Pediatricians Weigh In On If the COVID-19 Vaccine Will Be Required in Schools

Children as young as 6 months old are now eligible to get the Moderna and Pfizer-BioNTech's COVID-19 vaccines through an emergency use authorization by the Food and Drug Administration (FDA). The Centers for Disease Control and Prevention (CDC) has recommended that kids ages 6 months and older get immunized, and the President Biden administration has stressed that widespread vaccination in schools is crucial to end the pandemic.

Meanwhile, states and cities wrestle with whether to add the COVID-19 vaccine to the list of vaccinations they require students to get in order to attend school. However, the issue is a politically contentious one. Although one state (California) as well as several cities have proposed COVID vaccination requirements for students in middle school or high school, other states and school districts are challenging mandates, saying they are not inclusive of personal or religious beliefs.

Schools That Require the COVID-19 Vaccine

In October 2021, Governor Gavin Newsom announced that all schoolchildren in California will need to be vaccinated against COVID-19 as soon as the FDA enacts full approval for their age group. Once the vaccine is fully approved for kids 12 and over, it is proposed for California students in grades 7-12 to be required to get a vaccine. Likewise, vaccines may be required for grades K-6 after kids ages 5-11 get full approval. Illinois has passed a statewide vaccine requirement for students that is currently active, but it only applies to students in college or graduate school.

The Los Angeles Unified School District—the second largest in the country behind New York City—was the first major school district in the continental U.S. to put a vaccine requirement in place for students. Other school districts in California, Massachusetts, and elsewhere followed suit with various student vaccination mandates. However, many of those mandates are on hold due to legal challenges.

Other school districts around the country, including Cambridge Public Schools in Massachusetts, have rules that allow eligible students who aren't vaccinated to attend class, but they can't participate in school-sponsored social events, extracurricular activities like clubs or theater productions, or intramural sports.

Similarly, some school districts have opened the door to vaccination mandates by requiring that student-athletes be immunized against COVID-19 to help prevent the spread between schools. Schools in California, Hawaii, Maryland, and Virginia are among those who've passed orders mandating that student-athletes get the vaccine in order to participate in interscholastic sports.

Schools That Have Banned Vaccine Mandates

Though the CDC recommends the vaccine for anyone eligible, schools are not bound by these guidelines. This means school districts have the freedom to set their own vaccine mandates.

However, some school districts are limited by individual state laws. The Cincinnati Public School Board, for instance, discussed plans to require student COVID vaccination, but the state passed a bill preventing schools from requiring shots that have not received full approval by the FDA. At least 17 states now ban vaccine mandates for students, according to the National Academy for State Health Policy.

Much of the pushback stems from the fact that the vaccine has not yet received full FDA approval (just authorization) in kids ages 15 and younger. Moreover, the COVID-19 vaccine is available for some students but not all in some schools, like ones that start in Pre-K or kindergarten. Anthony Fauci, MD, has said he believes the vaccine will be available for babies, toddlers, and preschoolers by spring 2022.

Maria Rosas, MD, a board-certified doctor in pediatric infectious diseases at Florida-based KIDZ Medical Services, says she believes that once the COVID-19 vaccine is formally approved for children of all school ages, it will eventually be required by schools.

“All policy considerations for schools start with the goal of keeping students safe and physically present in schools,” she says. “Vaccines are one of the best preventive measures to create a safe environment for learning. Vaccination will decrease the disruption of education by significantly reducing outbreaks in school and keeping kids in school where they belong.”

The first step is the full FDA approval of the COVID-19 vaccine, not simply a temporary authorization. At this time, all 50 states have requirements for other vaccines in place for students, which is why Dr. Rosas believes adding the COVID-19 vaccine to that list is not out of the realm of possibility. It is just a matter of how soon it happens.

What Should Students Do to Remain COVID-19 Safe?

First, if your child is aged 6 months or older, follow CDC guidance and sign them up for the COVID-19 vaccine if you haven't already. (They can get their COVID-19 shot at the same time as their flu vaccine.) It's important for parents to make sure their children take other precautions while in the classroom, especially if they are not fully vaccinated or are around many other children who aren't.

Pediatrician Sunaina Suhag, MD, of the Austin Regional Clinic, emphasizes the importance of masking in schools where vaccination is not widespread at times of high community transmission levels. Dr. Suhag's recommendation for parents is to lead by example by wearing a mask in public places, even if it's not required.

Additionally, when parents get vaccinated, it helps protect their child from the virus, notes Zachary Hoy, MD, who specializes in pediatric infectious disease at Nashville Pediatric Infectious Disease. He says he believes it is especially important for parents of children not old enough to receive the vaccine to get vaccinated themselves.

Parents should also follow other preventive methods. “There are other strategies to decrease the likelihood of COVID-19 transmission or illness severity, such as mask-wearing, social distancing, and hand hygiene, but these are not as effective as fully vaccinating,” says Hoy.