Coronavirus FAQ: Is it OK for the kids to take a pic with Santa?

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My kids are so over seeing Santa Claus through Zoom. Can I bring them to the mall this year for the real deal?

Unfortunately, sitting on Santa's lap is almost a comical example of what NOT to do during the pandemic, says Dr. Abraar Karan, an infectious disease physician at Stanford University.

"All it takes is one person to be very infectious," he says.

The recipe for disaster can go something like this, he says: An unknowingly infected kid whispers his holiday wish list to Santa, along with COVID aerosols. Santa – whose mask doesn't fit well, due to the beard — gets an asymptomatic case and continues launching kid after kid off his lap, potentially passing the virus onto them. Then, all those kids too young to be vaccinated or wear a well-fitting mask go home to people congregating for the holidays.

Fortunately, there are some simple precautions that could make an in-person visit possible. Make sure everyone going is vaccinated if possible and wearing good-quality masks, says Dr. Jill Weatherhead, assistant professor of adult and pediatric infectious diseases at Baylor College of Medicine.

Consider the virus numbers in your area. Keep your visit short and sweet. And investigate the specific protocols at your mall. Some places require Santa and other staff working the photo booth, including photographers and other holiday characters, to be vaccinated. Most malls allow kids to take a physically distanced picture instead of sitting on Santa's lap. Some malls require everyone to wear masks. And some require parents to reserve a spot for their kid's photo op in advance to help avoid over-crowding in the photo area.

You might be tempted to have Santa and your kid remove their masks for the photo – but experts say it's safest to keep them on. "In general, a few seconds in most circumstances will not be enough to transmit," Karan says — "but with SARS-CoV-2, we are constantly surprised."

As for Weatherhead, she says she has decided this year to take her children — a 6-year-old who is vaccinated, and a 4-year-old — to meet Santa in person. Last year, the kids could only view Santa from afar at an outdoor drive-by parade.

At her housing community where the Santa event takes place, Weatherhead says there are protocols about physical distancing. There is a limited number of people who can be in the photo area at any given time. Also, in Houston, where she lives, "the COVID case numbers are low now, so it's safer for us."

But her kids, she adds, will not be sitting on Santa's lap.

As for other traditions, such as mistletoe? Don't even think about hanging it at a gathering involving anyone other than immediate family, she says.

I'm boosted, but not everyone in my extended family has been vaccinated. Is it safe to attend the annual family holiday gathering?

Unfortunately, a booster shot is not a free pass for risky behavior, says Weatherhead. In fact, she says, emerging evidence suggests three jabs is now what's needed to better protect against omicron, compared to two jabs for the original strain.

Socializing indoors with a mix of vaccinated and unvaccinated people is a higher risk activity, she says. The question comes down to how much risk you're willing to accept.

"You need to make sure you feel safe and are in an environment that is right for you," she adds.

There are ways to make the gathering a bit safer. You can move the party outdoors. Require guests to take a rapid COVID test before coming to the party. Wear masks when they're not eating or drinking. And increase ventilation by opening up windows and doors — or set up portable air cleaners inside the home if you live in a cold climate.

But Weatherhead warns that these measures won't necessarily make the party "risk-free"

That likely means that anyone at high risk of COVID-19 will want to avoid being indoors with unvaccinated folks, says Karan. If you're boosted and not at high risk, he adds, your chances of getting a severe case of COVID is unlikely — though it's too early to say how boosters impact long COVID, the lingering symptoms that can persist months after a coronavirus infection.

In any case, your best bet is to bring the topic up with the party host and your family members ahead of time, says Weatherhead, and discuss a plan to mitigate risk at the gathering.

"I recommend erring on the side of communication, being up front and having honest conversations about keeping everyone safe so it's fun for everyone and people feel respected and comfortable," she says.

Just be prepared to make alternate plans if not everyone in the family wants to comply.

Are the side effects from the booster different from the side effects from the first two jabs? And do they last longer? I got boosted six weeks ago, and my arm still hurts. Should I be concerned?

No new side effects have been noted in people getting boosters.

"They're the same side effects that were identified previously, mild side effects that usually last 1 to 2 days," Weatherhead says.

Those include pain, redness and swelling at the injection site, chills, fatigue, headache and fever — and, in the case of Moderna, a rash on the arm 5 to 9 days later.

If you had one of the very, very rare severe or allergic reactions to your first jabs, for example, anaphylaxis, you'll want to talk to your doctor before getting boosted, she says. The doctor may recommend a different type of booster shot and a longer monitoring period right after you get jabbed.

And if your arm hurts for months? That's extremely unusual, Karan says.

"There's no robust evidence to show that boosters would give you long-lasting side effects," he says. "But there will be anomalies — it's possible to have a longer inflammatory reaction [in the arm where you got the shot]. I've never seen it, but I won't say it's impossible."

It's so rare, though, that it's not something for the general public to worry about. And it's more likely that it's unrelated to the booster, Karan adds. "You could trip over your shoelace the day after your booster," but that doesn't mean the booster caused you to trip.

You can report anything you believe could be an adverse effect to the Vaccine Adverse Event Reporting System, a program co-managed by the Centers for Disease Control and Prevention and the U.S. Food and Drug Administration, says Weatherhead. The system helps monitor the safety of newly licensed vaccines.

Sheila Mulrooney Eldred is a freelance health journalist in Minneapolis. She has written about COVID-19 for many publications, including The New York Times, Kaiser Health News, Medscape and The Washington Post. More at sheilaeldred.pressfolios.com. On Twitter: @milepostmedia.

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