A ruling from the California Supreme Court last week reconfirmed that individual school districts do not have the authority to require students to be vaccinated against COVID-19. A few weeks earlier, officials in Governor Gavin Newsom’s administration confirmed that they had abandoned plans to mandate COVID vaccination of schoolchildren, and that similar legislation was being introduced. dropped last year. That means, at least for the foreseeable future, it’s unlikely there will be any COVID vaccines on the way list of 10 vaccinations California requires to go to school.
Some may fear that this puts children and communities at unnecessary risk. But both our current scientific understanding of the COVID-19 vaccines and the drawbacks of making them mandatory suggest that government officials and courts made the right decision.
Unlike the other vaccines required for school enrollment in California, the COVID vaccines are unreliable in preventing infection or transmission, offer at its best modest only a few months of protection against infection.
The vaccines already required for school attendance, such as those against measles, mumps, rubella and polio, reliably prevent outbreaks when local vaccination rates reach a certain threshold. The hepatitis B And chicken pox (chickensmallpox) vaccines provide years of protection against infection, reducing long-term transmission risks. The tetanus vaccine only provides individual protection, but it is administered in combination with vaccines against diphtheria and whooping cough, which provide long-term protection against outbreaks.
We’ve never had any evidence that the COVID vaccines would work as vaccines that provide high levels of durable protection against infection and transmission, conferring so-called herd immunity. Obviously they wouldn’t since 2021 And even clearer since the emergence of the Omicron variant. A study found that after about five months, the COVID infection rate among vaccinated and unvaccinated adolescents was essentially the same. And COVID vaccines not appear to also reduce the chance of infected people to infect others.
To be clear, there is Good evidence that the COVID-19 vaccines have provided individual protection against serious illness and death. But the risks for most children are small at this point. That’s what the Centers for Disease Control and Prevention estimates more than 96% of children have been infected with the virus, and studies continue to show post-infectious or “natural” immunity at least as protective as vaccine-induced immunity.
What’s more, one recent research of the Omicron variant in England found a COVID death rate in those under 20 of just 2 in every 1 million infections. It also found that no children with previous infections had died from a subsequent SARS-CoV-2 infection. Fortunately, the COVID-associated condition known as childhood multisystem inflammatory syndrome (MIS-C). all but disappearedand of high quality studies Get on to show that’s how long COVID is rare in children.
Some children are at greater risk for COVID than others. However, the lack 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 And Adolescents support individualized approaches to COVID vaccination that weigh expected benefits against known potential side effects. A well-defined vaccine-associated risk is myocarditis, or inflammation of the heart muscle, which occurs disproportionately in adolescent and young adult males with possible serious And permanent implications. A high-quality prospective study estimated that the side effect would occur in about 1 in 3,000 13- to 18-year-old men receiving a second dose of the Pfizer vaccine. A school mandate would therefore require many children to take on known risks for unclear benefits.
For an international context, schools and universities in Europe generally do not require a COVID vaccination. The European CDC focuses on providing the bivalent booster to those who are age 60 and older or have underlying conditions that put them at high risk. Britain offers boosters only to those who are age 50 and older, work in care homes, or are otherwise at high risk. France just announced that starting next fall it will not recommend vaccination of people under 65 who are not considered high risk.
A statewide vaccine mandate also threatens to send thousands of students back to distance education. Therefore, the Los Angeles Unified School District is in effect indefinitely postponed the January 2022 deadline for students 12 and older to get a COVID vaccination. It became clear that more than 30,000 unvaccinated students could be banned from classrooms, disproportionately affect young people of color who had already suffered significant educational gaps during the pandemic.
With California’s COVID vaccination rate hovering around 68% among 12 to 16 year olds, 38% among 5 to 11 year olds and only 8% among children under 5 years old, mandating the vaccines in California schools would reduce the declining enrollment in public schoolsfurther jeopardizing the budgets of struggling districts, whose students are again disproportionately the most vulnerable.
Restoring public confidence requires practices that weigh the expected benefits of an intervention against potential drawbacks. A school vaccination mandate for COVID-19 would not substantially reduce 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 views are her own.