As the United States rolls out the first doses of coronavirus vaccines, state leaders and federal public health officials generally agree that teachers and school employees should get their shots before there are enough doses for the general public.
But exactly when that would happen may vary depending on states’ distribution plans. And the question of who should get the scarce vaccine first and how to set priorities has raised complicated ethical, scientific, and logistical challenges for state and federal leaders.
Vaccinating teachers may give a shot in the arm to efforts to reopen schools, providing a broader societal benefit, proponents argue. But workers in other fields that are crucial to the economy, like agriculture and law enforcement, may be more likely to be part of populations at higher risk for serious illness if they contract COVID-19, medical ethicists have warned.
“We want our schools open and our teachers protected,” Arizona Gov. Doug Ducey, a Republican, said as he announced plans to prioritize educators in a Dec. 2 briefing without setting a specific timetable for doing so. “We know that teachers desperately want to get back into their classrooms safely.”
We want our schools open and our teachers protected.
Ducey is one of a growing list of state leaders who’ve said educators, and school employees more broadly, will be near the front of the line in their states’ vaccination campaigns.
Exactly how soon educators are inoculated may depend on who is included with them in their priority group. Some governors have grouped educators with other career clusters in their plans. Utah Gov. Gary Herbert, a Republican, has taken the unusual step of listing teachers as a priority group of their own. He expects they will start receiving vaccines in January, the Deseret News reported.
State leaders plan to follow guidance from a small federal advisory board that has said health-care workers who work directly with patients and residents of long-term care facilities should get the very limited supply of doses that started going out this week. What comes next is less certain.
“The nation faces an unprecedented logistical and social justice challenge in allocating vaccines under scarcity in the next half year or so,” a group of physicians wrote Dec. 1 after analyzing state plans.
And those challenges will be top of mind even before the vaccine is available to children, which will require additional research and planning.
Here are some things to consider as states decide when it’s school employees’ turn to receive the vaccine.
How limited are initial vaccine supplies?
After the Food and Drug Administration issued an emergency use authorization for Pfizer-BioNTech’s COVID-19 vaccine Saturday, shipping companies immediately began transporting about 2.9 million doses to states around the country under required ultracold storage.
Each person will need two doses of the Pfizer vaccine, the only one to win approval so far, spaced 21 days apart.
Moncef Slaoui, head of Operation Warp Speed, the federal vaccine distribution effort, said at a Dec. 2 briefing that he expects to distribute enough doses to fully vaccinate 20 million people by the end of the year, though some local health officials have been skeptical of that ambitious timeline. That includes an initial shipment of 6 million doses that authorities are preparing to send as soon as the FDA approves a second vaccine, by biotech firm Moderna, as early as this week.
Who determines if teachers get moved to the front of the vaccine line?
Federal officials don’t mandate when individual populations will be vaccinated. All states and territories and six major cities have created vaccine distribution plans that explain how they will funnel shipments to health-care providers and how they will determine who gets inoculated first.
States’ plans generally indicate that they intend to closely follow the recommendations of a CDC-assembled panel of independent scientists called the Advisory Committee on Immunization Practices. That group, which normally makes recommendations about things such as routine childhood vaccination schedules, plans a series of special meetings to review its priorities.
The committee will identify priority populations until there are enough vaccines available for the general population, a time known as Phase 2. There is no set time frame for reaching Phase 2, and much of the timing will depend on whether additional vaccines are approved, how quickly pharmaceutical companies can produce them, and a host of logistical concerns states must tackle.
The committee’s tentative timeline for Phase 1, which it reviewed at a Nov. 23 meeting, would include “essential workers,” like school employees, transportation workers, and first responders, in Phase 1b. But before those populations receive shots, states plan to follow the board’s formal recommendation to target the very limited initial vaccine shipments to health-care workers, who are likely to be exposed to the virus through routine work, and to residents of long-term care facilities like nursing homes, who have made up a disproportionate share of the roughly 300,000 Americans who’ve died of COVID-19.
