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Will the COVID-19 Vaccine Be Mandatory for Kids?

Parents logo Parents 11/24/2020 Nicole Harris
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An effective vaccine will be crucial in the fight against SARS-CoV-2, the virus that causes COVID-19. With help from the White House’s Operation Warp Speed, several manufacturers have been conducting clinical trials for vaccine candidates. Experts hope that one will receive approval for public use by the Food and Drug Administration (FDA) in the middle of 2021. 

In order for coronavirus spread to slow down, a large portion of the population would need to get vaccinated. “If enough people do not take the vaccine, then it won’t work to curb the pandemic,” explains Supriya Narasimhan, M.D., M.S. (Epi), Division Chief of Infectious Diseases, Hospital Epidemiologist, and Medical Director of Infection Prevention at Santa Clara Valley Medical Center. 

Naturally, this raises some questions for parents—especially those concerned about the vaccine’s safety. Can the federal, state, or local government mandate vaccines? What about your child’s school or your employer? Here’s what families need to know.

First, Is The COVID-19 Vaccine Safe?

Not everyone is happy with the government's sped-up vaccine approval timeline. According to a Gallup survey released in early December, about 63 percent of Americans say they would get vaccinated. Many of the others worry that researchers sacrificed safety precautions to develop a COVID-19 vaccine faster. Medical professionals, however, don't necessarily shares these fears.

The FDA worked closely with experts to develop an effective vaccine design—even before they had any candidates, says Christine Turley, M.D., Pediatrics Specialist and vice chair of research at Atrium Health Levine Children’s. The organization saved time by speeding through administrative components, she says, but the safety protocols have been followed properly.

“I’m encouraged that the National Institutes of Health (NIH) and Dr. Anthony Fauci promised data transparency and ensured us that scientific rigor will not be compromised by the Data Safety Monitoring Board (DSMB) for vaccine monitoring,” adds Dr. Narasimhan. “I’m also cautiously optimistic because preliminary reports of vaccine efficacy are much more promising than initially projected." (Initial FDA requirements for vaccine efficacy was 50 percent, but the current vaccine frontrunners—Pfizer and Moderna—have shown about 95 percent efficacy.)

It’s important to note, though, that clinical trials for a COVID-19 vaccine have largely excluded children—although Pfizer has started conducting pediatric trials, and others will likely follow suit. We don’t yet know if children will be approved for a vaccine with the general population, or if more research needs to be done first. The FDA wants to ensure the safety of the vaccine before making it available to kids. 

Can the Government Mandate a COVID-19 Vaccine?

In an interview with Newsweek published on January 1, infectious disease expert Anthony Fauci said he doesn't think a vaccine would be mandated for all American citizens. That said, when it comes to public health, the federal, state, and local governments have different regulations and policies. Here's where they stand:

Federal Government and Vaccines

The federal government would have a difficult time mandating a vaccine. Thanks to limitations set forth in the Constitution, public health measures generally fall to the states. Nevertheless the White House could still encourage or recommend that American citizens get the COVID-19 vaccine. It could also implement incentives—for example, citizens can’t get a U.S. passport or driver’s license without proof of vaccination. 

State Governments and Vaccines

States can require vaccines if it’s considered necessary for public health. You can thank a 1905 Supreme Court case called Jacobson v. Massachusetts, which set the precedent by letting Cambridge mandate the smallpox vaccination during an outbreak. Failure to comply resulted in a $5 fine.

There has already been some talk about potential vaccine mandates in certain states. In November, for example, the New York State Bar Association passed a resolution urging lawmakers to consider implementing a vaccine mandate for residents. Nothing is set in stone, though, and it’s up to the lawmakers to make the final decision.

Keep in mind that states can’t just mandate any vaccine. It must be recommended by the Advisory Committee on Immunization Practices (ACIP)—and even then, it will likely go through plenty of legal debates with state legislatures or city councils. Given the current political climate, experts also acknowledge that public outcry would probably result from a mandate, and they’ll consider whether universal vaccination is worth the unrest.

Local Governments and Vaccines

As long as it's reasonable and in the public interest, cities can also mandate vaccines. Some experts believe this could take place in hot spots, such as big cities. It actually happened during the New York City measles outbreak of 2019, which led to vaccination orders in four zip codes in Williamsburg, Brooklyn. Those who refused the measles-mumps-rubella (MMR) vaccine faced a $1,000 fine.

Can School Districts Mandate Vaccines?

Schools already mandate certain vaccines, such as polio, DTap (diphtheria, tetanus, and pertussis), MMR (measles, rumps, and rubella), varicella (chickenpox), and hepatitis B. There's nothing to say they can't also mandate the COVID-19 vaccine. "Everything will be on the table for discussion," said Dr. Fauci in the Newsweek interview. The decision actually falls to the states, which also make the call about medical, religious, and philosophical exemptions. 

When making the decision, experts will weigh the pros and the cons, deciding if the benefits of vaccination outweigh any potential risks. They’ll also consider the following information: COVID-19 generally presents with mild symptoms in children, although severe cases and deaths have rarely been reported. However, school-bound children could spread the virus to parents, grandparents, and others with underlying health conditions. Vaccinating children could eliminate one major source of coronavirus spread, possibly increasing the effectiveness of herd immunity, notes Dr. Turley.

Can Employers Regulate Vaccines?

Listen up, moms and dads: Employers have the power to mandate vaccinations for their employees, and they could technically fire anyone who doesn't follow protocol. Of course, there are some exceptions, and certain companies (such as healthcare facilities and nursing homes) are more likely to implement regulations. Employers must also consider religious exemptions under the Civil Rights Act of 1964, as well as medical exemptions under the Americans with Disabilities Act.

Can Businesses Mandate Vaccines?

Can your family's favorite store, restaurant, salon, or event venue require vaccinations? As it turns out, the answer is yes. Even without a statewide or local vaccine mandate, businesses are allowed to set their own policies—just like they can turn away shirtless or shoeless customers. Business owners simply can't discriminate based on cultural, religious, or other reasons.


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