Next week, Granville County resident Kara Lewis will send her 9-year-old daughter back to school at C.G. Credle Elementary School.
"She is so ready, we spent all year last year online. She misses her friends," Lewis said.
But with the rising cases of the COVID-19 Delta variant among children, Lewis, who works full-time in Durham, is worried.
"I am a little concerned just because she is too young for the vaccination. She has to wear a mask every day. I'm just not sure how the kids are going to do honestly," said Lewis.
Nadine Holmes is feeling the same way.
The Pennsylvania native dropped off her son at Duke University, where he'll spend his freshman year in another wave of this pandemic.
"We wanted him to get vaccinated and he did. I'm concerned," said Holmes. "He's going to wear his mask, he's going to do the right thing and just try to be part of the solution and not the problem."
The problem is not enough young people who are eligible for the vaccine are getting vaccinated.
Health leaders say that's causing the spread.
COVID-19 cases among children are up.
On Tuesday, state health leaders reported that 438 cases in children were tied to 50 outbreaks in schools and childcare centers, compared to 255 cases connected to 34 outbreaks last week.
"As a pediatrician, as a mom, as a part of my community I am really worried about the increase in cases," said Dr. Gabriela Maradiaga Panayotti, a pediatrician and associate professor at Duke.
She said she is noticing more parents are getting their children tested for COVID after coming into contact with someone at school or daycare who tested positive.
She said it's important for children and adults to wear their masks, especially those too young to get vaccinated.
And for people age 12 and older to get their shot.
"One of the main messages we are sharing, and I expect the state will share, is really finding ways to encourage young people to find their voice and take action as part of their legacy in this pandemic and get vaccinated," Panayotti said. "The vaccine is incredibly effective. Almost everybody we see in the hospital are people who are sick and not vaccinated."
Panayotti said the Delta variant is spreading so rapidly because it's very contagious.
A sick person can infect as many as eight people in close proximity vs. infecting as many as two people under the original strain of SARS-CoV-2.