As the supply of Covid-19 vaccines begins to widen toward meeting the immense demand, some observers have proposed that policy makers put college students close to the top of the list.
Christopher R. Marsicano, head of the College Crisis Initiative at Davidson College, argued in a recent op-ed that vaccinating college students would help protect everyone. “The broader principle in administering vaccine shots equitably is to diminish the risk for those who are most at danger to spread the virus,” he wrote. “Vaccinating college students is an effective way to lower that danger, for two major reasons: College students are mobile and spread Covid-19 with them whenever they travel, and they live in congregate living facilities where infection rates are much higher than in other housing setups.”
Ohio’s governor seemed to reference that idea in saying on Monday that the state would work with its colleges to ensure all students would be vaccinated before leaving for summer break (all residents over the age of 16 are currently eligible). An Ohio news outlet reported that Gov. Mike DeWine said “college students are high in capability to spread,” adding that “this is a big concern that we have for that whole age group.”
Experts contacted by The Chronicle were mixed on whether policies that prioritized college students would be good for public health.
The American College Health Association, which has pushed for college students to receive vaccines before the end of the spring term to prevent them from spreading the coronavirus as they disperse over the summer, is now advocating for an even earlier timeline, assuming there are ample doses available.
“If we have adequate vaccine in April, it seems that, given what we have seen over spring break, that it is a very reasonable request that states expand that eligibility to allow college students to get vaccines,” said Anita Barkin, co-chair of the association’s Covid-19 Task Force.
Other experts, however, warn that more progress needs to be made on vaccinating more-vulnerable populations before college students who are not otherwise eligible — because of their health conditions or work — get their shot.
David Michaels, a professor at George Washington University’s school of public health who served on the Biden administration’s Covid-19 advisory board during the presidential transition, pointed to national data indicating that more than one in four adults in the United States over the age of 65 have not yet received a single shot of any vaccine.
“Many states have essentially abandoned the additional efforts necessary to get these older people vaccinated, and they’re most at risk for serious illness and death,” he said. Seniors may need help navigating online appointment-making systems, or getting transportation to vaccination sites. Some people who are already eligible may be hesitant to get the vaccine, and states should focus on changing some of their minds, Michaels said.
The known benefits of directly protecting vulnerable people outweigh those of indirectly protecting them through immunizing less at-risk community members, said R. Alta Charo, professor emerita of law and bioethics at the University of Wisconsin at Madison. “While the data is showing good signs of reduced spread by vaccinated individuals, that data is still not as robust as the data demonstrating personal protection from being vaccinated,” she wrote in an email. Meanwhile, for high-risk individuals — “until they are vaccinated, they have limited ways to protect themselves.”
“Once we have more vaccine available, which should be very soon, it’s reasonable to vaccinate college students, especially ones who are returning to multigenerational families, and colleges should certainly do this,” Michaels said. “But right now, I’d like to see the states focused on older people, people with comorbidities, and essential workers.”
Rebecca L. Smith, an associate professor of pathobiology who works on the University of Illinois at Urbana-Champaign’s testing strategy, also advocates for ensuring more-vulnerable people get vaccines before college students. “Personally, I would much rather see the vaccines go to those marginalized communities who are put at risk because of systematic issues in access to health care, as well as their work requiring them to be in person and in contact with other people,” she said. “It’s about protecting the people who have less choice about being high risk for infection.”
Once the major vulnerable groups have been well vaccinated, then there may be room for debate over who’s next, should a lack of supply require it. Smith advocated for jurisdictions to use sophisticated models that can predict the chain effects of vaccinating one group over another to help them decide. It could be that vaccinating college students does have greater effects, societywide, than reaching some other groups with moderate risks, but Smith wasn’t comfortable making those calls without modeling data.
Higher-risk populations don’t need to be 100-percent vaccinated before jurisdictions move on to college students, said Michaels. After all, there may be some people who refuse the vaccine. But officials need to have made serious efforts to reach as many top-priority people as possible. “I don’t think we’re at that point,” Michaels said.
The debate over whether college students should be prioritized right now may become moot. If it takes colleges weeks to prepare a mass-vaccination campaign, by that time, there may be enough shots available that officials don’t need to make difficult choices. Experts that The Chronicle talked to generally supported the idea of getting shots in college students’ arms before they travel for the summer.
