This article is adapted from a new Chronicle special report, Reopening Campus: How to Do It Safely and Succeed, which looks at how colleges are planning for a fall semester unlike any other.
It won’t look quite like it did before the Covid-19 pandemic, however. According to scores of college officials, masking will remain the norm at most campuses at least through the end of 2021. Social distancing will still be required, but might gradually be relaxed depending on infection rates. Students will continue to monitor themselves for symptoms and, at many colleges, record those data on apps. Where possible, they will live in less densely populated dorms. And many classes and activities will stay at least partly online.
But whatever else colleges do right, if students, faculty, and staff members aren’t vaccinated in high enough numbers, institutions’ plans will crumble.
“To us,” says Michael Huey, interim CEO of the American College Health Association and former assistant vice president for student-health services at Emory University, “the key thing is to get as many students, faculty, and staff vaccinated before the fall semester, because everything is going to hinge on that.”
Colleges cannot make vaccination mandatory right now, some lawyers advise, because the vaccines are not yet available to all and are under federal emergency-use authorization. Some public-health experts expect full FDA authorization in late spring or early summer, however, and lawyers say that will change the legal context for vaccination mandates. Already, more than three dozen colleges have announced that they will require Covid vaccination for enrollment this fall, among them Brown University, Cornell University, Fort Lewis College, Nova Southeastern University, and Rutgers University. As with shots for measles, mumps, and rubella, there will be some religious and medical exemptions.
“Best estimates,” says Michael Deichen, associate vice president for student health services at the University of Central Florida, “are that a very large number of students will not get vaccinated if it remains voluntary. In order for campuses to return to a new normal, vaccine requirements will likely be necessary.” He points out that young adults are a major driver of the broader population spread. “Vaccine requirements for college students would therefore also be a terrific step toward achieving herd immunity in the U.S. and finally subduing Covid-19.”
Ezekiel J. Emanuel, vice provost of global initiatives and a professor of medical ethics and health policy at the University of Pennsylvania, argues in a recent New York Times op-ed that “all colleges and school districts should mandate that students who are authorized to receive Covid-19 vaccines get them.”
Daryl Lowe, a lawyer who is the associate vice president for student affairs at Spelman College, an HBCU for women, questions whether it is “within the scope of any institution to incentivize or encourage vaccinations. Especially if a student were to have an adverse reaction, how far could liability potentially extend to the institution?”
He would also be reluctant to pressure scared students to get the shot given some racist, exploitative medical practices, like the Tuskegee syphilis study, in America’s history, and continued health disparities today. (He emphasizes that these are his opinions and not official stances on the part of Spelman.)
Lawmakers, mostly Republicans, in almost half the states have proposed bills that would prohibit requiring vaccines of workers, saying that should be a matter of personal choice.
Legal analysts say those state bills might face court challenges if they pass, because they conflict with employers’ responsibility to keep workplaces safe. Such laws probably wouldn’t prevent private colleges from eventually requiring vaccination, but they could pose legal conundrums for public colleges. Those usually follow local, state, and CDC health guidelines, says Scott Schneider, a partner with the law firm Husch Blackwell.
But whether they concern vaccination, mask-wearing, or other policies, what happens when state and CDC guidelines conflict? That, he says, is a gray area.
In Iowa, where the governor has taken a position against so-called vaccine passports, the president of the Board of Regents announced that students at the state’s three public universities will not be required to have been vaccinated to attend classes on campus in the fall. However, he said, “We continue to strongly encourage members of our campus community to get vaccinated.”
On March 10, Texas’s governor, Greg Abbott, rescinded the state’s mask mandate and announced Texas was open for business at 100-percent capacity. Texas Tech University is continuing to require masks, bolstered by an emergency resolution by the student senate in support of them for the spring. But its president, Lawrence Schovanec, has announced that the university plans to operate at normal capacity in classrooms this fall.
And what if, come fall, the Centers for Disease Control and Prevention is still recommending Covid-19 policies more restrictive than the state’s? “We will follow the advice of the CDC and local public-health experts with respect to the use of masks in our classrooms and hygienic practices,” Schovanec wrote in his memos about Texas Tech’s fall plans. Asked about CDC guidelines about distancing in classrooms that differ from the state’s, though, he said, “In many classrooms, you would not see that observed.”
Hailyn Chen, a co-managing partner in the law firm Munger, Tolles, and Olson, says that “some public institutions are creations of their state’s constitution and so enjoy so-called constitutional autonomy from the state legislature on all matters except for financial and budgetary oversight. That is the case with the University of California.” Then again, public colleges in those states may still have to comply with state laws if those are tied to crucial funding, she says.
