Could Texas students eventually be required to get a COVID-19 vaccine?

As trucks carrying the COVID-19 vaccine fan out across the state, many families are asking: Will this shot be required for Texas school children?

For now, the answer is no. Receiving the coronavirus shot is a voluntary process, and neither of the authorized vaccines are approved for use in young children.

It could be months or longer before there’s a vaccine available for kids, and it’s unclear whether even that would lead to a push for a mandate in Texas.

“Until we have data that shows good efficacy and safety in children, then conversations about whether it will be suggested or mandated for school attendance is something that’s about 75 steps down the road,” said Dr. Jason Terk, a pediatrician in Keller and chair of the Texas Public Health Coalition.

A more pressing concern for doctors is that vaccinations against other illnesses are lagging this year. A major reason is that families put off routine doctor appointments because of the pandemic. But some health experts worry the polarization over COVID-19 has spilled over and could have a chilling effect.

“It would be a catastrophic failure of our healthcare system if an outbreak of measles or whooping cough accompanied the global COVID-19 pandemic,” Dr. Seth D. Kaplan, president of the Texas Pediatric Society, testified at a recent state Senate health committee hearing.

Doctors are stepping up efforts to assure parents it’s safe to come in for appointments and to get their children, and themselves, vaccinated.

“We have a culture right now in which vaccines are one of the most important public health interventions for our society,” Terk said. “Yet we have forces in our society that are aligned against vaccinations, and are frankly trying to undermine a successful rollout.”

Vaccine mandates

Each state has the authority to set its own vaccination requirements for school children as well opt-out provisions.

Some leaders across the country have already started weighing in on possible requirements for the coronavirus. In New Jersey, for example, the chairman of the state Senate’s health committee said he eventually wants to require students to get a COVID-19 vaccine as a condition of attending school. The Pennsylvania health secretary, meanwhile, said the state has no plans to make it mandatory for anyone — including school children.

It’s unlikely Texas would move toward a mandatory requirement, said Rep. Stephanie Klick, R-Fort Worth. Klick sits on the state’s vaccine allocation panel and noted that it didn’t focus on whether children should be required to get the vaccination. She said it’s possible such a discussion will reach the legislature.

“I think politically, in Texas, it probably wouldn’t happen,” she said. “Consent is a huge aspect of our healthcare system.”

State leaders may be hesitant to push such a requirement because of the pushback that occurred in previous efforts.

Former Gov. Rick Perry was dogged for years by his 2007 attempt to mandate all sixth-grade girls get the HPV vaccine. His order would’ve made Texas the first state to require immunization against the sexually transmitted virus that can cause cervical cancer, but the legislature overturned it.

“The biggest lesson is when you have something that’s new and you try to push it without a longer term record of effectiveness and safety, it may come back to hurt,” Kaplan said.

Chilling effect

A September state report on the Texas Vaccines for Children Program, which provides low-cost vaccines to eligible children, outlined steep declines in immunizations since the pandemic began.

Late summer is typically a busy time for vaccinations as families prepare to go back to school. But the number of doses administered through the program in August was 32% lower than in the same month last year. Not only were many parents worried about going to the doctor, but more than 100 healthcare sites that participated in the vaccination program had been suspended as of July 31 “due to inactivity,” according to the report.

At his own Frisco practice, Kaplan has noticed more parents are becoming apprehensive about vaccinating their children.

“It’s just these sort of vague concerns about hearing that it might not be safe,” he told The Dallas Morning News. “All we can do is continue to educate and advocate.”

Texas law requires several immunizations for school attendance, including shots to protect against polio, measles and whooping cough. But like many other states, it allows families to opt out for a variety of reasons.

Doctors can write a medical exemption if they believe the vaccine may be detrimental to a child’s health. Parents can also object based on personal or religious beliefs.

More and more parents have chosen to forgo vaccines for their children in recent years, even after theories that immunizations are linked to autism were debunked.

Nearly 73,000 students — about 1.35% — opted out of at least one vaccine using the “conscientious exemption,” according to state data from last school year. Five years earlier, roughly 41,000 students used conscientious exemption.

Health experts worry that more kids missing doses will mean increased risk of outbreaks of vaccine-preventable diseases and hurt so-called herd immunity.

So advocacy groups are focused on immunization education ahead of a broader COVID-19 vaccine rollout. Immunization Action Coalition’s chief strategy officer L.J Tan said it’s incumbent on experts to explain how much scientific review goes into authorizing vaccines and tamp down people’s fears. If they’re successful, he hopes they can boost people’s confidence in all approved vaccines.

Roughly four in 10 American adults said they definitely won’t or probably wouldn’t get a coronavirus vaccine, according to a Pew Research Center survey released this month. About half of that group said they may change their mind once more information is available.

Allison Winnike, the president and CEO of the Texas-based Immunization Partnership nonprofit, said she repeatedly hears concerns about how quickly the vaccine was developed. In response, she points to the country’s robust process for authorizing vaccines.

It seems fast, she said, because the two COVID-19 vaccines were authorized for emergency use.

“Just because they’re doing that — because we have 2,000 to 3,000 Americans dying every single day — does not mean the regular, long-term vaccine safety and efficacy approval process has been shut down,” she said.

What’s next

Clinical trials involving younger children are in the beginning stages, so it’s unknown when such vaccines will be available for widespread use. Moderna’s vaccine is authorized for use for those 18 and older, while Pfizer’s is approved for people 16 and up.

The American Academy of Pediatrics is urging drug manufacturers to step up their research on how children and adolescents react to the vaccine.

“Trials in children must keep pace with the tremendous amount of data being generated in adult trials, and this should be initiated safely and as soon as possible so there could be a vaccine authorized for younger children before the next school year begins,” the group’s president, Sally Goza, said in a statement

Kaplan said that while he’s hopeful there will be a vaccine approved for children before next fall, he’s not convinced it will be. Until then, he said it’s vital people continue wearing masks and social distancing.

“We really have to get a lot of data,” he said. “Once we do have the safety and efficacy data available, we will certainly advocate for vaccination.”

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