Also included in early priority groups are people 65 and older and people with high-risk medical conditions. The advisory committee will next discuss these priorities Saturday.
How do school employees fit into the “essential worker” calculation for vaccines?
Several governors have singled out school employees as they’ve announced their state plans, recognizing the strain remote learning and continued uncertainty have placed on families.
On a Dec. 4 conference call, Kentucky Gov. Andy Beshear, a Democrat, asked superintendents to begin compiling lists of school staff who want to be vaccinated, prioritizing those at higher risk of exposure to the virus. The state will begin vaccinating school employees and emergency medical service workers immediately after it works through long-term care residents and health-care workers, the Lexington Herald Leader reported.
“That recognizes the exposure that educators have within the building,” Beshear told superintendents. “But it also recognizes the absolute, critical importance of what they do and how much better in-person classes are.”
Still, Kentucky won’t receive enough vaccines in its initial shipment to cover everyone in line before educators, so it may take some time before they get their first doses.
Other governors who’ve said school employees should get precedence have included them alongside other essential workers, such as police officers, in their vaccine plans, which may lengthen the time it takes to cover everyone in a priority group.
It’s up to states to consider who is an essential worker and whether certain professions deserve higher priority. The tentative federal vaccine plan links back to an expansive Department of Homeland Security Definition of “critical infrastructure workers” that says it is meant to be “overly inclusive” and encompasses everything from 911 call center operators and restaurant cooks to warehouse employees and real estate agents.
Education organizations have pushed to include schools as a priority, even as groups from other industries have made similar pushes, including zoo workers, restaurant employees, manufacturing companies, and law enforcement.
“Our students need to come back to school safely, educators want to welcome them back, and no one should have to risk their health to make this a reality,” a coalition of national education organizations and teachers’ unions wrote in a Nov. 30 letter to the CDC advisory committee.
More-specific industry groups that work in education, like the National School Transportation Association, which represents school bus drivers, have also pushed for their members to get early doses.
Some policymakers have suggested there needs to be a strong link between vaccines and the end of remote learning.
When the Kansas Board of Education recently approved a vaccine resolution, member Michelle Dombrosky, a Republican, abstained, saying teachers should be teaching in-person if they want an early dose.
Will every school employee in a state get the vaccine at the same time?
Even if they are included in early vaccine groups, it may take months for all school employees to be covered.
The CDC advisory board has suggested supplies may not arrive quickly enough for states to immunize everyone in a priority group at once. State plans anticipate this, suggesting they may use factors such as poverty and demographics to determine populations that are at higher risk.
Logistical challenges may also play a factor. For example, school employees in rural areas may receive the Moderna vaccine, which does not require the specialized refrigeration of the Pfizer inoculation.
Will the vaccine bring “normal” operations back to schools?
The public will have to continue taking precautions against the coronavirus well into 2021, even after receiving the vaccine, epidemiologists have stressed.
While clinical trials have demonstrated that the vaccine protects individuals from severe illness, further research is needed to determine whether it will stop recipients from transmitting the virus to others. Also unknown is exactly how long vaccine-provided immunity lasts.
That means schools will have to continue mask-wearing, social distancing, and hand-washing efforts, even after most adults are vaccinated.
President-elect Joe Biden has pledged to inoculate 100 million Americans in his first 100 days in office. But that time period lapses April 30, which is cutting it close to the end of the school year in some states.
Anthony Fauci, the nation’s chief epidemiologist, has said he expects states to move into Phase 2, when supplies are more abundant and the general population starts receiving the vaccine by “late March or early April.”
“It is really going to depend on the efficiency of the rollout,” he said in an MSNBC interview.
It may also take months before children, who are considered at lower risk of severe illness from COVID-19, can be vaccinated. The CDC recommendation applies to people ages 16 and older, and clinical trials have not yet been conducted on children.