of this intervention has not yet been performed. In this study, we performed a systematic review to assess research on the effectiveness of mask wearing in children.

Methods:

We performed database searches up to February 2023. The studies were screened by title and abstract, and included studies were further screened as full-text references. A risk-of-bias analysis was performed by two independent reviewers and adjudicated by a third reviewer.

Results:

We screened 597 studies and included 22 in the final analysis. There were no randomised controlled trials in children assessing the benefits of mask wearing to reduce SARS-CoV-2 infection or transmission. The six observational studies reporting an association between child masking and lower infection rate or antibody seropositivity had critical (n=5) or serious (n=1) risk of bias; all six were potentially confounded by important differences between masked and unmasked groups and two were shown to have non-significant results when reanalysed. Sixteen other observational studies found no association between mask wearing and infection or transmission.

Conclusions::

Real-world effectiveness of child mask mandates against SARS-CoV-2 transmission or infection has not been demonstrated with high-quality evidence.The current body of scientific data does not support masking children for protection against COVID-19.