The Covid-19 vaccine will be part of the recommended vaccination schedules for both children and adults in 2023, following a unanimous vote by the independent Advisory Committee on Immunization Practices of the US Centers for Disease Control and Prevention.
That does not make vaccinations mandatory for anyone, a point that was emphasized in the debate before Thursday’s vote. Board members responded to public concerns that adding Covid-19 vaccinations to the schedule would force schools to require shots.
“We recognize that there is concern about this, but moving to the recommended Covid-19 immunization schedule does not affect the number of vaccines required for school entry, if any,” said Dr. Nirav Shah, board member and director of the Maine Center. For Disease Control and Prevention.
“In fact, there are vaccines that are scheduled right now that are not required for school attendance in many jurisdictions, such as seasonal influenza. Local control is important, and we respect that. The decision about school entry vaccines is where it used to be, which is at the state level. at the regional level and at the municipal level, if there is one. These are the decisions about the vaccinations necessary to enter school, if there are any. This debate does not change that.”
In fact, Covid-19 vaccines are expressly prohibited from being included in school mandates in at least 20 states. Only California and the District of Columbia have announced that Covid-19 shots will be among the mandated vaccinations for students, but those mandates were not implemented this school year.
It’s been almost a year since eligibility for the Covid-19 vaccine was expanded to include everyone in the US over the age of 5, but coverage among children still lags behind that of adults. Although these vaccines and related mandates have become highly politicized during the pandemic, experts say vaccine skepticism among parents is nothing new.
Although the Covid-19 shot will not be mandatory for school, all 50 states have laws requiring specific vaccinations for students; most of these include measles, mumps and rubella (MMR), diphtheria, tetanus and pertussis (DTaP) and varicella shots. .
The use of these school-mandated vaccines, long before Covid-19, declined during the pandemic.
In the 2020-21 school year, kindergarten vaccination coverage fell below 94%, below the overall goal of 95% set by the US Department of Health and Human Services for the first time in the Healthy People Project. time in six years
A CNN analysis of the latest CDC data suggests that students in states with stricter school vaccination requirements are more likely to get shots.
All school immunization laws exempt children for specific medical reasons. But 44 states and Washington, D.C., also provide religious exemptions, and 15 states allow philosophical or moral exemptions for children, according to the National Conference of State Legislatures.
According to CNN’s analysis, states that were stricter with exemptions were much more likely to meet the 95% coverage goal. In the 2020-21 school year, on average, about 96% of kindergarten students received the MMR vaccine in states that allowed only medical exemptions, compared to 92% of students in states that also allowed philosophical or moral exemptions.
The full impact of the pandemic on children’s routines Vaccination rates are unclear: It will be several more months before the CDC shares national data Compliance rates for mandatory vaccinations in the 2021-22 school year, and schools are working on outreach and programming to ensure that as many students as possible stay up-to-date on their vaccines in the 2022-23 school year.
Correcting the decline in student vaccination coverage will likely depend on better access to care, information and outreach, and school vaccination mandates can help.
With many people who are hesitant, “because of something they’ve heard or something they’ve read,” said Dr. Jesse Hackell, who wrote a 2016 clinical report addressing vaccine skepticism. “Most people. [who are hesitant] They have a very free concern about vaccines. It is not accurate in most cases.’
A small fraction of parents — about 2% to 3% — are strongly against vaccines, and that rate has remained consistent over the years, said Hackell, who also chairs the American Academy of Pediatrics’ Committee on Ambulatory Practice and Medicine.
Overall vaccination coverage among kindergartners fell in the 2020-21 school year, but the share of exempt students also fell from 2.5% to 2.1%, according to CDC data. The rate has changed less than 1 percentage point over the past 10 years.
About 3% of U.S. kindergarteners (about 120,000 students) were believed to be noncompliant with mandatory vaccinations in the 2020-21 school year.
“Maybe the mandates won’t do anything for the people who would pull their kids out of public school,” Hackell said. “But the vast majority of parents they are not against They are in doubt, or in doubt. And when there’s pressure to do it for another reason, like taking your child to school, they come.”
Enforcement of vaccination mandates rests with the education system, and practices vary by state. Ultimately, some students drop out because they aren’t up to date, but most states offer temporary enrollment periods that allow kids to stay in school if they show proof of at least one shot in a series or an upcoming appointment.
According to the CDC, “school officials may prefer to keep students in school when they have access to education, safe supervision, nutrition, and social services while they work with parents or guardians to get children vaccinated.”
And many states do their best to help students stay up-to-date on immunizations, with vaccination programs and direct follow-up with parents.
“I think the decline in the last year or two is partly related to the pandemic,” Hackell said. “What we’re seeing, I think, is a slight difference between children who have a medical home and those who have a private one. [doctor] against children receiving immunizations from a public source” such as in a school clinic.
Mississippi is an impressive example of finding ways to keep childhood vaccination rates high, Hackell says. Public schools are the only option for many in the state, where poverty rates are higher than anywhere else in the US.
Despite the great public need brought on by the pandemic and struggles for additional resources, 99 percent of Mississippi’s preschools met required vaccine coverage in the 2020-21 school year, better than any other state, according to the CDC.
“They’ve done a tremendous job on this,” Hackell said, and it shows the power of the commands. Mississippi is strict with exemptions — one of six states that only allow medical reasons — and only 0.1 percent of kindergartens were exempt in the 2020-21 school year.
Hackell says he would be most concerned if he saw a sustained decline in vaccination rates for highly contagious diseases, especially measles and polio. And he’s concerned about pockets of low vaccination rates in some communities.
Schools are public spaces with a level of control, and the target is 95% vaccination coverage.
“We know it will never be 100%, because there are some people who are medically unable to be vaccinated. But if you have 95%, that means that in any school classroom of 30 children, there could be one unvaccinated child. And so if that child brings a case of something to class, there is no one else to give it to,” he said. “It stops there with a case.”
And when it comes to adding Covid-19 vaccines to the CDC’s recommended immunization schedule, the focus is still on public health, not on adding another condition.
“I’ve had parents come to my office, and I say, ‘What are you here for?’ And they say: “Well, we’re here for vaccines so our kids can go to school.” And I said, ‘OK, I understand that, but I’m really not vaccinating so you can go to school, I’m vaccinating because I want to prevent serious illness and death in your children,'” Dr. Matthew Daley, ACIP member and Kaiser Permanente Colorado A senior researcher at the Health Research Institute said at Thursday’s advisory meeting.
“And having the school’s immunization requirement helps because it gets you into the office, but that’s not my goal. My goal is to prevent serious diseases.’