Montana Chapter 

3031 Grand Ave #157 

May 20, 2021
Billings, MT 59102 
Phone: 844/228-7480 
E-mail: info@mtpeds.org  Dear Governor Gianforte,
 

Montana Chapter  
Executive Committee 
We are writing as physicians who have been caring for children and adolescents with
President  COVID-19, and as Montana parents, family and community members. We recognize the
John Cole, MD, FAAP 
310 Sunnyview Lane  toll that this pandemic has taken on our entire population, and more specifically how it has
Kalispell, MT 59901 
Phone: (406) 752-5111  impacted our children’s mental and physical health.
Vice President 
Lauren Wilson, MD, FAAP  Regarding mental health, data from the Centers of Disease Control and Prevention (CDC)
3031 Grand Ave #157 
Billings, MT 59715  demonstrates that pediatric mental health related emergency department (ED) visits
Phone: (844) 228-7480 
Secretary-Treasurer  increased 24% for children aged 5-11 years old and 31% for 12-17 years old in 2020
Teresa Blaskovich, MD, FAAP 
3301 Avenue E  compared to 2019.1 Another study found that “Adolescents experienced social and
Billings, MT 59102 
Phone: (406) 281-8700  emotional difficulties directly due to the pandemic, and these were uniquely associated with
Executive Director  their self-reported mental health problems.”2
Kylee Bodley 
3031 Grand Ave #157 
Billings, MT 59102  And while fortunately rare, some children and adolescents do become severely ill and/or
Phone: (844) 228-7480 
E-mail: kbodleymtaap@gmail.com  die from COVID-19. However, many more children may have an initial mild course of
Immediate Past President 
Cathy White, MD, FAAP 
illness but subsequently suffer from chronic symptoms (“long haul” COVID-19) which can
445 Centennial Ave 
Butte, MT 59701 
be severe enough to impair their daily function.3
Phone: (406) 723-4075 
Chapter Web site  Our Montana Chapter of the American Academy of Pediatrics had sent you a letter strongly
www.mtpeds.org 
  recommending universal mask use by all students and staff in schools and school-related
activities, cosigned by many of our medical association partners, on February 25th, 2021
which was in reply to your February 12th, 2021 Directive implementing Executive Order
2-2021. Your Directive states “Access to school is essential to the developmental, social,
mental, and educational needs of school-age children. Schools should make reasonable
efforts to follow school guidelines and best practices recommended by the CDC and the
Montana Office of Public Instruction.”

Now, this letter is being written in response to the Montana Office of Public Instruction’s
Memorandum dated May 19th, 2021, which “strongly recommends that school districts
across Montana rescind, or allow to expire, any existing face covering mandates.” It also
states that “OPI supports schools making the decision to remove those mandates for the
remainder of the present school year.”

The CDC’s statement this month that fully vaccinated people may resume most activities
without wearing a mask applies only to people who are FULLY VACCINATED. The CDC
updated their Operational Strategy for K-12 Schools through Phased Prevention on May
15th, 2021, and they recommend schools continue to use the current COVID-19 prevention
The Montana Chapter of the American Academy of Pediatrics is Incorporated in Montana
 strategies, which includes universal and correct use of masks.4

Children 12-15 years old may now receive the COVID-19 vaccine but will not be fully
vaccinated until after the last day of school. As defined by the CDC, being fully vaccinated
requires that two weeks have passed after their second dose in a 2-dose series. Children
younger than 12 years old will most likely not be able to receive their first dose until after
the 2021-2022 school year begins.

We empathize with the desire to return to normalcy, however since most school-aged
children will not have the opportunity to be vaccinated, we unequivocally recommend
that Montana schools continue to require masks at this time. We believe that
increasing vaccination rates among our children will decrease COVID-19 and allow
them to remain in school, while removing the mask mandates in school will have the
opposite effect. If our goal is to improve the mental and physical health of our
children, let us encourage vaccination while maintaining mask use in schools.

Sincerely,

The Montana Chapter of the American Academy of Pediatrics

____________________

References

1. Centers for Disease Control and Prevention. (2020, November 12). Mental Health–Related Emergency Department Visits
Among Children Aged 18 Years During the COVID-19 Pandemic - United States, January 1–October 17, 2020. Centers for
Disease Control and Prevention. https://www.cdc.gov/mmwr/volumes/69/wr/mm6945a3.htm.

2. Rogers, A. (2020, October 31). Adolescents’ Perceived Socio-Emotional Impact of COVID-19 and Implications for Mental
Health: Results From a U.S.-Based Mixed-Methods Study.
https://www.jahonline.org/article/S1054-139X(20)30592-9/fulltext.

3. Thomson, H. (2021, February 27). Children with Long COVID. New scientist (1971).
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7927578/.

4. Centers for Disease Control and Prevention. (2021, May 15). Operational Strategy for K-12 Schools through Phased
Prevention. https://www.cdc.gov/coronavirus/2019-ncov/community/schools-childcare/operation-strategy.html.

The Montana Chapter of the American Academy of Pediatrics is Incorporated in Montana