Will schools and day cares mandate COVID vaccines or masks for fall 2021 back to school?

Most of the country's schools and day cares are preparing to reopen this fall for fully in-person instruction and care, if they haven't done so already.

But will children and teachers be required to wear masks, with the delta variant of COVID-19 spreading and vaccination rates stagnating? For that matter, can kids and teachers be required to get the vaccine?

We rounded up the basic rules around masks, social distancing and vaccinations. Details can vary significantly between school districts and states, and the guidelines are changing, but here's what we know now.

Will kids have to wear masks in school?

As of late July, the Centers for Disease Control and Prevention recommends mask-wearing among all students, staff and teachers to protect children who aren’t yet eligible for the vaccines. The new guidance marks a significant shift from recommendations issued earlier in the month that said masks weren’t necessary for vaccinated students and employees.

The change was prompted in part by spread of the delta variant of COVID-19, which is more transmissible than the original virus, and stagnant vaccination rates. Serious COVID-related illness among children is rare, but cases have spiked over the summer as the delta variant has taken over.

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States and districts were already making decisions about in-school protocols on their own before the latest guidance was issued. As a result, existing policies vary widely depending on where families live and are constantly changing.

In Maryland, Gov. Larry Hogan in June said children should not have to wear masks or socially distance in schools this fall because the state's virus positivity rates dropped so low. In early August, despite a spike in new infections, Hogan maintained he would not reinstate a statewide mask mandate. In Massachusetts, students won’t have to wear masks in school as things stand now. But a group of Democratic lawmakers recently wrote a letter urging Gov. Charlie Baker, also a Democrat, to reinstate an indoor mask requirement for “students and staff alike” at schools and child care centers.

Louisiana Gov. John Bel Edwards reinstated a statewide indoor mask mandate, including for K-12 schools and colleges, on Aug. 2.

Several large districts, including Chicago Public Schools and Atlanta Public Schools, said shortly before the CDC’s latest announcement that they will require masks when classrooms reopen. Schools in Kansas City, Missouri, are likely to follow suit amid a surge in COVID-19 cases, despite earlier plans to lift its mask mandate for vaccinated students. In Washington state, health department officials said all students and teachers will be required to wear masks in classrooms this fall.

Washington, D.C. staff, students and visitors must wear masks and socially distance in schools this fall.

Confusion reigns in other places, such as New York, which has not yet issued guidance about masks in schools this fall.

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Kindergarten students wear masks and are socially distanced during in-school class at Concord Road Elementary School in Ardsley, New York, on Tuesday, December 1, 2020.
Kindergarten students wear masks and are socially distanced during in-school class at Concord Road Elementary School in Ardsley, New York, on Tuesday, December 1, 2020.

Do kids have to wear masks in day care?

The latest CDC guidance doesn’t include specific recommendations for day care centers. But even after child care providers are vaccinated, COVID-19 restrictions are likely to continue in some fashion.

Right now, the agency recommends children 2 and older should wear masks indoors, except when they're eating or sleeping. But mask requirements – including age thresholds – are typically dictated by local and state health departments and vary widely based on geography.

In states such as Kentucky, Massachusetts and North Carolina, children younger than 5 are exempt from mask mandates.

Regardless of adults’ vaccination status, the CDC warned earlier this year, “there will be a need to continue prevention measures for the foreseeable future including wearing masks, physical distancing, and other important prevention strategies.”

Other recommended strategies include ventilation, limiting nonessential visitors, temperature and symptom checks, staggered scheduling for pickup or dropoff and grouping children in cohorts.

Babies and children under 2 should never wear a face covering because of the risk of suffocation, notes Kim Kruckel, the executive director of the California-based Child Care Law Center.

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Can schools mandate students get the vaccine for COVID-19?

Generally speaking, private institutions, including day cares, can decide whether to require students to be vaccinated against COVID-19 as a prerequisite for enrollment. But vaccines have yet to be approved for children younger than 12.

For school districts, vaccine requirements are largely left up to states, but none have yet required children to receive the COVID-19 vaccine to reenter school, according to the National Conference of State Legislatures. In fact, at least seven states have passed laws prohibiting schools from requiring students to be vaccinated – or show proof of vaccination – against COVID-19, according to a recent CNN analysis. Those states include Alabama, Arkansas, Florida, Indiana, Montana, Oklahoma and Utah.

As of late July, 27% of 12- to 15-year-olds and 39% of 16- and 17-year-olds were fully vaccinated, CDC data show.

Just under two-thirds of parents plan to vaccinate all their children, and 27% don't plan to vaccinate any of their children against COVID-19, according to a survey in May by the COVID Collaborative, Ad Council and the Council of the Great City Schools.

However, about 75% of respondents said they'd be more likely to vaccinate their children if it was required by schools.

Children under 12 likely won’t be eligible for the vaccines until the end of this year at the earliest. And parents are split over whether they’ll have their young children vaccinated. In a survey by the University of Michigan, 49% of parents with children ages 3 through 11 said they’d get likely get their child vaccinated, while 51% said they likely wouldn’t.

Can schools and day cares require teachers to be vaccinated?

Employers such as schools, both public and private, have the right to require vaccination as a condition of employment – even before the vaccines are fully approved by the Food and Drug Administration, according to a memo issued by the U.S. Justice Department in early July. The law that allows for the use of unapproved medical products such as vaccines in public health emergencies only requires that certain information be provided to potential recipients, the department concluded. The law doesn’t prohibit entities from mandating vaccination.

