A California Supreme Court decision last week reaffirmed that individual school districts lack the authority to require students to be vaccinated against COVID-19. A few weeks before that, the officials of the governor. The Gavin Newsom administration confirmed that it had dropped plans to require schoolchildren to be vaccinated against COVID, and legislation was passed to a similar effect. abandonment last year. That means that, at least for the foreseeable future, COVID vaccines are unlikely to be added to the list of 10 vaccines California requires attending school.
Some may fear that this puts children and communities at unnecessary risk. But both our current scientific understanding of COVID-19 vaccines and the drawbacks of mandating them suggest that state officials and the courts made the right decision.
Unlike the other vaccines required for school enrollment in California, COVID vaccines are not reliable in preventing infection or transmission. providing at best modest protection against infection for only a couple of months.
By contrast, vaccines already required for school attendance, such as measles, mumps, rubella, and polio vaccines, reliably prevent outbreaks when local vaccination rates reach a certain threshold. he hepatitis B other chickenpox (chicken)smallpox) Vaccines provide protection against infection for years, which decreases the risks of long-term transmission. The tetanus vaccine only provides individual protection, but it is given in combination with the diphtheria and pertussis vaccines, which protect against long-term outbreaks.
We never had any evidence that COVID vaccines would work as vaccines providing a high degree of long-lasting protection against infection and transmission, conferring so-called herd immunity. it has become clear that since 2021 other even clearer since the appearance of the Omicron variant. One study found that after about five months, the rate of COVID infection among vaccinated and unvaccinated teens ended up being essentially the same. and covid vaccines does not appear to reduce the chances of infected people infecting others.
To be clear, there is good evidence that COVID-19 vaccines have provided individual protection against severe disease and death. But the risks for most children at this point are slight. The Centers for Disease Control and Prevention estimates that more than 96% of children have been infected with the virus, and studies continue to show that post-infectious or “natural” immunity is at least as protective such as vaccine-induced immunity.
What’s more, a recent study of the Omicron variant in England found an under-20 COVID mortality rate of just 2 per 1 million infections. It also found that no children with prior infections had died of subsequent SARS-CoV-2 infection. The COVID-associated condition known as multisystem inflammatory syndrome in children (MIS-C) has fortunately almost disappearedand high quality studies continue demonstrate that long COVID is rare among children.
Some children are at higher risk of COVID than others. However, the absence of a state mandate will not discourage families and doctors from deciding to vaccinate these children.
The risk-benefit analyzes of my own research team for children other young adults support individualized approaches to COVID vaccination that weigh expected benefits against possible known side effects. A well-defined risk associated with the vaccine is myocarditis, or inflammation of the heart muscle, which occurs disproportionately in adolescent and young adult males with serious other lasting consequences. A high-quality prospective study estimated that the side effect would occur in about 1 in 3,000 Men ages 13 to 18 receiving second doses of the Pfizer vaccine. Therefore, a school mandate would require many children to take known risks in exchange for unclear benefits.
For the international context, schools and universities in Europe generally do not require vaccination against COVID. he European CDC is focusing on providing the bivalent booster to people who are over the age of 60 or have underlying conditions that put them at high risk. Brittany is offering boosters only to those who are age 50 or older, work in nursing homes, or are at high risk. france alone Announced that starting next fall, it will not recommend vaccination of people under 65 who are not considered high risk.
A statewide vaccination mandate also threatens to return thousands of students to remote learning. That is why the Los Angeles Unified School District indefinitely postponed their January 2022 deadline for students ages 12 and older to get a COVID vaccine. It became apparent that more than 30,000 unvaccinated students could be excluded from classrooms, disproportionately affecting young people color who had already suffered substantial educational setbacks during the pandemic.
With California COVID vaccination rates ranging from about 68% among children ages 12-16, 38% among children ages 5-11, and just 8% among children under 5 years of age, requiring vaccinations in California schools could exacerbate declining enrollment in public schoolsfurther jeopardizing the budgets of struggling districts whose students are, again, disproportionately the most vulnerable.
Restoring public trust requires practices that weigh the expected gains from any intervention against the potential harm. A school vaccination mandate for COVID-19 would not substantially reduce the health risks to our children or communities, but it could unnecessarily exclude students from classrooms where they need to be.
Tracy Beth Høeg is a research epidemiologist at UC San Francisco and a physician. These opinions are your own.
