Can Colleges Make the COVID-19 Vaccine Mandatory?

In early 2020, a flood of colleges announced campus shutdowns. In early 2021, a slower but steady stream began announcing COVID-19 vaccine requirements. With fall here, more than 700 U.S. colleges, including most prestigious schools and state flagships, say students coming to campus must get a vaccine.

Most U.S. colleges already require vaccines for viral diseases like measles, mumps, and rubella. Some attorneys say universities have the same right to mandate COVID-19 vaccines, especially now that one of the three COVID-19 vaccines currently used in the U.S. has FDA approval.

For as long as the vaccines retained emergency use authorization (EUA) status, the mandates fell in a legal gray zone. Several colleges said they wouldn’t issue a mandate without full approval. However, federal agencies, including the Department of Education, permit employers to require their employees to get a COVID-19 vaccine, setting a precedent that courts have confirmed.

Eight students from Indiana University (IU) brought a lawsuit against their college arguing that the COVID-19 vaccine requirement violates their right to personal autonomy and bodily integrity and the right to reject medical treatment.

U.S. District Court Judge Damon Leichty upheld IU’s mandate, writing that beyond taking advantage of religious and medical exemptions students can choose to attend a different school. Justice Amy Coney Barrett confirmed Leichty’s decision when she threw out the IU students’ appeal to the Supreme Court.

Students cannot simply attend college elsewhere, argued a lawsuit brought by students of Rutgers University and Children’s Health Defense against the New Jersey university’s vaccine requirement. The plaintiffs asserted that most schools have the same requirement and any transfer could jeopardize degree progression. The University of Virginia disenrolled 238 students for failing to report vaccination status — the Charlottesville campus requires the vaccine or a medical or religious exemption.

While just over half of college-aged Americans were willing to get a COVID-19 vaccine last December, a spring poll found that 85% of prospective college students would attend a college that required inoculation. Amid late summer talk of variants, breakthroughs, and booster shots, colleges doubled down on COVID-19 mandates. Over the last two weeks of July, vaccination rates increased 56% nationally. Over half of college-aged people (57%) have now been vaccinated.

Despite the uptick in compliance, Americans ages 18-29 remain the least likely to want a COVID-19 vaccine. Black and Hispanic Americans also remain less likely than white Americans to have received one, raising questions about educational access and campus diversity this fall.

Politicians in 20 states so far — Alabama, Alaska, Arizona, Arkansas, Florida, Georgia, Idaho, Indiana, Iowa, Missouri, Montana, North Dakota, Ohio, Oklahoma, South Carolina, South Dakota, Tennessee, Texas, Utah, and Wyoming — have signed legislation or executive orders barring COVID-19 proof of vaccination requirements. Indiana’s attorney general said state universities may require COVID-19 vaccines but can’t force students to provide proof.

All states require colleges to accommodate students who refuse a vaccine for medical reasons. Most states — save for California, Maine, Mississippi, New York, West Virginia, and now Connecticut — also allow exemptions for religious reasons.

At least one public university system in a state that has not barred such proof of vaccination — the Ohio State University — said it will not mandate the vaccine. According to the university, students will only be asked about their vaccination status for the purpose of outbreak monitoring. Most institutions that have not mandated COVID-19 vaccines plan to incentivize students instead.

In Ohio, children ages 12-17 who received at least one COVID-19 shot were eligible to win full-ride scholarships to any of the system’s 14 campuses. And New York raffled off college scholarships to the City University of New York (CUNY) and State University of New York (SUNY) systems.

Vaccinated students have been promised prizes, greater access to events, and a pass on the mandatory COVID-19 testing that most schools plan to continue this fall. Meanwhile, some schools plan to keep unvaccinated students off campus. At Brown University, for example, students who refuse a COVID-19 vaccine must file a petition to study remotely or take a leave of absence in the fall.

Now that everyone ages 12 and older is eligible for COVID-19 vaccines, more than half of all Americans are fully vaccinated, according to the Centers for Disease Control and Prevention (CDC). This includes more than 61% of Americans ages 18 and older and more than 80% of Americans ages 65 and older.

However, as more young people receive COVID-19 vaccines, the CDC has alerted clinicians of a rare but possible connection between the mRNA vaccines (Pfizer-BioNTech and Moderna) and a heart inflammation problem, mostly among young males. Data from VAERS show that in the 30 days following a second dose of an mRNA vaccine, there was an elevated number of cases of myocarditis, or inflammation of the heart, in people ages 16-24.

Other rare but adverse reactions to the vaccines among young people include anaphylaxis, Bell’s palsy, and blood clotting. Administration of the Johnson & Johnson COVID-19 vaccine — a cornerstone of some colleges’ vaccination plans — was temporarily paused by the U.S. for 11 days in April following reports of severe blood clotting.

While the CDC quickly went back to recommending the Johnson & Johnson vaccine, the shot has been suspended in Denmark and is no longer administered to young people in Italy and Belgium. Similar health issues occurred with the AstraZeneca vaccine in Europe, leading the U.K. to advise against administering the shot to people under 30.

While researchers continue to monitor the safety and efficacy of these vaccines, the CDC strongly recommends COVID-19 vaccines for Americans 12 and older. The Biden administration is also in the process of developing a plan to offer booster shots. Additionally, Pfizer-BioNTech and Moderna are continuing to test vaccines on children and babies as young as six months.

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