Colleges must require vaccination

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Note: This editorial appeared in Science on Aug. 27, 2021.

This week, the US Food and Drug Administration (FDA) granted full approval to the Pfizer-BioNTech coronavirus vaccine for individuals 16 years and older. This milestone decision, the first full approval of a vaccine for COVID-19, will almost certainly clear a path for businesses, hospitals, and government agencies that have not already done so to adopt vaccine mandates for their employees. For colleges and universities that have been on the fence about requiring the vaccine, the FDA's decision may be especially welcome news.

As of earlier this week, 753 campuses require the vaccination. According to a map from the Chronicle of Higher Education, most of these schools are in "blue" states. There is no doubt that COVID-19 vaccination has become politicized. Now, with the full FDA approval, there is even less reason for the political hue of a state to deter universities, as citadels of science and reason, from making every attempt to implement vaccine mandates.

Indiana University, a public institution where I stepped down as president at the end of June, announced a COVID-19 vaccine mandate for all students, faculty, and staff in May, just as the Delta variant was starting to surge in the United States. Indiana is a "red" state, and this decision triggered one of the first legal disputes in the nation over the college vaccine mandate.

The university's public health experts were emphatic that vaccination would be the only way to ensure a return to mostly normal operations and a more typical university experience this fall. And the university's leadership viewed the mandate, which includes appropriate exemptions, as a continuation of its science- and public health–driven approach to manage the pandemic on all of its campuses throughout Indiana.

Opposition to this decision was expected, and just days after announcing the mandate, 35 state senators sent me a strongly worded letter urging the university to reconsider and rescind the mandate.

"We find ourselves on the cusp of victory over an enemy we have come to know as the novel coronavirus…," the senators wrote. "After 14 months of fighting and enduring the COVID-19 war, our state is finally returning to the path of normalcy. Regrettably, decisionmakers at Indiana University have veered away from that path."

In late June, eight students filed a lawsuit against Indiana University, alleging that the vaccine mandate violated their constitutional rights by forcing them to receive unwanted medical treatment. The following month, a federal judge decisively rejected this argument on the grounds that students, in fact, do have options—they can get vaccinated, apply for an exemption, or choose to attend another school.

Earlier this month, an appeals court unanimously upheld the judge's decision, and on 12 August, Supreme Court Justice Amy Coney Barrett denied a bid to block Indiana University's mandate. This third ruling, now from the nation's highest court, signals that similar vaccine requirements are very likely to pass legal muster.

Public data, as well as the consensus of medical and scientific opinion, indicate that the battle against COVID-19 is far from over. Vaccination rates in many areas of the United States simply are not high enough to prevent enough COVID-19 infections and transmission. In Indiana, COVID-19 case rates are the highest they have been since May, and vaccination rates languish. The highly contagious Delta variant is stoking a deadly new surge of cases, hospitalizations, and deaths, especially in places with low vaccination rates.

As the nation's top public health experts have repeatedly expressed, vaccine mandates, which continue to receive high public support, represent the best path to increase vaccination numbers to the levels necessary to defeat the virus and avoid the risk of continuing mutations and variants. The Delta variant has been bad. The next variant could be worse.

Fortunately, more universities are deciding that the situation is serious enough to require vaccine mandates. And the American College Health Association released a statement this month, which was signed by more than two dozen higher education organizations, condemning state-level restrictions that bar colleges from requiring the COVID-19 vaccine or adopting other public health measures, such as masking.

For all states—red, blue, or purple—the message is clear. Political differences must be put aside in the interest of public health and safety at the state's colleges, universities, and the communities that they serve through their vital education and research missions.