State Health Leaders Must Do More to Advance Non-Partisan COVID-19 Vaccine Requirements


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The wrong people are governing COVID-19 vaccine requirements. The federal government is attempting to mandate vaccines for businesses and public employees. But on the local level, state leaders with the most capital to advance COVID vaccine requirements for kids remain silent while their school superintendents address concerns about youth vaccine mandates during school board meetings.


We need state health authorities to do more to promote non-partisan COVID vaccine rules for children. Unfortunately, we will continue to see low COVID-19 vaccine rates for U.S. kids without coordinated efforts from state and local health leaders.


According to a 2019 study, at least 90% of 2-year-olds across the US had received the required school vaccines such as polio, Hepatitis B, & MRR. But only 17.6% of 5-11-year-olds had been completely vaccinated against COVID-19.


The lack of state efforts to increase children’s COVID vaccine coverage is dangerous. Ahead of the upcoming midterms, science and common sense has taken a back seat to polarization and hyper-nationalism. In red states especially, politics are suppressing COVID-19 youth vaccine rates, leading to conflicting messages about COVID-19 vaccine safety for kids.


Republican states report lower-than-average youth vaccine rates than the national COVID vaccine rate for children. The 16 states banning COVID-19 youth vaccine requirements report that an average of only 12% of their 5-11 year-olds are completely vaccinated. This rate is five percentage points lower than the national average for that same age group.


The number of 5-11-year-olds receiving COVID-19 vaccines peaked before Thanksgiving and has since flatlined. State health authorities are the best positioned to build political capital towards vaccine requirements. We must act quickly to do more while keeping our eye on the longer-term goal of making COVID-19 vaccine requirements.

The path to statewide vaccine mandates for kids is long, but high expectations and transparency are critical state-led actions to increase youth vaccination rates and keep them safe in the short term.  Many people still have their doubts about the vaccine, especially the concept of giving it to their children, so our public health leaders need to meet people where they are and educate them about the benefits of vaccination with humility and clarity.


In Maine, where over one-third of 5-11-year-olds are fully vaccinated, the state department of education and health authority took a forward-looking approach to vaccine transparency. Early on, the Department of Health and Human Services defined a system for tracking self-reported vaccination coverage at the school and district levels. This strategy has paid off. As a result, Maine ranks among the top five states for 5-11-year-old vaccine coverage.


State coordination is the necessary and immediate next step. Too many state health leaders relinquish their role in increasing youth COVID-19 vaccine rates. Instead, they rely on federal and local governments to make bold moves for vaccine requirements without building necessary state initiatives to support such policies. Unfortunately, the lack of state efforts to advance vaccine requirements may lead to longstanding challenges to keep kids safe and learning in person.


More state health leaders should follow Maine’s lead and take an aggressive but reasonable approach to increase COVID-19 vaccine rates for kids. In the immediate term, state health leaders must coordinate with state education agencies to develop a system for tracking and reporting youth COVID-19 vaccination rates at the most local level possible. In some cases, that may be the district, and in others, it may be the building level.


In the long term, state health authorities need to coordinate with state boards of education to understand the school-based context for requiring a new vaccine mandate. All efforts must balance the short-term goal of increasing COVID-19 vaccine rates and the longer-term plan to build momentum towards adding COVID-19 to the existing vaccine requirements.

Dr. Christine M. T. Pitts

Dr. Christine M. T. Pitts serves as Resident Policy Fellow at the Center on Reinventing Public Education, overseeing policy leadership at research, advocacy, and government relations. A former teacher and administrator, she previously led research and evaluation for Portland Public Schools. She also served as Policy Advisor at NWEA, where she oversaw state and federal policy to advance equity and innovation in educational assessment. Follow her on Twitter @cmtpitts.

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