As the coronavirus pandemic continues to upend schooling across the country, many educators, policymakers, parents, and students have staked their hopes of returning to normal on the development of a vaccine.
There are three coronavirus vaccines that show promising results from late stage trials, and two—from drug makers Pfizer and Moderna—that have applied for emergency authorization from the federal government.
But once a vaccine becomes widely available, will lawmakers leave it up to families to choose to get inoculated or will they require schoolchildren to get a COVID-19 vaccine to attend school? Public polling shows that large swaths of the public are hesitant about getting a newly developed vaccine.
Fifty-eight percent of American adults said in a Gallup poll released in November that they would get a COVID-19 vaccine. The most common reason cited for not wanting to get a vaccine was the speed at which it has been developed. Forty-four percent of educators indicated in a recent EdWeek Research Center poll that they were very likely to get a COVID-19 vaccine once it’s available. Another 27 percent said they were somewhat likely.
But while states have the ultimate authority to mandate vaccines, the question, some experts say, is whether they should.
“When a vaccine is brand new, our first order of business is educating people,” said Kelly Moore, the associate director for immunization education at the Immunization Action Coalition, a national group that promotes vaccines and vaccine education. “We’re not talking about requirements even in a situation like this where there is an urgent need.”
Can states mandate a COVID-19 vaccine for children in schools?
A COVID-19 vaccine for children is still a long way off. While Pfizer, one of three drug makers that has a vaccine on the runway, has started testing its vaccine in children 12 and older, it could be well into the 2020-21 school year before children can start getting vaccinated against the coronavirus.
But when a vaccine is available, states have the power to mandate it, per a 1905 Supreme Court ruling, Jacobson v. Commonwealth of Massachusetts. All 50 states require vaccines—typically for diseases such as polio, measles, and tetanus—for children to attend school. However, most states allow families to opt out of getting their children vaccinated for either religious or personal reasons.
State leaders are only beginning to broach the issue of whether a COVID-19 will be required for schoolchildren and other populations.
Tennessee Governor Bill Lee said in a recent press conference that the COVID-19 vaccine will be optional for kids attending schools.
Pennsylvania’s health secretary has said the state will not require students to get the vaccine, according to local media.
In August, New Mexico Governor Michelle Lujan Grisham said schoolchildren could be among the groups the state is considering requiring a vaccine for.
What are the challenges to requiring a vaccine for school?
While it’s common to require children to be vaccinated before attending public school, and important for ensuring a safe learning environment, the calculus for mandating a brand new vaccine is different, said Moore of the Immunization Action Coalition.
There are still important questions to be answered about the vaccine, such as how long it will protect people, how effective it will be in children, and whether there might be rare or longer-term side effects that haven’t cropped up in clinical trials, which began over the summer.
“We always monitor the safety of the vaccines after we start using them,” she said. “We will learn a lot early on with these vaccines, and eventually when there is ample vaccine for the public, and we have studied the vaccines in children, if we find that the vaccines are especially helpful in children, then we will look at whether a requirement will be appropriate for children.”
Some public health experts also worry that immediately mandating that children receive a new vaccine may backfire.
The HPV vaccine, which prevents cancer-causing infections, serves as an example.
“When it was just approved by the FDA, there were efforts to require it for girls as soon as it was licensed,” said Moore. “However, regrettably, they jumped over the part where you really educate parents about what this vaccine does ... you ran into a situation where parents were being told to give their children something they weren’t familiar with.”
Moore said that resistance to the HPV vaccine lingers even today, despite the vaccine’s strong track record on effectiveness and safety.
Even among parents who generally trust the science behind vaccines, there can be hesitancy when it comes to inoculating their children with something new, said Allison Winnike, the president and CEO of the Immunization Partnership, a vaccine advocacy and education nonprofit based in Texas.
“That’s a trend—when new vaccines come out, a lot of people say, ‘I’m going to give it a little bit of time to see what happens,’” she said. “There will be people who say, ‘I don’t want to be first in line with my kids, I’m going to wait a year or two.’ This is going to be a process to get out of the pandemic.”
But even if states don’t require a COVID-19 vaccine for schoolchildren right off the bat, said Moore and Winnike, that doesn’t mean states won’t at a later time.
What does this all mean for schools?
In the short term, it means that schools will likely have to continue with mitigation efforts such as social distancing and mask wearing. How soon things can start returning to normal, Moore said, will depend largely on how many adults get vaccinated against the coronavirus.
Teachers may get priority over some groups in receiving a coronavirus vaccine, which would likely help control the spread in schools.
Schools will have a vital role in educating and connecting families to public health information from state and federal governments about the COVID-19 vaccine—why it’s safe and important to get, as well as free or low-cost ways to obtain it, said Winnike.
“That’s the place where all the parents are having daily or weekly touchpoints” already, she said, so it makes sense for schools to help get the messaging out from public health officials.
Schools will also be crucial to making sure children get caught up on any regular vaccinations they may have missed during the pandemic. Public health officials are worried that with a drop in vaccination rates overall, there could be a resurgence of diseases such as measles.
“Measles is still out there and once we start traveling again it can get into U.S. schools very easily,” said Moore. “Schools can play an important role in enforcing those school entry requirements rather than giving [parents] a pass or waiving those requirements even temporarily.”
A version of this news article first appeared in the Rules for Engagement blog.