But schools generally have refrained from requiring employees to get vaccinated against COVID-19, partly because the vaccines are still being distributed under an emergency use authorization.

"When final approval is issued, and vaccines are accessible, I think that the question is going to be when to mandate the COVID-19 vaccine, and how to uphold that mandate in a consistent way," said John Comegno, an attorney in New Jersey who specializes in education law.

One major network of charter schools in New York City – Success Academy, which serves about 20,000 children in 47 schools – in February became one of the first to require staff to be vaccinated. Charter schools are publicly funded but managed by private companies, so they have more flexibility than traditional public schools.

Since then, Public Prep, a smaller New York City charter network with four schools, has required staff to be vaccinated by the start of the fall term.

The Centers for Disease Control and Prevention expanded emergency-use authorization in kids ages 12 to 15 on May 12.
The Centers for Disease Control and Prevention expanded emergency-use authorization in kids ages 12 to 15 on May 12.

How many teachers are vaccinated?

There's little current national data on how many educators are fully vaccinated, in part because many districts aren’t tracking staff immunization rates. As of late March, the Centers for Disease Control and Prevention estimated 80% of teachers, school staff and child care workers had received at least one COVID-19 vaccine dose.

But a different national survey launched by President Joe Biden's administration to provide a monthly snapshot of school reopening suggests that CDC estimate is overly optimistic. More than half of elementary and middle schools reported they don't know how many of their teachers are vaccinated, the survey showed. Two states – Utah and Montana – refused to participate in the question.

There's no national data on vaccination rates among early childhood education staff. However, a survey conducted in March by the CDC indicated vaccination rates among preschool workers mirrored that of the general adult population, with younger respondents more likely to express hesitancy, according to Nikki Garro, director of early childhood health programs at Child Care Aware of America.

Can parents or schools ask teachers if they're vaccinated?

Schools can ask teachers if they're vaccinated, but the teacher doesn't have to answer. Schools cannot ask employees why they haven't gotten vaccinated, as that question could be a violation of the Americans with Disabilities Act, which protects employees from having to share information about their disability with their employers.

State and local privacy laws keep schools from sharing with parents information about a specific teacher's vaccination status. But schools can release information about aggregate staff vaccination rates, according to Education Week magazine.

A parent can legally ask individual teachers if they're vaccinated. But again, the teacher doesn't have to answer.

"Anyone can refuse to answer the question, but they should be prepared to be treated as if they are unvaccinated," wrote Sarah Whitley Coles, a University of Arizona College of Medicine professor, in Dear Pandemic, a website and newsletter that offers family-friendly medical advice.

What protocols will parents have to follow?

The protocols vary by locale and institution. However, the CDC recommends moving school pickup and dropoff to outside the building as a means to limit the spread of the coronavirus that causes COVID-19. This practice is very common, according to Garro, of Child Care Aware.

The new CDC guidance recommends schools require all visitors to wear masks indoors. It also advises schools to limit the number of nonessential visitors and volunteers on campus. School activities involving adults who are not fully vaccinated should be avoided, particularly in areas with moderate-to-high COVID-19 transmission, the guidance says.

Rebecca Beebe drops her 5-year-old son, Truman, off at child care at University Avenue Discovery Center in Madison, Wis., on Aug. 13.
Rebecca Beebe drops her 5-year-old son, Truman, off at child care at University Avenue Discovery Center in Madison, Wis., on Aug. 13.

What kinds of incentives are schools offering to encourage vaccinations?

Letting teens skip class to get vaccinated is a common strategy, in use in places such as Hartford, Connecticut. Arkansas is encouraging school districts to use American Rescue Plan money to hold on-site vaccination clinics for students, excusing their absences if they're getting a shot. Some districts are also tapping "youth ambassadors" to encourage their peers to get their shots.

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In Washington, Spokane Public Schools in June offered extra graduation tickets to vaccinated parents, according to the Spokesman-Review. In Joplin, Missouri, the Board of Education in late July approved a voluntary program that would give $25 to each vaccinated school district employee or substitute teacher. Employees also have the chance to win an additional $2,500. The program runs through mid-September.

Throughout June – which President Biden declared the National Month of Action for COVID-19 Vaccinations – several large early-childhood education providers provided free child care to parents and caregivers getting or recovering from their shots. While vaccinations are free, many parents have cited child care as a reason for not taking advantage of the opportunity.

The U.S. Department of Health and Human Services has issued guidance encouraging states to use their American Rescue Plan money to provide financial incentives such as bonuses to child care providers that offer extended hours or weekend services so parents can get vaccinated. Such incentives are considered "quality expenditures," according to the department.

Visit vaccines.gov/incentives for more information.

Early childhood education coverage at USA TODAY is made possible in part by a grant from Save the Children. Save the Children does not provide editorial input.

Contact Erin Richards at (414) 207-3145 or erin.richards@usatoday.com. Follow her on Twitter at @emrichards.

Contact Alia Wong at (202) 507-2256 or awong@usatoday.com. Follow her on Twitter at @aliaemily.

This article originally appeared on USA TODAY: Back to school: Mask, COVID-19 vaccine requirements and guidance