{"id":10090,"date":"2021-05-03T10:35:48","date_gmt":"2021-05-03T14:35:48","guid":{"rendered":"https:\/\/blogs.nejm.org\/hiv-id-observations\/?p=10090"},"modified":"2021-05-03T10:35:48","modified_gmt":"2021-05-03T14:35:48","slug":"some-colleges-require-covid-19-vaccination-why-dont-they-all","status":"publish","type":"post","link":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/some-colleges-require-covid-19-vaccination-why-dont-they-all\/2021\/05\/03\/","title":{"rendered":"Some Colleges Require COVID-19 Vaccination — Why Don’t They All?"},"content":{"rendered":"
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Horse Feathers, 1932. Paramount Pictures.<\/p><\/div>\n

Each time a college announces that it requires that students be immunized for COVID-19 to attend in-person classes or to live on campus, I do a little cheer. Sometimes it’s accompanied by a happy dance — especially when it’s right in my neighborhood.<\/a><\/p>\n

Why?<\/p>\n

Because ever since the pandemic started, carefully done epidemiologic studies consistently show that older teens and young adults have the highest incidence of infection.<\/a><\/p>\n

This fact might be counterintuitive, since older people bear the disproportionate share of severe disease. As a result, the media quite regularly gets it wrong, by reporting each time when cases surge anew that “this time it’s different — it’s young adults.”<\/p>\n

Nope. It’s always<\/em> been younger adults. They just don’t get as sick. And during the first wave in early 2020, with testing severely limited, we could only test the sickest people — sometimes only those who came to the hospital. Infections in younger people went undiagnosed, since most cases were mild or asymptomatic.<\/p>\n

But three key points about COVID-19 in young people should strongly favor mandatory college immunization. First, some<\/em> young adults get quite sick indeed. Some have lengthy post-COVID symptoms that keep them out of school or work for weeks or months. Some get hospitalized<\/a>. Some even die, with tragically so many years of life lost.<\/p>\n

Second, outbreaks on college campuses can be large, disruptive, and enormously resource-intensive to control.<\/a> The testing and infection control protocols vary from school to school, but all are costly in both time and dollars.<\/p>\n

Finally, young adults with COVID-19 play a key role in perpetuating the epidemic. Mild disease is still contagious, of course, and communities with in-person higher education experienced an increase in COVID-19 incidence<\/a>, suggesting that infections in students lead to transmissions both on campus and off.<\/p>\n

Indeed, vaccinating college students may be a critical strategy in bringing the pandemic under control. Health economist Dr. Zoe McLaren summarized this benefit nicely in this thread:<\/p>\n

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Young people have a lot more power to end the pandemic than they might realize. Some modeling studies actually show that, under certain conditions, high vaccination rates of people 16-24 could end the pandemic more quickly than vaccinating the vulnerable. 5\/8<\/p>\n

— Zo\u00eb McLaren, Ph.D. (@ZoeMcLaren) March 21, 2021<\/a><\/p><\/blockquote>\n