Will kids need shot for school?

Regulatory, legislative processes make a mandate very challenging

The U.S. Food and Drug Administration’s authorization this week of Pfizer’s COVID-19 vaccine for children as young as 12 has many California parents wondering: Will they have to get their middle and high school kids vaccinated to send them back to classrooms this fall?

For now, a requirement for middle and high schoolers this fall seems unlikely. Regulatory and legislative steps that stand in the way would take months to resolve, and there’s little appetite now even among California’s most ardent vaccine boosters to push for a mandate.

“Given where we are in the legislative calendar, it would be challenging,” said state Sen. Richard Pan, D-Sacramento, a pediatrician who has authored bills to limit vaccine exemptions for schoolchildren and crack down on doctors who issue them freely. “First of all, most importantly, we have to be sure the 12 and ups have access to the vaccine.”

But it’s not out of the question that such a requirement could be imposed later in the school year or the following year if schools start seeing outbreaks.

The University of California and California State University systems already announced plans last month to require students and staff to be immunized at the start of the fall term, if the FDA first grants full approval of one or more vaccines and supplies remain adequate.

But the university systems have their own authority to impose such requirements, Pan said. For K-12 schools, it would require state legislation to mandate COVID-19 vaccines.

Pfizer’s vaccine could become available to children as young as 12 before the end of this week. Moderna and Johnson & Johnson are still testing their vaccines in 12-to18-year-olds.

So far, though, the FDA has granted the vaccines only emergency use authorization, allowing their use during a public health emergency based on two months of evidence from a large clinical trial that they are safe and effective. Full approval requires six months of evidence.

Pfizer filed last week for full approval of its COVID-19 vaccine for those 16 and older under an expedited process expected to take six months, which if granted would cover college and older high school students some time this fall. But the drugmaker will have to wait longer for clinical trial results to be completed before seeking full approval of the vaccine for middle school kids, 12 to 15.

For California K-12 schools, the Department of Education says the state cannot mandate vaccines that are under emergency authorization. Pan said there are provisions that would allow state health authorities to order it, but they have never been used, and aren’t likely to be.

California requires children entering transitional kindergarten through 12th grade public and private schools to be immunized against diphtheria, tetanus, pertussis (whooping cough), polio, hepatitis B, measles, mumps, rubella and chickenpox.

Those are diseases for which the risk to children from infection is seen as far greater than any posed by the shots. But the requirement has been controversial among parents who question that calculus and who fought unsuccessfully against the state’s 2015 elimination of “personal belief” exemptions, a bill authored by Pan.

Larry Cook, whose Stop Mandatory Vaccination group helped lead that opposition, said parents uncomfortable with a COVID-19 childhood vaccine mandate should “flee California and get to a safe state that respects parental rights.”

But even vaccine advocates are in no rush to see the Golden State require COVID-19 shots for students. Leah Russin, director of Vaccinate California, a Palo Alto nonprofit promoting vaccination, said that although she’s looking to enroll her own kids ages 7 and 1 in COVID-19 vaccine trials, she doesn’t support a mandate for public school kids before the vaccines are fully approved.

“I’m definitely in favor of mandatory vaccines for routine childhood illnesses, approved for non-emergency use,” Russin said. “The COVID vaccine is still under emergency use authorization, and that is a bit different. In terms of public confidence, there is a difference and I think that matters.”

Russin said “there’s a lot we can do before we start talking about mandates,” like making vaccines more accessible through schools and pediatricians’ offices.

“We need to do a much better job explaining more fully what the vaccines are doing and why we need them, listening to people’s concerns and responding sympathetically,” she said.

Parents remain split on vaccinating their kids. According to a Kaiser Family Foundation survey last week, 29% of parents of children younger than 18 say they’ll get their child vaccinated as soon as it is authorized and available for them. But 32% want to see how the vaccine is working before getting their child vaccinated, 15% will only do so if their school requires it and 19% say they definitely won’t get their child vaccinated.

Katherine Korsak, mother of a 10-year-old daughter and 12-year-old son in the West Contra Costa Unified School District, got vaccinated herself but is not comfortable subjecting her kids to it now, concerned about possible long-term side effects. Instead, she plans to keep her kids in online instruction, which she says they prefer.

“I want more data before I am willing to subject my children to this vaccine,” Korsak said. “I do not think this is vaccine hesitancy, I think it is just protecting my children from side effects of a vaccine we know little about.”

Brandi Donlon, mother of a 16-year-old sophomore at Pleasanton’s Foothill High School, said she’s glad he just got vaccinated, especially because he plays an indoor sport: basketball.

“I feel there is a higher risk of catching the virus,” Donlon said. “The school is also COVID testing the players once a week, as a precaution. Schools require vaccines for other viruses, so asking parents to get the COVID vaccine for their kids isn’t surprising to me.”