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MED+PROCTOR IMMUNIZATION BLOG

College campuses drove major COVID-19 outbreaks. Now, will they require the vaccine?

André Le Duc doesn’t consider himself a fortune teller. As the University of Oregon’s chief of safety and risks, Le Duc prides himself on planning, often way into the future.

So when the novel coronavirus started to spread in China in early 2020, Le Duc knew it wasn’t going away anytime soon. He told his university administration to start planning immediately, and mentally preparing, for a months-long, worldwide pandemic

In a disaster situation, Le Duc said, timing is everything: “Every minute you have, you need to be thinking two to three months out. … The question we kept asking was, ‘What’s next?’”

Now, after nearly a year and the loss of close to 290,000 Americans, what’s next is a vaccine.

The first doses of the COVID-19 vaccine are expected to be administered to Americans as soon as this weekend. States are prioritizing frontline health workers and other vulnerable populations as the first to be immunized, but colleges like the University of Oregon are also front of mind. After all, college students fueled some of the nation's top outbreaks this fall, and they're expected to return to campuses early in 2021.

Will they – can they – be required to get the vaccine once it's readily available? And why are college students different than schoolchildren? 

It's complicated, education experts across the country say – and we're a long way from answers. 

Vaccine not available to younger students

Because the vaccine was not tested on children, elementary, middle and high school students won’t be required to get one, at least for the foreseeable future. Most states require at least some vaccines for public school students, but states vary widely on allowable exceptions. Teachers and staff members could be a different story. 

Schools close for millions: Teachers are getting sick and COVID-19 cases are surging. Some districts are holding out

A coalition of top education stakeholders, the Learning First Alliance, has argued prioritizing school personnel – teachers, administrators, classroom aides, and custodial workers – is key to reopening schools. But Richard Long, the executive director at Learning First, stopped short of saying school staff should be required to get the vaccine. 

“It’s not a black and white issue,” he said. “It’s not like teachers surrender all their rights to make their own decisions when they become teachers.” 

Some elected officials have already said they won’t require vaccination, including Tennessee Gov. Bill Lee and New York Mayor Bill de Blasio.

Regardless of whether they eventually require the vaccine, America's schools have a huge role in the rollout, said Laurie Combe, president of the National Association of School Nurses.

"It's our role as school nurses to educate the public," she said. "When students don't receive the immunizations they should, that creates a problem not just for the school, but spread in the larger community." 

College students should be vaccinated – but when?

At colleges, the dilemma is different. Their students can be vaccinated – but it's unclear when will there be enough doses available for them.

“There are so many hurdles in place before we have this vaccine out there,” said Michael Baughman, a Philadelphia lawyer who works with colleges on compliance with state and federal laws. “Even if colleges wanted to mandate it, we’re not going to have the supply to do that until at least the next (2021-22) academic year. 

“States might pass laws at some point that do mandate it – but we’re a long way from that even being practical.”  

How to keep a college from exploding with COVID-19: One school's solution

Then there's the issue of how colleges would even administer a vaccine.

The American College Health Association has not made a decision about whether colleges should require the COVID-19 vaccine – it's waiting for guidance from the Centers for Disease Control and Prevention . But Gerri Taylor, the ACHA’s COVID-19 co-chair and a nurse practitioner, has concerns about vaccine rollout, regardless of whether it’s mandated. 

“Many colleges still don’t have enough supplies or staff to do testing regularly,” she said. “If you can’t even get a test, how are you going to get a vaccine?”

It's important for colleges to have their own vaccination plans. Many low-income students lack regular access to health care or financial support from their family, so they'd need a place to get the shot.

The vaccine dose itself will be free, the federal government says. Providers could charge an administrative fee to pay for people to administer the shot, but the CDC says this will be reimbursed by the federal government or private insurance.

But the logistical issues – from staffing to storage to space to hold vaccine clinics – are significant. 

Le Duc at the University of Oregon knows firsthand about those potential barriers. Almost six years ago, in February 2015, a meningitis B outbreak at the Eugene campus left one student dead – and administrators like Le Duc with lessons they can apply today, as coronavirus continues to infect millions of Americans. 

 

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