During the COVID-19 pandemic, as always, all children should ride properly restrained in the appropriate car safety seat (CSS), belt-positioning booster seat, travel vest, or seat belt on every trip in every vehicle. Appropriate restraint use saves lives, and caregivers have a responsibility to transport children safely. Caregivers need to know how to mitigate the risk of transmission of SARS-CoV-2, the virus that causes COVID-19, during transportation. Current guidance from the American Academy of Pediatrics includes wearing masks in school and child care for all children 2 years and older and staff, regardless of vaccination status; this includes during transportation on a school bus. This guidance is extremely important, because people who are asymptomatic may transmit SARS-CoV-2 even if vaccinated. In accordance with Centers for Disease Control and Prevention (CDC) recommendations, all bus drivers and support personnel should be vaccinated and wear masks properly on the bus.
Car safety seats and seat belts, as specified by the manufacturer, may be cleaned but must not be disinfected, because chemicals can degrade the necessary strength, possibly affecting crashworthiness. In most cases, all parts of car safety seats and vehicle seat belts can only be cleaned with mild detergent and water; this helps ensure the restraint system will perform as intended in the event of a crash.
Because car safety seats and seat belts cannot be disinfected, caregivers should use alternate means to prevent transmission of SARS-CoV-2 during transportation. Caregivers should follow established precautions to reduce spread of SARS-CoV-2, including immunization against COVID-19, physical distancing, using face masks, and practicing hand hygiene. Caregivers of children with special needs (eg, compromised immune systems, tracheostomy tubes, or use of a wheelchair) must take the child’s specific needs into account when developing a transportation plan.
Guidance for Carriers Who Transport Multiple Children: School Buses, Child Care Vans, and Other Vehicles Used to Transport Multiple Children
- Pair the child and the seat; establish an organized seating plan so that the same child uses the same car safety seat or seat belt on every trip in the vehicle. School buses should be loaded from back to front and unloaded from front to back. If no passenger shows signs of COVID-19, routine cleaning is appropriate.
- If an adult or child is suspected or identified as being SARS-CoV-2 positive, any seat system that the individual had contact with or was in proximity to (6 ft/2 m) should be removed, if possible, from service for at least 24 hours and then cleaned according to manufacturer’s specifications and returned to service.
- Seat systems that cannot be disinfected should be removed from the vehicle and stored out of reach or in a securely tied plastic bag, ideally for 72 hours, after which they may be returned to service, For seat systems that cannot be removed from vehicles for thorough cleaning, the seating position should be removed from service for 72 hours. In school buses and other passenger vehicles, the vehicle seat usually can be disinfected.
- If a vehicle transports multiple groups of children during the day, seating areas should be cleaned between each group of children.
Guidance for Families
- If a car safety seat or seat belt is always used by the same individual and not by anyone else, and the individual does not have symptoms of COVID-19, routine cleaning is appropriate.
- If an individual is identified as being SARS-CoV-2 positive, any seat system that individual had contact with or was in proximity to (6 ft/2 m) should not be used for 24 hours and then cleaned according to manufacturer’s recommendations . Vehicle seats may be disinfected. Car safety seats should be removed from the vehicle and stored out of reach or in a securely tied plastic bag, ideally for a few days, after which they may be cleaned and returned to service. During this time, a substitute car seat or harness device must be used.
- If the affected individual used a seat belt, the seating position should be taken out of service, ideally for a few days, after which the seat and seat belt may be cleaned and returned to service. If a family has another vehicle available, they may consider using the alternate vehicle during this period.
- Public transit systems present situations in which the risk of contracting an infectious disease may be increased. Public transportation should be used sparingly and only if necessary, to reduce the risk of transmitting SARS-CoV-2 to an individual at higher risk. All riders should practice physical distancing, wear face masks, and practice frequent hand sanitizing. For added safety, passengers may consider wearing eye protection.
Supplemental information on COVID-19 and Safe Transportation in Motor Vehicles can be found here.
- COVID-19 Guidance for Safe Schools
- Guidance on Providing Pediatric Well-Care During COVID-19
- Guidance Related to Childcare During COVID-19
- COVID-19 Interim Guidance: Return to Sports and Physical Activity
- Face Masks
- Information for Parents on HealthyChildren.org: Travel Safety During the COVID-19 Pandemic
Interim Guidance Disclaimer: The COVID-19 clinical interim guidance provided here has been updated based on current evidence and information available at the time of publishing. Guidance will be regularly reviewed with regards to the evolving nature of the pandemic and emerging evidence. All interim guidance will be presumed to expire on June 30, 2023 unless otherwise specified.
American Academy of Pediatrics