California school vaccine mandate coming soon, but questions remain

October 29, 2021

A nurse gives a Pfizer-BioNTech vaccine shot to Gizelle Carrillo, 14, at Eagle Rock High School on Aug. 30, 2021.

California’s school vaccine mandate is moving closer to reality with the imminent approval of the Pfizer Covid-19 vaccine for children ages 5 to 11. But regulations around the mandate have left many confused.

Can students with a personal belief exemption attend school? Will state lawmakers move to eliminate some exemptions? Will the mandate kick in after the vaccine is authorized for emergency use by the Federal Drug Administration or when it gains full approval?

Although a federal Food and Drug Administration advisory board on Tuesday recommended the vaccine be given emergency use authorization, that won’t be enough to activate California’s school vaccine mandate. The new state regulation doesn’t kick in until vaccines for juveniles, ages 12 -17, and children, ages 5 to 11, are fully authorized by the FDA.

Earlier this month, Gov. Gavin Newsom announced that all public and private school students and employees must be vaccinated by July to be on campuses. They will no longer be able to be tested as an alternative to a vaccine unless they are eligible for medical or personal belief exemptions.

“We want our kids back in school without episodic closures,” Newsom said Wednesday. “California has outperformed the nation in keeping our kids safely back for in-person instruction because of the social-emotional benefits. States that don’t follow masking guidance and vaccination efforts have substantially higher school closures than the state of California.”

The FDA is expected to consider the advisory board’s recommendation and decide within the next week whether to approve the vaccine for emergency use. The pediatric vaccine will be given in two doses 21 days apart, like the adult and adolescent doses. But the doses will only be 10 micrograms — or a third the amount of the adult dose.

Once the vaccines are fully approved, students have until the next term to complete their vaccinations before they can attend school in person. State officials have said that July 1 is the earliest the mandate is expected to begin.

But the state isn’t waiting for full approval from the FDA to begin vaccinating children whose families want the vaccine. California Health and Human Services Agency Secretary Mark Ghaly said Wednesday that he anticipates that 1.2 million doses of the vaccine for children ages 5 to 11 will be available in the state once emergency use is approved.

The Centers for Disease Control and Prevention reports that Covid-19 is now the eighth-leading killer of young people, he said.

“So this is not just another thing for kids to take a hit, to take one for the team,” Ghaly said. “This is about protecting kids, prioritizing kids, keeping schools going, keeping schools safe, getting back to normal.”

State officials have been working with school districts to establish clinics on school campuses so children can begin getting vaccinated as soon as possible.

California state Sen. Richard Pan, a pediatrician who chairs the Senate Health Committee, said it is important for parents to vaccinate their children. Along with the immediate health risks of Covid-19, which has killed about 600 U.S. children, risks include long-term health problems like infertility, brain fog and heart inflammation.

“Why would any parent want their child to be the guinea pig, to find out what it is like to be infected by Covid?” Pan said. “We don’t know what happens, what all the long-term impacts are.”

In the meantime, there is still a lot to do to ensure the smooth rollout of the school vaccine mandate while the vaccine awaits full approval, which isn’t likely to happen until at least midyear, said Pan, who authored the 2015 law that eliminated personal belief exemptions for the vaccines required to enroll in the state’s K-12 schools, as well as legislation in 2019 that tightened regulations on medical exemptions.

Because the Covid vaccine mandate for schoolchildren was established by regulation instead of legislation, it must allow for a personal belief exemption. Students with these exemptions can attend school in person, Pan said. Students who choose independent study, which allows them to study from home, won’t have to file an exemption or get vaccinated, he said.

State officials haven’t developed rules around personal belief exemptions, Pan said. Before the state eliminated the personal belief exemption for the other 10 vaccines legally required to attend school, families were required to go to a doctor to learn about the disease and vaccine before they could sign a personal belief exemption.

“The law is silent on that,” Pan said of the process to get the exemption for a Covid vaccine. “It says it has to allow a personal belief exemption, but it’s silent on the process.”

State legislators have indicated they are considering legislation to strengthen the vaccine requirement, which could include eliminating some exemptions or outlining how families must obtain exemptions.

“We are considering legislation,” Pan said. “We are identifying a variety of issues that need to be addressed to ensure we get high vaccination rates in schools and that we keep schools safe. Vaccinations are part of that, as well as masking.”

Amending the state health code to add the Covid-19 vaccine to the list of required immunizations may be difficult, Pan said. The state health code calls for students to be checked for required vaccinations when they enter kindergarten and again in seventh grade. The Covid vaccination, which has waning immunity, would require more frequent checks, he said.

“We designed the law to eventually get everyone vaccinated, but we weren’t chasing everyone down for Covid-19,” Pan said. “We would have to check everyone’s vaccine status.”

Pan isn’t certain that legislation can capture all the flexibility that would be required to implement a vaccine mandate that may require boosters and regular checks to ensure people are fully vaccinated. Instead, he said, legislators could establish guidelines and authority that allow the California Department of Public Health to make adjustments as needed.

Before they write new vaccine legislation, legislators will talk to stakeholders such as school district officials to decide the types of resources they might need to implement the program, he said.

Pan is confident legislators can work out these policy issues before the vaccine is fully approved.

“Ultimately the goal is to be sure we have safe schools,” Pan said. “It’s not about forcing students to get vaccinated. It’s about safe schools.”

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