State COVID Vax Mandates for Teachers Often Left Out Daycare Workers

Fewer than half of states that required COVID-19 vaccination or testing for school teachers implemented the same requirements for childcare professionals, researchers found.

As of Nov. 1, 2021, 10 states, along with Washington, D.C., issued directives that required either COVID vaccination or routine testing for teachers, while no states issued directives for childcare professionals alone, reported Walter Gilliam, PhD, of Yale School of Medicine in New Haven, Connecticut, and colleagues in a JAMA Pediatrics research letter.

The gap between the two professions suggests “an unwarranted disparity between childcare and school settings in states’ efforts to promote vaccinations,” they argued.

Gilliam and team listed several reasons why childcare professionals should be vaccinated, including a possible higher risk for COVID among staff and children in childcare settings, since very young kids are not yet eligible for the vaccine and are “possibly less adherent to non-pharmaceutical interventions,” such as masking and social distancing.

As of late last spring, childcare professionals had lower vaccination rates versus teachers (78% vs 90%, respectively), the authors pointed out. They are also more likely to be of a racial or ethnic minority and thus may be at higher risk for COVID-associated morbidity and mortality.

However, Gilliam and colleagues noted that the main limitation to their study was that there was no way to determine why some directives included childcare professionals and others did not, though they suggested this could have possibly been due to “greater political pressure” to get teachers vaccinated or due to the fact that schools are publicly funded and childcare programs are privately funded and “may not be subject to the same risks for noncompliance.”

For this study, Gilliam’s team examined official archives of executive orders for all 50 states and Washington, D.C. They found that no states passed legislation that required vaccination. While seven states offered a testing alternative to vaccination, three states required vaccination without such an alternative, they noted. New York allowed routine testing with “opt-out vaccination” if individuals did not want to be screened on a weekly basis. Six states did not specify any exemptions for vaccination, with the rest allowing medical or religious belief exemptions. No states allowed “personal belief exemptions.”

All states required formal proof of vaccination through either a CDC vaccination card or a state immunization registry rather than “personal attestation,” they added.

Gilliam and colleagues encouraged “equitable consideration” of childcare professionals in these vaccination or testing requirements, noting that “states should consider expanding directives to include childcare professionals to bridge the COVID-19 vaccination gap” between these workers and teachers.