A top virus expert is warning Maryland lawmakers to proceed cautiously before mandating coronavirus vaccinations for public school students.
As children return to in-class learning, there has been growing discussion over requiring students and teachers to be vaccinated. Dr. Daniel Salmon, director of the Institute for Vaccine Safety at the Johns Hopkins Bloomberg School of Public Health, Monday warned legislators that requiring such vaccinations for children could be complicated.
“I think the argument for teachers is more compelling than it is for children, both because it is a workplace issue and therefore a requirement for employment versus a child who is in a vulnerable population,” said Salmon during a briefing Monday with the Senate Education, Health and Environmental Affairs Committee. “I think I would probably start with teachers than with children.”
A premature mandate could result in strong political backlash, he added.
“The HPV vaccine is really a great lesson in that,” said Salomon. “The premature effort really undermined the immunization program for decades. We could be in a place where the benefits outweigh the risks so there would be an ethical and perhaps even legal argument for mandating, it but if pragmatically it creates great backlash you may not actually accomplish much other than to undermine confidence in the program.”
Currently, the Pfizer vaccine is fully approved for use in adults. And while children ages 12 and over can get vaccinated under an emergency authorization, full approval may not come before the end of the year.
Even that final approval may not be enough to tip the scales in favor of mandating children to be vaccinated just yet, Salmon said.
“I think the burden for safety is higher to make it mandatory than it is to make it authorized or licensed,” he said. “I would argue and many would agree, you need more (public) confidence in the safety than to just simply make (the vaccine) available.”
Sen. Mary Washington, D-Baltimore, said Salmon’s argument is “a political question about keeping our kids safe versus a public health reality.”
Prince George’s County Public Schools Chief Executive Officer Monica Goldson dismissed the politics.
“I have to be honest, if I focused on the political piece of it, I’d never be able to make a decision,” said Goldson. “So I have to focus on the health side of it. I’m sorry.”
Lawmakers in recent weeks have raised questions about requiring vaccinations first among teachers but also for the eligible student population as a condition of entering the classroom.
Sen. Paul Pinsky, chair of the committee, said lawmakers are interested in finding ways of “protecting our children, protecting school staff and indirectly protecting the community at large.”
Included in the debate, he said should be discussions about mandating vaccinations for school staff and students.
“We want to leave this open to a broader conversation,” said Pinsky.
There is currently no statewide vaccination requirement for teachers, but a number of jurisdictions — including Howard and Prince George’s counties — are requiring teachers to prove they’ve been vaccinated or submit to weekly testing.
The Maryland State Board of Education last week passed emergency regulations that, if approved by a legislative committee in September, would require the use of masks in all school buildings.
The Joint Committee on Administrative, Executive and Legislative review is scheduled to vote on the mask regulations on Sept. 14.
“In the case of masks, it seems really simple,” said Salmon. “It’s one of the easiest things you can do. It’s not a huge infringement and it works pretty well. I think with vaccines, the equation is a little more complicated.”
Goldson and other school leaders are limited in what they can do, including mandating vaccinations for students.
“The Maryland Health Department controls adopting the rules and regulations that govern student vaccinations. That is why my hands are tied,” Goldson said. “If that article did not exist … I would have required athletes (to be vaccinated) by now.”
Cases in children are growing rapidly nationally. In the last week, the number of children with COVID-19 grew from 26,000 to 200,000, according to Dr. Karen Kotloff, professor of pediatrics at the University of Maryland Medical System.
“Even though children are much less likely to have severe disease, much less likely to have fatal disease, when you start increasing the numbers of children (with infections) then the number of children with adverse outcomes increases even though the percentage doesn’t increase,” she said.
It is likely, Klatoff said, that the delta variant and the return of children to the classroom are driving the increases.
Sen Jason Gallion, R-Harford and Cecil counties, questioned whether it would be a better strategy to require children who are more vulnerable to wear masks while allowing others to attend school without a mask.
Currently, only about 500 children nationally have died of COVID-19, but Kotloff said increasing the number of patients could push that number higher.
“You don’t have to have an underlying condition to have a fatal COVID infection,” said Kotloff. “How do you know which child that’s going to be to protect that child’s life?”