One of my close relatives took the Sinopharm Chinese state vaccine over Christmas. Part of the calculation behind this was it made sense to boost the immune response and create antibodies, even if it was not totally effective. Furthermore, major political figures were taking it, governments in other countries were approving it, so it must have some safety profile. That actually made sense to me even though weeks later the Chinese government in a two-sentence announcement revealed that it was no more than 79% effective. It made me wonder. What would schools think if their Chinese students arrived with a Sinopharm vaccination certificate next year? Would governments accept low efficacy vaccination certificates instead of PCR tests for airport entry? Would schools do the same? This kind of issue has already arrived in our daily life. As a perfect example of the kind of thing one should not do, I actually asked a nurse I know in our building during a shared elevator ride, whether she had received the vaccine: when she replied that she was actually about to that very afternoon, I followed up with “which one?”, as if I had a right to her personal medical file, and was in a place to make judgments about her healthcare. It was time to write an article and think deeply about the issues.
It is my guess that vaccinations will play a relatively small part in school decision making and here is why. To begin with, none of the western approved vaccinations are approved for children below the age of 16 (Pfizer vaccine threshold is 16, Moderna’s is 18) and there have been to date no clinical trials completed on children: many are planned, some are underway in populations as young as 12, and hopefully by the time the next school year rolls out there will be a lot more data and a pediatric vaccine. We should bear in mind that from the early stages of the virus there has been significant concern that certain child populations are having a very different reaction known as Multisystem Inflammatory Syndrome in Children (MIS-C), and so the safety profiles will be heavily scrutinized in many areas. It would be very difficult for state governments to mandate vaccinations for all school-age children until not only the safety profiles have been well documented but also until a very large percentage of the adult population has been inoculated and we are on a path to herd immunity.
And what about teacher vaccinations? For those who have been vaccinated the real unknown at this point is the length of immunity. There is little data beyond the length of the trials. Schools are in no position to mandate boosters if the supply is limited and the data is unclear. We have already started to see mutations occur in various places and these variants bring up the question of whether the vaccinations will be more like yearly flu vaccines that have to be tinkered with yearly for emerging strains or longer-lasting shots. The new variants have also begun to raise the question of whether they can create more “super-spreader” events, and raise doubts on the emerging data that transmission in schools is no worse than in the population at large. At some point, the focus will move away from vaccinations and to therapeutic options and whether we can manage ourselves out of the coronavirus over the next few years, just as we manage ourselves through every flu season with the annual risks and mortality.
There is lots of talk about teachers being classified as essential workers and getting the vaccine early, but it is difficult to see how this will change the conversation. The teachers’ unions have dug in their heels on school safety and we are even seeing resistance among front-line health workers to receiving the vaccines even with priority access. The LA Times reported this on December 31, 2020:
“At St. Elizabeth Community Hospital in Tehama County, fewer than half of the 700 hospital workers eligible for the vaccine were willing to take the shot when it was first offered. At Providence Holy Cross Medical Center in Mission Hills, one in five frontline nurses and doctors have declined the shot. Roughly 20% to 40% of L.A. County’s frontline workers who were offered the vaccine did the same, according to county public health officials.”LA Times
This last year has been punctuated by disagreement on the level of community spread of COVID-19 at schools with teachers’ unions often pitted against school administration and parents. The vaccination issue has already started to deepen these wounds and we have seen significant disagreement play out in areas like Chicago on this issue. The Chicago Tribune reported that Chicago’s public health commissioner, Dr. Allison Arwady, said return to schools had nothing to do with vaccinations:
“It has to do with the fact that we have seen, not just here in Chicago but around the country and around the world, that … we don’t see schools driving community spread. We don’t see them as significant sources of infection.”The Chicago Tribune
Imposing vaccination requirements when the data is still unclear and where the political divide is so acute on this issue, seems like an unwise choice. Schools are more than ever reliant on teacher talent to stem and fix the deficits the pandemic has wreaked on our student populations. A recent report by McKinsey & Company quantified the urgency for students beyond emotional wellness:
“While the worst-case scenarios from the spring may have been averted, the cumulative learning loss could be substantial, especially in mathematics—with students on average likely to lose five to nine months of learning by the end of this school year. Students of color could be six to 12 months behind, compared with four to eight months for white students. While all students are suffering, those who came into the pandemic with the fewest academic opportunities are on track to exit with the greatest learning loss.”McKinsey & Company
Assuming that we have by the next school year started to put a lid on the pandemic, we will likely be still looking at opening protocols with a lot more data but no panacea for a return to normal: masks, social distancing, testing, hybrid and adjusted schedules will all feature in planning.