Will COVID-19 Vaccines Be Required In Schools?

On Friday, December 11, the Food Drug and Administration (FDA) approved the Pfizer-BioNTech COVID-19 vaccine for emergency use authorization. Many are looking toward the vaccine as a possible solution to the rising COVID-19 cases forcing institutions—like schools—across the country to close. However, despite the approval and dissemination of the Pfizer vaccine, some experts believe vaccine mandates in schools are unlikely to happen.

William Moss, MD, MPH, executive director at the International Vaccine Access Center at John Hopkins, believes that there won’t be a vaccine mandate for schools because of previous vaccination precedents. “Where I see mandatory vaccines are in healthcare settings," Moss tells Verywell. "Many hospitals require that anyone who has patient contact has to get an influenza vaccine. So there’s precedent in those settings. I don’t anticipate a state mandating COVID-19 vaccines for children.” 

Challenges In Requiring a Vaccine in Schools

Coupled with a lack of precedent, the current Pfizer vaccine has been approved only for emergency use in individuals 16 years and older. “Right now, the trials have only included children over 12 years of age,” Moss says. “In the coming months, the trials will need to include younger children so that we can be sure about the dosing and make sure that it’s both safe and effective." Without testing and FDA approval, vaccines wouldn’t be allowed to be distributed to children under 16, regardless of the setting.

Implementing a vaccine mandate would also be challenging because vaccine-related laws are conducted at the state level, with variation in vaccine compliance across state lines. All 50 states have legislation requiring certain vaccines for students with some medical and religious exemptions. Currently, there are 15 states that allow philosophical exemptions for those who object to getting immunizations due to personal reasons or moral beliefs.

Vaccine compliance also varies at the school level. For example, private schools are more likely to have higher rates of exemptions to school immunization requirements compared to public schools, a research study finds. Exemption rates were significantly higher in states where personal belief exemptions were allowed. Children attending a private school may be at higher risk of vaccine-preventable diseases than public school children. 

Even if a COVID-19 vaccine was approved, a school mandate would be difficult to achieve because of the way COVID-19 expresses in children. The symptomatic profile of children with COVID-19 is much less severe compared to older adults. As a result, parents may not feel an urgent need to have their children vaccinated.

Dan Cooper, MD, professor of pediatrics at the University of California-Irvine, contrasts this with something like polio, which had dramatic and visible effects during the first half of the 20th century.

“Polio could cripple children and required assisted ventilation," Copper tells Verywell. "So the idea of finding a vaccine would prevent that, when you think about the risk to benefit ratio, was very different than for COVID-19."

For polio, the benefit of getting the vaccine outweighed the risk of getting a disease that could cause paralysis in children.

Monitoring Vaccine Misinformation 

Vaccine hesitancy among parents predates the COVID-19 pandemic. In 1998, researchers published a research study in The Lancet that suggested that the measles, mumps, and rubella (MMR) vaccine was linked to developmental disorders including autism in children.

The paper has since been retracted because no sufficient data can conclude that the MMR vaccine and autism are linked. However, the published story still holds ramifications in today’s society. After the study was published, many parents across the world chose not to vaccinate their kids out of fear of complications.

While misinformation and conspiracy theories about the COVID-19 vaccines may be causing confusion about vaccinations among the general public, it's important to stay informed. “I think all parents want to do what’s best for their children. And sometimes, fear or misinformation around vaccines can complicate that decision-making process,” Moss says. “We want to protect our children. I actually think the best way is to vaccinate them, not avoid vaccination.” 

To stay informed about COVID-19 vaccinations and information about upcoming candidates, you can visit the FDA COVID-19 website.