Both the Pfizer-BioNTech and Moderna COVID-19 vaccines are only authorized for emergency use in adults. They are not approved for use with children. But as more K-12 schools return to face-to-face teaching, will young children need to get vaccinated when a vaccine is approved for them?
In a December survey by the National Parents Union and just now reported in Education Week, sixty percent of parents would let their child get vaccinated against COVID-19. One-fourth would not. And fifteen percent were uncertain. These vaccination acceptance rates are similar to the Kaiser Family Foundation surveys that found 63 percent in favor of adult vaccination in August, and rising to 71 percent in their December survey.
Education policies come under state jurisdiction. The decision on whether to require students to get vaccinated with a COVID-19 vaccine will face different state requirements.
State education officials nationwide were alerted to the extent of the anti-vax movement and its consequences when in 2017, an unvaccinated 6-year-old boy arrived at an Oregon hospital suffering the symptoms of tetanus and struggling to breathe. This tetanus infection (also called lockjaw) had been eradicated in Oregon for nearly 30 years, thanks to the DTaP vaccine given to children. DTaP protects against diphtheria, tetanus and pertussis. But after being in the intensive care unit for 47 days, his life saved by a ventilator and drugs to reduce muscle spasms caused by the tetanus infection—his parents refused to allow him to receive the regular childhood vaccinations.
States legally require children to be educated, either in public, private or home schools. All states likewise have requirements for children to be vaccinated in order to attend school. While tetanus is not contagious, other diseases spread easily and contagion is one risk of attending schools. The reasons for having students vaccinated have a long and solid history. Our oldest citizens remember the Mother’s March against polio and the annual bouts with measles, chickenpox and whooping cough. Measles is super-contagious. But the MMR vaccine made measles rare in the United States until the anti-vax movement grew in response to the now solidly disproved claim that vaccines caused autism. When measles outbreaks erupted again in the U.S., some states tightened laws on exemptions.
All states have good reason to provide student medical exemptions. A small number of students have medical conditions that make vaccines risky. To protect these vulnerable children, it is even more important that the vast majority of their classmates are vaccinated to prevent transmission to them. This is the level that provides “herd immunity.” Four states (CA, ME, NY and WV) only allow a medical exemption for students. All other s students must be vaccinated to attend school and/or child care.
Most states allow parents to exempt their child from vaccination for medical or religious purposes (AK, AL, CT, DE, FL, GA, IA, IL, IN, KS, KY, MA, MD, MT, NC, NE, NH, NJ, NM, RI, SC, SD, TN, VT and WY). However, very few religions have a formal anti-vaccine stance. Personal belief does not qualify for religious exemption except in LA and MN.
The remaining states accept the full range of medical reasons or religious or personal beliefs (AR, AZ, CO, ID, MI, MO, ND, OH, OK, OR, PA, TX, UT, VA, WA or WI).
These listings appear on the CDC website along with other variations, such as Missouri only allowing personal belief exemption for childcare, but not K-12 school. Medical exemptions may be permanent or require annual renewal, etc.
COVID-19 vaccines approved for children are unlikely to be available this spring semester. When they are eventually approved, schools may help in distribution. But less than half of schools have a full-time school nurse. The executive director of the school superintendent’s association expects some districts will mandate the vaccine, and that it will likely be legally contested.
There are a wide range of vaccinations used today: DTaP (diphtheria, tetanus and pertussis), MMR (mumps, measles and rubella), varicella (chickenpox), meningococcal ACWY, HPV and many others. But thanks to earlier widespread vaccination, students today do not have to worry about smallpox or polio.