“Ultimately, it will depend on how broad each state’s rules are,” says Derin B. Dickerson, a partner with the law firm Alston and Bird. “Each state can decide to include or exclude public colleges from the reach of any vaccine mandates or prohibitions on vaccine mandates.”
For all the political eddies swirling around the topic, remember, says Edward M. Cramp, a partner at the law firm Duane Morris, if there is, in some situations, legal risk to mandating vaccines, there’s also risk in not doing so. No college wants to be the test case if a student or employee falls ill or dies because vaccination rates on that campus are low. Nor does any college want the competitive disadvantage of negative publicity should they become known as a Covid hot spot.
Huey, of ACHA, says it’s key to get as many students as possible vaccinated before that “mass-migration event” of returning home for the summer so that they don’t spread the virus. In early March, the association announced that it had entered a $2-million collaborative agreement with the CDC “to address vaccine hesitancy, increase vaccination visibility, and combat vaccine misinformation in campus communities. The project will include development and dissemination of a vaccine confidence toolkit for faculty and staff, a social media toolkit, and a national student social-media campaign.” ACHA is working with student-affairs, college-leadership, intercollegiate athletics, state-government, and other organizations.
At the University of North Carolina at Greensboro, vaccinated students can enter a lottery to win a meal plan, a textbook scholarship, or even a grand prize of free housing for the academic year.
Corey Hébert, the chief medical officer at Dillard University, an HBCU in New Orleans, says he appeals to students’ sense of community responsibility and their visions of restored normalcy to encourage them to get vaccinated, just as he does for masking, distancing, and Covid-testing.
The City University of New York has begun a #VaxUpCUNY campaign that includes a video from Sandra Lindsay, an alumna of the university’s nursing program and the first person in the United States to receive a Covid vaccination. “The virus does not discriminate,” she says in the video. “I am seeing too many minorities die as we’re disproportionately affected — two to three times more than our white counterparts. Covid affects young people, people with no comorbidities. Our best defense forward is a vaccination. This is the only thing that will get us out of this dark time and preserve life.”
Health experts are trained not to make assumptions about why someone might hesitate to get vaccinated, Huey explains in an interview with The Chronicle. “The key,” he says, “is to ask the person, ‘What are you concerned about? And let’s talk about it.’”
“You build your vaccination pool one person at a time,” he says. Skeptics are just that — they haven’t dug in their heels — and “there are a large number of people who are in the wait-and-see category.”
The clock is ticking, and the more people who are vaccinated, and the sooner they are vaccinated, the less chance that runaway coronavirus variants will assert themselves. The more cases you have, Huey says, the more opportunity the virus has to mutate into faster, more infectious strains.
James Giordano, a professor of neurology and a bioethicist at Georgetown University, says colleges have to strike a balance between maintaining the public good on their campuses and respecting autonomy. Effective, efficient Covid policies, he says, don’t necessarily require a vaccine mandate. Rather, they might spell out what will and won’t be available to those who are not vaccinated. Maybe those who aren’t vaccinated will need to live in a separate residence area, or attend classes remotely — at least if there is a campus outbreak. Maybe they will be required to wear an N-95 mask even when masking policies over all have been relaxed.
But Anna Gonzalez, vice president for student affairs and dean of students at Harvey Mudd College, sees problems with the separation of unvaccinated students.
“While some schools are talking about separating students into residence halls of who will be vaccinated and who won’t be,” she says, “we believe that this will be a serious violation of HIPAA in terms of outing someone’s medical record by virtue of where they live. It may also cause some serious ‘shaming’ of students, faculty, and staff in terms of people making assumptions about the reasons people have for not being vaccinated.”
What would be best, administrators agree, is if voluntary-vaccination rates are so high that these problems don’t arise and colleges don’t have to go down legal rabbit holes to keep their campuses safe.
Amir St. Clair, associate vice president and executive director for Covid-19 response and recovery at Emory University, says that surveys of the university’s faculty and staff members show that about 80 percent plan to get vaccinated.
Robert Turner Schooley, a professor of infectious diseases and a key architect of the University of California at San Diego’s Covid-management program, acknowledges possible complications but hopes they won’t arise.
“These vaccines are so damned good,” he says, “it’s very hard to imagine why everyone in the country wouldn’t want to be vaccinated.”
Francie Diep contributed to this article, which was adapted from a new Chronicle special report, Reopening Campus: Strategies for Safety and Success. You can purchase the report here .