Issue: October 2021
Disclosures: Lee reports no relevant financial disclosures.
October 21, 2021
2 min read
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Should COVID-19 vaccination be mandated in schools?

Issue: October 2021
Disclosures: Lee reports no relevant financial disclosures.
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As the COVID-19 pandemic progresses, the emergence of more transmissible variants has coincided with an increase in the proportion of U.S. cases reported among children.

With vaccine authorization expected to be expanded to younger age groups, we asked Bruce Y. Lee, MD, MBA, professor of health policy and management at the City University of New York School of Public Health, whether schools should mandate COVID-19 vaccines.

Bruce Y. Lee
Bruce Y. Lee

Here’s the challenge — the COVID-19 coronavirus pandemic has been and remains a national emergency. Every day this emergency continues, more lives are lost and the more suffering and costs accrue, as our study published in Health Affairs showed. Our study published in July 2020 in the American Journal of Preventive Medicine showed that the United States must reach at least 70% vaccination coverage to “return to normal” and not have to continue other COVID-19 precautions such as social distancing and face mask wearing. With the more contagious delta variant of SARS-CoV-2 spreading, this threshold is likely higher, potentially in the 80% range or higher. It will be difficult to achieve this coverage without vaccinating school-aged children because they constitute around 15% of the population. Plus, as described in our publication in Expert Review of Anti-infective Therapy, prior studies have shown that schools can be superspreading locations for infectious diseases because kids can interact heavily there and end up bringing the virus back to their homes.

Those who remain unvaccinated put those vaccinated and families at a higher risk for getting infected, but a number of people have shown that they are not willing to get voluntarily vaccinated to protect others. These are the reasons why all 50 states already have had vaccination requirements (eg, measles) for school enrollment since the 1980s. Therefore, while SARS-CoV-2 is still spreading widely and in an uncontrolled manner, it would make sense for the leaders of all 50 states to cooperate and add COVID-19 vaccination as a requirement to attend school in person, assuming that the vaccine gets approved for the relevant age groups. There can be distance learning options set up for those who still do not want to comply.

Click here to read the Cover Story, “Pace of pediatric vaccine trials leaves children ‘stuck in neutral’.”