Since the beginning of the coronavirus pandemic, children have been largely spared the worst health impacts of COVID-19. The same SARS-CoV-2 virus capable of killing a 50-year-old might leave a four-year-old unscathed.

Now, the U.S. Centers for Disease Control and Prevention is recommending K-12 schools reopen this fall, saying the health risks should be weighed against the detriment of being kept home—which disproportionately impacts low-income and minority children and those with disabilities who may rely more on programs like school lunch and after-school care. When those children are kept from school, their grades grades slip, mental and physical health suffers, key times to socialize are lost, and many are falling behind on their routine vaccines.

“Children are suffering in different ways from adults,” says Megan Tschudy, a pediatrician at the Johns Hopkins University School of Medicine.

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