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States, not the CDC, set requirements for school vaccines

The CDC's early coronavirus test was poorly designed and it also came with problematic instructions, NPR has learned.
Jessica McGowan
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The CDC's early coronavirus test was poorly designed and it also came with problematic instructions, NPR has learned.

A Centers for Disease Control and Prevention advisory committee on Thursday that the agency should its recommended to add the COVID-19 vaccine, including to the schedule for children.

But in the lead-up to the vote by the Advisory Committee on Immunization Practices, false claims spread widely that it would mean the vaccine would be required to attend school.

However, the CDC doesn鈥檛 have the authority to set school immunization requirements, and the vote doesn鈥檛 mandate the vaccine for schoolchildren. That鈥檚 a decision left to the states.

The claim gained momentum after it was shared by Fox News host Tucker Carlson this week.

鈥淭he CDC is about to add the COVID vaccine to the childhood immunization schedule, which would make the vax mandatory for kids to attend school,鈥 Carlson tweeted on Tuesday night. The tweet included a segment from his show in which he began by making the same claim.

Another popular tweet similarly claimed the CDC committee鈥檚 vote would make the vaccine 鈥渕andatory for school registration.鈥

But the public health agency doesn鈥檛 determine school vaccine requirements.

鈥淪tates have the authority to enact state laws requiring vaccination, not the CDC,鈥 said Wendy Mariner, a professor emerita of health law, ethics and human rights at Boston University. 鈥淎CIP has no authority to make law.鈥

CDC spokesperson Kate Grusich told The Associated Press in an email that the agency 鈥渙nly makes recommendations for use of vaccines, while school-entry vaccination requirements are determined by state or local jurisdictions.鈥

Grusich explained that the action was meant to streamline clinical guidance for health care providers by adding COVID-19 vaccines to a single list of all currently licensed, authorized and routinely recommended vaccines.

鈥淚t鈥檚 important to note that there are no changes in COVID-19 vaccine policy,鈥 she said.

The immunization practices advisory committee is a body of experts that makes recommendations to the CDC about vaccines. Its recommendation to update the schedules, which included other revisions, still needs to be formally adopted by the agency and the amended schedules wouldn鈥檛 take effect until 2023, Grusich said.

Fox News referred the AP to a follow-up segment by Carlson on Wednesday night, in which he revisited the topic and claimed 鈥渕ore than a dozen states follow the CDC鈥檚 immunization schedule to set vaccination requirements 鈥 not suggestions, requirements 鈥 for children to be educated.鈥

For example, the Virginia Department of Health states that "vaccines must be administered in accordance with the CDC鈥檚 schedule,鈥欌 he stated. He cited Massachusetts as another example.

But those states do not list every vaccine from the schedule in their school requirements.

Virginia, for example, the annual flu vaccine in order to attend school 鈥 even though the vaccine appears on the CDC鈥檚 . Nor does .

A Virginia Department of Health spokesperson, Maria Reppas, said in an email that there "is no direct, immediate impact on COVID-19 vaccine being added to the immunization schedule on school-required vaccines in Virginia." Reppas said changes to the school requirements would need legislative or regulatory action.

Dr. William Schaffner, a vaccine policy expert and professor of infectious diseases at Vanderbilt University Medical Center, said he was not aware of any states that automatically require all vaccines on the schedule for school.

鈥淭hose are recommendations that go to pediatricians and family doctors as they care for children,鈥 Schaffner said. 鈥淭hey鈥檙e just recommendations, there are no automatic mandates that follow.鈥

There has also been reluctance by many states to require the human papillomavirus, or HPV, vaccine, even though it appears on the childhood schedule, Schaffner said.

States can use legislation to require specific vaccines or can authorize a state agency or local health entity to require specific vaccines for certain age groups, Mariner said. She added that some states include private schools when establishing requirements, though in other cases, private schools may also voluntarily require vaccinations.
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