But sometime during the planning process, you start to think: what about people who aren’t vaccinated against COVID-19? Did Uncle Tom get the shot? Will my kids be safe this year? Great Aunt Sue is 93 years old and vaccinated, but is it safe for her to be around people who aren’t yet? “The rules for safety haven’t changed during the holidays,” emphasizes William Li, MD, an internationally-renowned medical doctor, researcher, founder and president of the Angiogenesis Foundation, and author of New York Times bestseller “Eat To Beat Disease.” As of November 2022, over 68% of all Americans have been fully vaccinated, which means that approximately 228 million people have gotten both primary doses. However, it’s best to take extra safety precautions, especially if some people at your table are unvaccinated. Safety measures may include wearing a mask indoors, hosting your celebration outdoors if the weather permits, and/or getting together in smaller groups. Let’s take a closer look at how to prioritize health and safety during this holiday season.

Is It Safe to Gather If Some People Are Unvaccinated?

Keeping your kids and vulnerable family members safe at gatherings is a top priority this holiday season, and rightfully so. “While it is quite safe to gather in small numbers with fully vaccinated people, it is not very safe to gather with people who are unvaccinated,” advises Dr. Li. “If you choose to do so, precautions are important.” People who are unvaccinated face the highest risks at larger get-togethers. To protect your unvaccinated kids, you may consider asking any unvaccinated guests to wear a mask when not eating and maintain social distance. If the weather permits, consider eating outdoors. If you have to be indoors, keeping doors and windows open to maintain good airflow will also help reduce the chances of transmission. “We have rented propane heaters in case it is too chilly to stay outside without them,” says Brianna Leonhard, a mother of two toddlers and the founder of Third Row Adventures, a travel blog focusing on road trips with young families, who will gather with her large extended family this holiday season. “We are encouraging everyone to stay outside as much as possible and we will not be going inside as a group. We will set up a buffet line outside as well as tables and chairs.”

Protecting Unvaccinated Children

While children do not tend to become very ill if they contract COVID-19, it is possible for children who are infected to transmit COVID-19 to others or become severely ill themselves. For their protection, make sure you know if the people they may be exposed to during holiday gatherings are vaccinated or not. “The risks of your child getting COVID-19 versus the risk of prolonging a visit from their loved one need to be weighed,” notes Erica Susky, an infection control practitioner (ICP) in hospital epidemiology who has been focused on COVID-19 infection control since the pandemic began. Kids who are not vaccinated should follow all the basic COVID-19 safety rules—they should wear a mask, maintain social distance, and wash their hands frequently and properly. “Let the kids play together in a separate room from the adults in cold-weather regions or play outdoors where it’s warmer,” suggests Dr. Li. It may be easier to create opportunities for socially distanced play than to constantly have to remind kids to stay socially distant. Leonhard has borrowed a variety of ride-on toys to keep the kids at her family gathering occupied. “They are single rider only so the kids can keep active and moving while outside and safety spaced apart,” she notes.

What If My Kid Only Has 1 Shot So Far?

If you have a young child, it’s possible they may not have both installments before the holidays. Both shots are necessary to be considered fully vaccinated. While the first shot offers limited protection against COVID-19, it is safest to use the same safety precautions with anyone who is not fully vaccinated. Both shots are required for full protection. Your kids should continue to wear a mask and avoid large groups until after their second dose.

Keeping Grandparents Safe

Relationships between grandparents and their grandchildren are strong in many families. Being able to spend in-person time with these special family members is important, but it’s important to weigh out the risks and take the necessary precautions. Older individuals are at the highest risk of needing to be hospitalized or dying from COVID-19. The older a person is, the higher these risks become. “Because of this risk, they have the most to gain from being fully vaccinated,” notes Susky. Even if older family members are vaccinated, it may be wise for everyone present to wear masks, social distance, and avoid kissing these relatives this year (though it may be hard). If older adults in your family group are not vaccinated, it would be best not to gather with them for their own safety and the safety of your family. “If there are elderly people who are coming to a holiday gathering, I recommend not inviting people who are unvaccinated to the same event,” advises Dr. Li. “If they must be there, it would be wise to keep the grandparents as far away from them as possible.”

Is It Safe to Travel With Kids?

Many extended families are spread out geographically, and gathering for the holidays may require them to travel by plane, train, or bus. The Centers for Disease Control and Prevention (CDC) currently advises anyone who is not yet vaccinated to avoid travel. This includes people who have not yet received both doses. Whether or not your kids are fully vaccinated, take extra precautions if you do decide to travel. This is especially important in crowded, enclosed areas such as airplanes. Children and adults who are traveling should wash their hands frequently, wear masks, and avoid dense crowds whenever possible. It may also be protocol to get a PCR test done a few days before departing to ensure your family is negative for COVID-19. “Some holiday destinations have strict mandates to show a negative COVID-19 test, especially in other countries,” notes Dr. Li. “To avoid being turned away, research the local regulations for your destination.”

Do We Need Booster Shots Before Gathering?

Everyone is talking about booster shots now, and you may wonder whether you and your older children need to get yours before gathering for the holidays this year. Bivalent booster shots are currently available for individuals over five years of age. If it’s been six months since your second dose of Pfizer or Moderna (or two months for Johnson & Johnson), a booster shot is necessary for full protection. If it has been less than six months since your second shot, there is no need to get your booster before gathering.

Talking to Unvaccinated Family About Vaccine Status

It is important to know whether there will be unvaccinated guests at your holiday gatherings this year, especially if you have young children who can’t get their shots yet. These conversations may not always be easy to have, but they are important. “Ultimately, it is someone’s choice to not get vaccinated,” notes Susky. “As a parent, one is entitled to defer a visit with someone who chooses not to get vaccinated if one feels the risk of their child getting exposed to COVID-19 is too great. Frame it as everyone’s option to choose.” It may be wise to reach out to family members individually ahead of time to inquire about vaccination status. If sending out invitations for a family get together, consider adding a clause that says something along the lines of, “Not everyone is vaccinated, so we will ask you to wear a mask when not eating and we will keep the doors and windows open for the duration of the gathering.”

Setting Boundaries This Holiday Season

We cannot control others, but we can control ourselves and what we choose to expose our family members to. Keep this frame of mind if you know you have guests who may choose not to be vaccinated. Corinne Horsey, a California-based mom of two, hosted Thanksgiving dinner at her home in Los Angeles this year. Not all of Horsey’s family members are vaccinated. “I already know who is vaccinated and who isn’t, but I’m not going to put them on the spot about it,” she notes. “I’m not here to change their minds, but I [did] require them to show a negative COVID-19 test and wear a mask if they [wanted] to attend.” Setting boundaries may be more important than urging family members to get vaccinated. Depending on your comfort level, you may choose to require proof of vaccination, take people’s word for it, only allow those who are fully vaccinated to attend, or require people to show a recent negative test to join in the festivities. You may also choose not to attend a group event if you know others won’t be vaccinated. After everything we have been through since the start of the pandemic, it may be worth it to start getting back to yearly traditions and seeing loved ones. Vaccination status does not have to be the deciding factor in whether you see your extended family over the holidays, but it should play a role in what precautions you take. When in doubt, follow the basic safety rules of frequent hand washing, wearing masks while not eating, and gathering outdoors when possible.