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Can schools impose Covid-19 vaccines on children? What we know



Many education officials, public health officials, and parents believe that vaccinating children against Covid-19 will play a key role in resuming normal life in time for personal learning in the fall. This attitude has caused some parents to wonder: Will K-12 students be mandated to receive the vaccine to be allowed on campus this fall?

About 23% of young people between the ages of 12 and 15 have received at least one dose of the Pfizer vaccine since U.S. health authorities cleared it for use among that age group last month, according to the U.S. Centers for Disease Control and Prevention.

About 51% of the population is in favor of requiring vaccines for middle school students, 56% for high school students and 61% for college students, according to a Gallup survey of more than 3,500 adults conducted in May.

About 53% of parents of children between the ages of 1

2 and 15 said they plan to have their child vaccinated. The same percentage of parents of children under the age of 12 said they planned to have their children vaccinated when the green light is given.

Schools and school districts generally do not have the authority to mandate student vaccines.


Photo:

Mike Segar / Reuters

State vaccination policies will play a key role in whether schools can require Covid-19 vaccinations in a manner similar to how many shots are required for infectious diseases such as measles.

Can schools impose Covid-19 vaccines?

Schools and school districts generally do not have the authority to mandate student vaccines.

But other authorities can: namely, state legislators or health officials acting under legislative authority, said Dorit Rubinstein Reiss, a professor of public health law at the University of California Hastings College of Law.

The only exception is New York City, where a 2018 lawsuit over flu vaccinations means city officials are likely to require student vaccines in addition to those approved by the state.

“This is an area that is already quite regulated,” Mrs Reiss said.

Some states like California allow state health departments to add other vaccines to those required by law. But the health department has never taken advantage of that allowance, Ms. Reiss said. Each of the 10 vaccines on California’s approved list has been added through the state legislature, she said.

Have state lawmakers shown interest in requiring Covid-19 vaccines for K-12 students?

Not really, and that’s not surprising, according to Mrs Reiss. First, the vaccine is only approved for use in children 12 years of age and older. So arguing that a vaccine is necessary can prove difficult if only half of the school population can receive it, Ms Reiss said. It is unlikely that lawmakers will push for a mandate before the vaccine is approved for use by all school-age children. Another reason is that all three Covid-19 vaccines are currently approved under an emergency use authorization, Ms. Reiss said. Although this status does not necessarily preclude a mandate, it weakens the legal status.

Oklahoma became the first state to pass legislation blocking K-12 vaccine requirements. The bill, signed by Republican Gov. Kevin Stitt late last month, also bans schools from implementing a mask mandate on unvaccinated students. Similar bills banning schools from requiring the vaccine are finding their way through Michigan and Pennsylvania lawmakers.

Do school districts want the Covid-19 vaccine mandated?

Many are silent on the matter. New York Mayor Bill de Blasio, who has authority over schools, stated last week that he is not keen on a vaccination mandate.

“I think when we get started on mandate, we create conflict that we do not need in this,” Mr De Blasio said. He added that it would be better to increase vaccinations by educating about their effectiveness.

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Los Angeles Unified School District Superintendent Austin Beutner said vaccines should be made mandatory once they have been shown to be safe and effective.

“I would expect the state in the not too distant future – I do not know if it is weeks, months or hopefully not years – to give a mandate for it. Why do we treat Covid differently than we treat measles and mumps? It does not make sense to me, “said Mr. Beutner.

Mr. Beutner, head of the country’s second-largest school district, said he has been discussing a potential mandate with state lawmakers for several months and that when policy on the subject is set aside, many agree that the vaccine should be required. There are different views on when the right time is to implement it, he said.

Mr. Beutner resigns from his job at the end of the month.

Nearly 50 city school districts, including New York City, Los Angeles, Cleveland and Detroit, offer vaccinations to students and families in school buildings, according to the Council of the Great City Schools.

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What do the teachers say?

The National Education Association, the nation’s largest teachers ‘association, said it does not hold a national position, and the American Federation of Teachers, the second-largest teachers’ association, said it does not press for vaccination. Randi Weingarten, the group’s president, has said it is important to convince people of the vaccine’s effectiveness in overcoming the hesitation.

How effective are the Covid-19 vaccines in children?

The results of a Pfizer-BioNTech study of 2,260 adolescents found that the two-dose shot was 100% effective in protecting against symptomatic Covid-19 in 12- to 15-year-olds.

So far, researchers have not found evidence that the vaccines pose additional or different risks to children versus adults. The most common side effects of the vaccine, according to the CDC, are severe symptoms such as fever, muscle aches and chills.

Do school vaccine mandates work?

Yes, according to Dr. Paul Offit, director of the Vaccine Education Center at the Children’s Hospital in Philadelphia. Take the case of measles, the first vaccine mandated in schools in some states. According to a 2003 paper in the American Medical Association’s Journal of Ethics, “Evidence showed that states with school immunization laws had measles rates 40-51% lower than states without such laws.”

Such findings led to more state mandates and strict enforcement.

“Because of these mandates, we eventually removed measles from this country” for a while, said Dr. Offit.

Every state requires children to be vaccinated to go to school with vaccinations against mumps, measles and rubella as well as polio and diphtheria among the most common. But there are exceptions. Six states – West Virginia, Mississippi, New York, Maine, California and Connecticut – allow only medical exceptions.

Forty-four states and the District of Columbia admit religious exceptions, and 15 states allow philosophical exceptions, according to the National Conference of State Legislatures.

An increasing number of U.S. colleges will require students to receive Covid-19 vaccinations before returning to campus. The policies ignite a debate about whether companies and institutions such as schools can make vaccines a condition for participation. Photo: Ruby Wallau / Northeastern University

What about colleges?

Hundreds of colleges and universities – both public and private – require students to be vaccinated to participate in campus learning this fall.

The legal restrictions that bind K-12 schools do not always apply because most public universities have self-governing powers from the state, and private universities are generally not subject to state rules, Ms. Reiss said. But the autonomous powers of public universities are usually not strong enough to override state law. If states say public universities cannot make the Covid-19 vaccine a condition of participation, as in Oklahoma and Utah, the powers of universities may be limited, Ms. Reiss said.

What’s next?

Some public health experts and pediatricians warn that it may be wise to wait until more data is available before the Covid-19 vaccine is a requirement. Danny Benjamin, a professor of pediatrics at Duke University, said he wanted “maximum information” about the vaccine’s efficacy and mortality on a much larger scale than delivered through initial trials. “We are really early in the life cycle of the mandate,” said Dr. Benjamin.

Dr. Benjamin, whose four children have all received the vaccine, including two who were part of the initial trials, said that given the hesitation regarding vaccines, it is best not to rush for mandates. Instead, it would be better to encourage vaccinations through incentives and education, he said.

Write to Yoree Koh at yoree.koh@wsj.com

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