With one COVID-19 vaccine now in emergency use — and potentially more to follow — Pennsylvania’s weary teachers, parents, and students can see a path back towards normalcy.
A vaccine, if effective, could make in-person schooling substantially safer and lead to thousands of children reentering classrooms for the first time since mid-March.
But that hope is far from certainty. There are many unanswered questions about timing, compliance, and safety.
Keystone Crossroads canvassed experts to better understand what the latest vaccine news means for education.
Who is going to be vaccinated first?
School staff will get vaccinated before most students. That much is clear.
Pennsylvania Secretary of Health Rachel Levine told Marketplace last month that school staff are “absolutely essential personnel.” The state’s interim vaccination plan puts school staff in a tier with first responders, food processing workers, transit operators, and other “critical workers.”
Those recommendations largely follow vaccine sequencing guidelines released in September by the CDC’s Advisory Committee on Immunization Practices (ACIP).
That means school staff will be in the second phase of vaccinations, right after the tranche that includes frontline healthcare workers and those who either work or live in congregate care facilities.
“We are not a functioning society without schools — so this seems to be the right order of operations,” said Dr. Sarah Coles, a pediatrician from Phoenix who serves on a pair of other ACIP working groups.
When will school staff be immunized?
Although Pennsylvania’s phases set the general priorities for vaccination, we don’t know when exactly each group will get immunized.
It appears vaccinations of school staff aren’t imminent. When Keystone Crossroads reached out to school officials for this story, none said they’d gotten any word yet on the timing or procedures surrounding vaccination.
“The lack of clarity is because there’s a lot of unknown,” said Dr. Angela Shen, a visiting scientist at the Children’s Hospital of Philadelphia who specializes in vaccine access.
Shen compares vaccine manufacture and distribution to baking batches of brownies. If you burn one batch, it pushes back every subsequent batch.
And this is a very complicated brownie recipe. There’s logistics to manage around producing the vaccine, storing the vaccine, and coordinating follow-up appointments so that everyone gets the required two doses.
Shen says there are an estimated 87 million Americans in the distribution phase that includes school staff. It’s going to be a major lift for a country that has little blueprint for rapidly vaccinating adults en masse.
“The fuzziness is not for the sake of fuzziness,” said Shen. “It’s for the sake of, we’ve never executed such a mass vaccination campaign before.”
Could school staff get the vaccine in late Winter? Late Spring? Both are on the table.
Speaking on MSNBC Monday, Dr. Anthony Fauci said that he thinks members of the general public — those not in one of the priority categories — could start to get immunized in late March or early April.
If that projection holds, school staff would likely get vaccinated in the weeks before.
What about student vaccinations?
This is where things get even cloudier.
The Pfizer vaccine only has emergency authorization for patients 16 and older, which excludes most school-aged children.
Drug companies still have to run trials that include children before the FDA can consider a vaccination’s use in the vast majority of students.
Dr. Walter Orenstein, a former director of the immunization program for the CDC and a leading expert in the field, recently told Education Week that children may start getting vaccinated by the “middle of next year,” but said that’s a rough estimate.
The timing here is important, because schools would prefer that a vaccine become available before students return for the fall semester.
Either way, it’s likely there will be a stretch when staff have access to a vaccine and students do not.
What about a vaccine mandate for school staff?
It’s not unprecedented for employers to mandate vaccination. Healthcare providers, for instance, can require their employees to get the annual flu vaccine.
Most vaccination mandates involve states requiring children to get vaccinated in order to attend school. But the Supreme Court case that opened the door for mandatory vaccination actually involved a city government requiring an adult to get a smallpox vaccine.
The legal precedent, in other words, isn’t tethered to childhood vaccinations.
“I believe we probably have the right to make [the COVID-19] as a requirement,” said Jeffrey Sultanik, chair of the education law group at Fox Rothschild, a firm that works with dozens of school districts in Pennsylvania.
That said, experts think a mandate is unlikely.
Vaccine requirements aren’t typically used for vaccines that have emergency use authorizations, like the COVID-19 vaccine does. Pennsylvania has already said it won’t mandate vaccines for school children.
Some experts also worry that mandates, while generally effective, might not be as helpful in this case because the vaccine is so new.
“I’m not sure that saying, ‘You have to’ is the way to build trust,” said Coles.
Research also shows that it’s not good to bully people into vaccine acceptance or shame them for having doubts, Coles explains.
A smart approach focuses on the altruism of vaccination, Coles said. Explain to teachers that getting the vaccine helps protect those with higher risks or those who cannot protect themselves. It’s also helpful, she added, if the messaging comes from someone who school staff trust.
“Maybe it’s the school principal or a trusted person who works in the cafeteria — someone who is the heart of the community,” said Coles. “Those are the people we need to get vaccinated — to talk publicly about vaccines.”
If teachers are vaccinated, but students aren’t — is school safe?
There’s no simple way to answer that question. All risk is on a spectrum.
In-person schooling will likely be a lot safer once staff are immunized.
That’s true for a couple reasons.
First, staff are the most likely to get seriously ill from COVID-19. The disease does not sicken young people at the same rates it does adults — by a long shot.
“[Staff] are the members of the school community who usually have the most significant concerns around their own safety during in-person learning,” said Dr. Dorothy Novick, a pediatrician at the Children’s Hospital of Philadelphia who’s also on COVIDs safety advisory boards for a pair of area private schools.
There’s also evidence that children — especially younger children — are less apt to transmit the coronavirus.
“Many really good studies do show that schools themselves are not the major driver of transmission,” said Novick.
That said, there is still risk.
Some staff may not be able to get vaccinated for medical reasons. Plus, the vaccine is not 100 percent effective. Some small proportion of teachers who get the vaccine won’t actually be protected from the virus.
Add in a building full of children who aren’t vaccinated, and teachers will still face risks — particularly as long as community transmission remains high.
Will school go back to normal once teachers get vaccinated?
Quick answer — no.
Because of the reasons listed above, schools will likely continue to use all of the same mitigation strategies that they’ve used since the pandemic hit. That means masks, increased ventilation, and social distancing.
“It’s a long time before we’re talking about loosening up those mitigation strategies,” said Novick.
There could still be reluctance toward in-person learning from staff and parents — even after essential personnel get the vaccine.
Arthur Steinberg, chief trustee of the health and wellness fund for Philadelphia Federation of Teachers, said his union still expects the school district to guarantee all of the safety precautions his union has demanded for months.
“[A vaccine] does not replace it. It just makes it safer,” Steinberg said. “You still need adequate ventilation. You need adequate supplies of PPE. You need to practice social distancing.”
After staff get the vaccine, the questions won’t be about going back to normal. They’ll be about moving toward normal.
Can schools that were all virtual move to hybrid? Can a district relax distancing requirements so that all students have the option to learn in-person?
That’s likely the next phase of this conversation.
Normalcy, it appears, is still a speck on the horizon.
Read more from our partners, Keystone Crossroads.