California students can get vaccinated. When will the state let them take off their masks?

California schools next month will wrap up their fourth semester amid the coronavirus pandemic.

Children ages 5 to 11 soon will have to get vaccines to attend.

Now, some parents and doctors want to know what it will take to lift California's school mask mandate.

"California's children continue to endure greater in-school restrictions than most states," Dr. Jeanne Noble, director of COVID response at the University of California, San Francisco's Emergency Department and Dr. Monica Gandhi, director of the UC San Francisco Center for AIDS research, wrote in a recent letter to Gov. Gavin Newsom and other state leaders.

"Children and their families see no end in sight to restrictions, as there are currently no guideposts to indicate when they will be loosened or retired."

Over the summer, state officials, following guidance from the Centers for Disease Control, issued a universal indoor mask mandate for K-12 schools. That mandate was reaffirmed last month by Dr. Mark Ghaly, California Health and Human Services Agency Secretary, who said universal masking was key to preventing outbreaks and keeping schools open.

"Now is not the time to let our guard down — especially as the winter months approach," Ghaly said in a joint statement with State Public Health Officer Dr. Tomás Aragón.

Ghaly and Aragón said California will "continue to monitor conditions through the winter."

That's not good enough, Noble said.

"It's not quantitative. It's not a metric," Noble said. "I think it is a little bit condescending to just say 'through the winter' and not giving people any insight into what numbers they're using to make those decisions."

When asked under what circumstances the state would lift its mask requirement for schools, CDPH directed The Sacramento Bee to an Oct. 20 press release, which said the state will consider vaccination coverage status, availability of vaccines for children, community case and hospitalization rates, outbreaks, and ongoing vaccine effectiveness against variants to guide K-12 school operations.

"Ongoing vigilance is critical to protect against COVID-19. This is particularly important for schools, where many children are not vaccinated," Ghaly and Aragón said on Oct. 20. "Although infection rates are decreasing, more than 25 counties continue to experience high transmission, as classified by the Centers for Disease Control and Prevention."

California has issued some of the toughest COVID-19 restrictions in the nation. Earlier this year, in addition to mask mandates, Newsom announced students would be required to be vaccinated against the virus starting the term following full approval from the Food and Drug Administration for their age group.

The FDA on Oct. 29 issued emergency use authorization of the vaccine for kids ages 5 to 11. The federal government allocated 1.2 million pediatric doses to California, and on Nov. 3, the state began vaccinating the newest age group.

Based on current information about vaccine authorizations, the state expects to require COVID-19 vaccines for grades 7 to 12 starting July 1. CDPH said it is too early to predict when the state will require vaccines for children 5 to 11.

As of Nov. 10, 3.1% of children 5 to 11 had been partially vaccinated. None are reported as fully vaccinated yet. In the 12 to 17 age group, 67.7% of kids are fully or partially vaccinated, per state data.

Noble and Gandhi, in their letter to state leaders, said a clear set of guidelines about when California would ease its masking policy in schools would incentivize parents to vaccinate their kids.

"Without clear benefits from vaccination, such as attending school unmasked, many parents of elementary school children will feel ambivalent about vaccination and may postpone vaccinating their child until fully mandated several months from now," they wrote.

California is headed into what could be a rough season for COVID-19 infections. Last winter, cases spiked amid holiday gatherings. Now, even with vaccines widely available, state leaders are worried. about the possibility of another winter surge.

Newsom last week called it his "biggest anxiety."

Megan Bacigalupi, a mom of two and leader of the advocacy group CA Parent Power, said California isn't in the same situation it was last November. With 66.7% of Californians fully vaccinated, there is less chance of severe cases, she said.

"It seems like it's an anti-vaccine message to send to say, 'winter's coming' as if there's no distinction between 2020 and 2021," she said.

Some counties, like several in the Bay Area, have set certain benchmarks to meet in order to lift local mask mandates. Marin County, for example, just lifted its mask mandate after local spread fell to what officials defined as a "moderate" rate. Now, residents in Marin County can go maskless inside restaurants, bars and retail establishments.

But because of the state's mandate for all schools, students in Marin will still have to wear masks indoors.

"For parents, we look at this and we go, if there are off ramps for adults, why are kids any different?" Bacigalupi said.