Student Well-Being

Support for School Vaccine Mandates Is Declining, Survey Shows

As parents’ attitudes toward vaccines shift, school nurses remain at the forefront of educating families on the importance of childhood vaccinations
By Elizabeth Heubeck — December 16, 2022 3 min read
A student looks back at his mother as he is vaccinated at a school-based COVID-19 vaccination clinic for students 12 and older in San Pedro, Calif., on May 24, 2021. California lawmakers amended a bill Thursday, June 16, 2022, that would have let preteens be vaccinated without their parents consent, instead raising the proposed minimum age to 15.
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A growing share of parents say they oppose routine childhood vaccines as a prerequisite for school attendance—a setback for public-health advocates.

In a new survey from the Kaiser Family Foundation, 28 percent of adults said that parents should have the choice not to vaccinate their school-age children, even if it creates health risks for others. In 2019, 16 percent of adults held that view.

The latest survey—called the KFF COVID-10 Vaccine Monitor, found that, compared with in 2019, fewer adults believe that healthy children should have to get the MMR vaccine (which protects against measles, mumps, and rubella) in order to attend public school. Seventy-one percent of adults now are in favor of the MMR vaccine requirement, down from 82 percent in 2019, as reported in a Pew Research Center survey.

The changes in attitude are drawn largely along political party lines. KFF reported that 44 percent of Republicans and Republican-leaning independents now say “parents should be able to decide not to vaccinate their children”—an increase among this demographic from 20 percent in 2019. Currently, just 11 percent of Democratic-leaning adults agree with that statement, a proportion that has remained relatively unchanged since 2019, according to the data.

School nurses say vaccine mandates are critical

Linda Mendonca, the president of the National Association of School Nurses, said the results aren’t surprising given the battles over COVID vaccines in the past two years.

“It’s not terribly shocking with what we’ve been through during the pandemic and how people responded to the COVID vaccine,” she said.

Nonetheless, getting children vaccinated is critical to protecting people from illness and death. All states require vaccinations against measles, mumps, rubella, and other childhood diseases with some limited exemptions as a condition for school attendance.

Said Mendonca: “It is the position of the NASN that [the vaccination requirement] is about public health. Reaching a high vaccination coverage of school-aged children is what we strive to do.

“We know that vaccines save lives and prevent disease,” she added. “As school nurses, we certainly do what we can to promote health among school-aged children.”

Nurses are vaccine advocates and trusted source of advice

Mendonca points to several ways that school nurses actively encourage families to vaccinate their children. An integral part of their role involves routinely monitoring and ensuring that students are in compliance with vaccine requirements, she said. Additionally, many schools host vaccine clinics that are coordinated, promoted, and staffed by school nurses. And, as trusted members of the school community, school nurses make logical partners in the fight against vaccine hesitancy among families.

“School nurses have good rapport with families. Many times there are multiple siblings that go through the school, and families get to know the school nurse,” said Mendonca, who adds that because of their positive relationships with families, nurses are likely to effectively educate families on why it’s important that they vaccinate their children against contagious—and potentially deadly—diseases.

Mendonca offers this advice to school nurses when communicating with vaccine-hesitant parents: “Meet them where they are. Instead of shoving information down their throat that maybe they don’t want to hear, try to work with them and help them understand [the importance of vaccines].”

Instead of shoving information down their throat that maybe they don't want to hear, try to work with them and help them understand [the importance of vaccines].”

It may be easy for the public to forget why it’s so important to continue receiving vaccines such as the MMR, which has been in regular use in the United States by children over 12 months for more than 30 years—leading to far lower prevalence of the diseases it protects against.

But, as Mendonca notes, very real and pressing reasons persist as to why school nurses and other public-health advocates continue to educate the public on its importance.

“There have been outbreaks of measles recently. It is still prevalent. We don’t see it as much, but if we stop vaccinating, we are going to see more of these diseases,” Mendonca said. “We need to maintain that level of herd immunity.”

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