SAN FRANCISCO — In the first such action in the nation, Gov. Gavin Newsom issued a mandate Friday requiring all eligible public and private schoolchildren in California to be vaccinated against COVID-19, a policy the state expects to affect millions of students by fall 2022.
The mandate would take effect for grades 7 through 12 the semester following the U.S. Food and Drug Administration’s full authorization of the vaccine for children ages 12 and over, according to the governor’s office. Students in kindergarten through sixth grade would be phased in after the vaccine is authorized for younger children.
Currently, only individuals 16 or older are eligible to receive a vaccine that has full approval from the FDA. Children as young as 12 have been able to receive the vaccine under emergency authorization. For that reason, state officials expect the mandate to begin taking effect next fall.
Once in effect, students will not be allowed to attend classes in-person on campus without being vaccinated, just as with any other required childhood vaccine. Rare medical and religious exemptions would be available.
It will be up to schools and school districts to enforce the mandate, as they do with other required vaccines, including those for hepatitis B, tetanus, mumps, measles, polio and chickenpox.
Students 16 and older are currently eligible for the two-dose Pfizer-BioNTech COVID-19 vaccine, which has won full approval by the U.S. Food and Drug Administration. Children ages 12 to 15 have been able to receive Pfizer shots since May after the FDA authorized it for emergency use in that age group, with full approval widely anticipated by November.
Vaccines for children 5 to 11 are not that far off. Pfizer is expected to apply for authorization imminently, citing evidence from trials indicating that the shots are safe and effective for children in that range. The shots could be available for that group, under an emergency-use authorization, around Thanksgiving, according to the Associated Press.
With Newsom’s student vaccine mandate, California is once again moving faster than any other state on measures to combat a pandemic that has taken about 69,000 lives in the state. The Golden State was the first to order a strict lockdown early in the pandemic, and enacted a second stay-at-home order in most of the state again late last year.
Schools remained closed longer than in many other states and longer than many business sectors in California, leading to some intense criticism of the governor for not making school reopening a higher priority.
California became the first state to order all health care workers to get vaccinated. It was also the second state, following Hawaii, to impose strict vaccination rules for school staff, who must either be vaccinated or submit to weekly coronavirus testing. Other state workers must abide by similar regulations.
California has also been out front with other measures, such as mandating masks indoors at all K-12 campuses — a strategy subsequently endorsed by the U.S. Centers for Disease Control and Prevention. In contrast, governors in states such as Florida and Texas forbade mask mandates. And, while Newsom faces a legal challenge over requiring masks in schools, the script is flipped in other states, including Texas, where Gov. Greg Abbott’s ban on mask mandates is confronting a legal challenge from parents, with support from the U.S. Justice Department.
California’s vaccine requirements for health care workers allow for limited exemptions for medical reasons and religious beliefs.
Statewide, at least six school districts — including the two largest, Los Angeles and San Diego — have approved student vaccination mandates. Already, L.A. and San Diego have received cease-and-desist letters, a precursor to a lawsuit.
Some parents in L.A have asserted various reasons for opposing the mandate. A number of them are factually wrong, according to experts, such as claims that the vaccine is killing more people than the virus or that the vaccine poses a greater risk to children than COVID-19.
Other parents say the vaccines are too new for them to be comfortable having their children receive the shots.
The vaccinations have been available to everyone age 12 and up since May. Among all age groups, there have been 226 million administrations of the Pfizer-BioNTech vaccine in the U.S. since December, a mass rollout of vaccinations that has no parallel in U.S. history.
In that period nationwide, 54% of adolescents age 12 to 15 have received at least one dose of vaccine, as have 62% of 16- and 17-year-olds. If there was a safety problem with the vaccine for adolescents and teenagers, it would likely have surfaced by now, many experts say.
There were some early concerns about myocarditis — inflammation of the heart muscle — as a side effect of the Pfizer vaccine, mostly among young males. But further study revealed that of 8.9 million adolescents who had received the Pfizer vaccine through mid-July, there were fewer than 400 reports of myocarditis, the symptoms were generally mild, and there were no related reports of death.
The most common adverse pediatric events reported were dizziness, headache and fainting, some of which is likely related to a history of anxiety around needles, according to a report published by the CDC. Fainting is common among adolescents after any vaccination, the CDC said.
Some parents who oppose COVID-19 vaccine requirements point to the extremely low hospitalization and death rates among children who get infected. According to the CDC, 287 people age 12 to 17 have died from COVID-19 nationwide since the start of the pandemic; in California, according to the Department of Public Health, among children age 5 to 17, there have been 26 COVID-19 deaths.
But failing to vaccinate adolescents and teens will only prolong the pandemic, many experts say.
Young people “can be sources of transmission back into their own households,” putting their family members at risk — even vaccinated ones who might contract a breakthrough infection, said UCLA epidemiologist Dr. Robert Kim-Farley.
In Los Angeles County, unvaccinated adolescents age 12 to 17 are now the group with the highest coronavirus case rate in the last month — 19% worse than among unvaccinated younger adults under the age of 50, and 33% worse than among unvaccinated older adults.
“High vaccination rates are essential to keeping a lid on infectious diseases,” said UC San Francisco infectious diseases expert Dr. Monica Gandhi.
Although a majority of Los Angeles parents appear to have accepted the school district’s vaccine mandate for those 12 and older, thousands have not, based on recent vaccination rates.
As of Sept. 9, L.A. Unified interim Supt. Megan K. Reilly estimated that, of about 225,000 students in grades 6 through 12, roughly 80,000 were not yet vaccinated. The district has not recently updated those figures. Eligible L.A. students who have not received their first dose by Oct. 3 will be barred — starting next week — from participation in extracurricular activities, including clubs, sports, band and drama. L.A. Unified students must be fully immunized by Jan. 10 or they will be unable to begin the second semester taking classes in person.
Some parents have threatened to pull their children from L.A. schools, but the governor’s order could limit their options on where else they can go in the longer term.
Other L.A. parents strongly support the district’s vaccine mandate, saying that it makes their families safer.
“I will feel so much more at peace knowing that my children are sitting in class with children and staff that are vaccinated,” said Rosangela Salazar, a parent in L.A. Unified.
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