Last week, Minnesota received its first shipments of COVID-19 vaccine. Health care workers and those living and working in long-term care have already begun receiving their first of two doses — a priming dose, to be followed by a booster shot.
The rollout comes on the heels of a major shift in the local public education sector. As COVID-19 infection rates soared across the state and schools struggled to stay fully staffed, most districts that had started the year with at least some level of in-person learning transitioned to a remote-only format before Thanksgiving weekend.
For elementary educators and students, however, a return to in-person learning may not be all that far out. Gov. Tim Walz recently updated the state’s Safe Learning Plan, encouraging all elementary schools that are able to meet specific safety protocols — now including providing and requiring staff to wear face shields, in addition to masks — to return to a fully in-person format.
“The best place for our students to learn is in the classroom. For our youngest learners, in-person learning is critical for their health and development in both the short and long term,” Lt. Gov. Peggy Flanagan said in a press release Wednesday.
For instance, St. Paul Public Schools, which has been operating in a distance-only format since the start of the school year, recently announced that it plans to allow all pre-K through second-grade students return to full-time in-person learning beginning Feb. 1.
Given the delays in COVID-19 vaccine distribution — combined with the fact that even the current supply falls far short of the amount needed to vaccinate all health care workers and long-term care residents and workers in Minnesota — it’s clear that many teachers won’t have access to a COVID-19 vaccine prior to a return to in-person learning.
On Friday, MinnPost connected with Kris Ehresmann, the state Department of Health’s infectious disease director, to ask about the short- and long-term vaccination plan for schools. Here’s what we know so far.
When will the vaccine be made available to educators?
On Sunday, a federal advisory committee to the Centers for Disease Control and Prevention decided on guidance for the continued rollout of the COVID-19 vaccine. Those next in line include people ages 75 and older and frontline essential workers.
The Advisory Committee on Immunization Practices recommends including teachers in this next batch of essential workers, along with police officers, fire fighters, grocery store workers, and a few more categories — all deemed essential to keeping communities running.
Individual states have been left with the task of sorting out the more granular details of this next phase of the vaccine rollout. In Minnesota, a vaccine allocation workgroup will begin to iron out the details the week after Christmas, says Ehresmann.
“What we’re finding is we’re not getting as much vaccine as we want and need. So really what this is all predicated on is: How much vaccine becomes available?” she said, noting they have to finish vaccinating health care workers and long-term care residents and workers first.
Offering a cautious timeline, she said essential workers included in the ACIP’s phase 1b recommendation will likely start the vaccination process in February or March.
How, exactly, will that rollout look?
The distribution process for educators and school staff in Minnesota will vary from one district to another. Some districts may lean heavily on their school nurses, says Ehresmann. While others, she adds, may opt to set up some stand-alone clinics to aid in the administration of the vaccine, or decide on a different system.
The timeline remains a bit unclear at this point, as the state’s vaccine allocation workgroup still needs to decide where educators fall in line, within the essential workers category.
There is clarity around one important detail, though: school staff (not just teachers) are included in this next phase. That’s what Ehresmann had anticipated, given the guidance for health care worker vaccine distribution.
“With the guidance for health care workers, it is not just licensed providers. It is the dietary aids, the housekeeping — it’s everyone,” she said. “And, certainly, if we look at our data, we’ve seen transmission to the nutrition service people, the bus drivers, that type of thing.”
When will children have access to a vaccine?
The Pfizer COVID-19 vaccine has been approved for ages 16 and up; and the Moderna vaccine is approved for ages 18 and older. That means a good portion of high school students are already eligible to receive it.
Ehresmann sits on the national vaccine advisory committee that’s tasked with deciding how to proceed with making the vaccine available to younger children. “It’s a balancing act between we want kids to be vaccinated, we want kids to be in school, we want kids to have those normal necessary developmental experiences. But kids are not just little adults. And so there’s different considerations when you’re doing a clinical trial,” she said. “You want to take special care with children.”
Pfizer expanded its COVID-19 vaccine testing to children ages 12 and older in October. Moderna followed suit earlier this month. But no one is saying with any certainty, at this point, that the vaccine will be approved for children ahead of the next school year.
What does this all mean for a safe return to in-person learning?
Since children make up a large portion of the school population, the approach to protecting school communities will look different from the way it does for protecting long-term care facilities or other adult-based communities. As more and more adults in the greater community get vaccinated, though, school becomes safer for children. If you reduce ongoing community transmission and everyone benefits, including children.
“We do know that, even now, with many of the vaccines we have for which we have really tamped down transmission — like measles and things like that — there are some people who are not vaccinated,” Ehresmann said, noting some people can’t be vaccinated for medical reasons. “Yet they have the protection of the community around them.”
Additionally, educators will soon have the option to get vaccinated. It’s a game-changer, in terms of being able to staff for in-person learning. But it doesn’t cancel out the need to continue practicing all of the other safety measures — the social distancing, the sanitization, the face masks.
Denise Specht, president of Education Minnesota, warns against throwing caution to the wind, once educators begin to receive the vaccine. “The vaccine is important; and I do hope a lot of people consider taking it. But it won’t do the trick right off the bat. We’re in this for a long time,” she said.
Could the vaccine be mandated for school employees?
Both the Pfizer and Moderna COVID-19 vaccines have been approved under Emergency Use Authorization. Under this status, vaccination cannot be mandated. Once these vaccines receive approval from the U.S. Food and Drug Administration, however, that has the potential to change.
Asked about the possibility of a mandate for school employees, Specht said that’s the sort of thing that would have to be negotiated at a local level. If schools look to make immunization a condition of employment — or even just in-person teaching — at some point in the future, that’s something that would need to be bargained. And the present lack of information about how the vaccination impacts pregnant women is an area of particular concern, when it comes to mandating a vaccine. “That’s one thing we’re going to pay attention to — the impact on a predominantly female profession,” Specht said.
MinnPost reached out to the state Department of Employment and Economic Development, asking about the possibility of a future COVID-19 vaccine mandate for school employees, but did not hear back by deadline.
What about students? Could it be added to the list of mandated school immunizations?
Minnesota has a School Immunization Law, which requires all students enrolled in grades kindergarten through 12 to show they have received immunizations for five different infectious diseases: Polio; Diphtheria, tetanus, pertussis (DTaP); Measles, mumps, rubella (MMR); Hepatitis B (Hep B); and Varicella (chickenpox).
Ehresmann says a mandate for the new vaccine is not even under consideration, given its current Emergency Use Authorization status. Asked how it stacks up against those currently included in the School Immunization Law, she pointed to a couple of considerations. First, COVID-19 has been linked to a multisystem inflammatory syndrome in children. “That certainly is an issue. And we’ve seen a lot of that in Minnesota,” she said.
Second, we still don’t know a whole lot about the longer-term consequences and biological effects of the virus, especially in those who experienced very mild symptoms. This applies to children, as they generally have milder symptoms. “I think all of that will help to inform what kind of a decision gets made related to vaccinations for schools,” she said.
When it comes to mandated school vaccines, parents can apply for an exemption for both medical reasons and non-medical reasons, including their beliefs. During the 2018-2019 school year, for instance, 3.5 percent of Minnesota kindergarteners had a non-medical chickenpox vaccine exemption and 3.4 percent had a non-medical MMR vaccine exemption.
If the FDA approved a COVID-19 vaccine, state health officials would still need to review health data to determine how necessary a vaccine mandate for schools would be, Ehresmann said. And a whole host of consideration would need to be factored in: the epidemiology of the disease, the effectiveness of the vaccines, the impact in the school population, the transmission that occurs within not just an age group, but also in the school setting, and more.
In general, we haven’t seen the same level of infectiousness that we’ve seen with measles, she explained. But it’s still very infectious — and one more factor that experts will continue to monitor as they made long-term decisions around vaccinations.
“If we have good control of the virus in the community without it — and we don’t see problems in schools — all of that is a really important part of informing a decision like that,” she said, reiterating “it’s too early to project what would happen.”