An increasing number of school district leaders are setting up creative partnerships to vaccinate teachers and staff—and now some are pressing local health officials to let them expand to the community at large.
Sprawl, gentrification, and cycles of disinvestment have led to markedly different access to drug stores, supermarkets, and medical facilities across the United States, but nearly all communities still have schools, the leaders note. Centrally located and often at walkable distances for most residents, schools have the potential to serve as powerful vaccination hubs.
It’s unclear how many of the nation’s school districts currently host on-site vaccinations. Partly that’s a function of how much vaccine each state has received and where teachers and other school personnel fall on their tiered plans for rolling out vaccinations.
But if the idea picks up traction, it could increase public confidence in the COVID-19 vaccines and potentially also help prioritize communities that have been hardest hit by the virus—and face the most hurdles in access to vaccinations.
“What’s the one thing more Americans do together every year than anything else? Vote. And where do most people vote? At schools,” noted Austin Beutner, the superintendent of the Los Angeles Unified School District, who is pushing hard to situate vaccination clinics in some of its more than 1,000 schools. “We’re in the neighborhood. We’re the only civic institution that, by design, is located in communities. Even McDonald’s can’t get the real estate we get.”
Vaccinations are key to bringing students back, keeping teachers safe
Though more students than ever have returned to at least some in-person schooling, thousands of students in Los Angeles, Chicago, and other large city districts continue in remote learning, raising major concerns about the mental health and academic cost for students.
The benefit of vaccination isn’t merely the physical protection it provides; it is also psychological reassurance for those who work in schools and are wary that mitigation strategies and PPE will keep them safe on the job. Increasingly, vaccination has also become a dealbreaker for labor unions representing staff and other personnel in schools as part of negotiations on returning to in-person learning.
Leading efforts to vaccinate educators include Nevada’s Washoe County, which has some 10,000 employees. The district is working with its health district to offer a series of PODs—points of distribution—in two of its large high school campuses, in addition to vaccination slots at the health agency itself and local fire departments.
Among those different avenues, Washoe estimates it will have an average of 4 in 5 employees vaccinated by the end of this week, said Emily Ellison, the district’s chief human resources officer. That’s around the figure that health experts say will need to be vaccinated in order to achieve herd immunity.
We're in the neighborhood. We're the only civic institution that, by design, is located in communities.
“We are dealing with such a dynamic situation that’s so laden with emotion, and people have really complex lives right now, that having multiple options, and multiple channels for people to access the vaccine really helped,” Ellison said. “I think it sent a strong message for the support for the vaccine and for this process, but it also provided options to fit into what are complicated lives. The more difficult something is to access, the less likely people are to access it.”
In the Phoenix Union High School District in Arizona, Superintendent Chad Gestson has led the organizing of PODs for educators in Maricopa County. So far, at its four school locations, the clinics have administered more than 7,000 of doses to teachers and staff from area private and charter schools, as well as public schools.
Logistics and differing state priorities cloud the school vaccination picture
School districts that decide to work in partnership with health agencies to expand vaccination options do have some logistical challenges to work through. Liability concerns about vaccination are one potential issue, as is making sure there are enough county health staff and school nurses who are prepared to administer the injections. (Some districts are relying on county staff, while their own school nurses supervise the 15-minute waiting periods following vaccination; in others, it’s a mix of health professionals giving the shots.)
Another wrinkle concerns the vaccines’ different handling requirements, said Ellison, noting that Washoe County’s school PODs offered the Moderna vaccine. That vaccine has less-stringent refrigeration requirements than Pfizer’s, which was offered at the non-school sites.
And bad winter weather can be a challenge to setting up outdoor, drive-through vaccination sites at schools’ athletic facility parking lots.
But the biggest barrier probably remains supply. Shortages of the vaccines remain a major problem in cities like Los Angeles, where the district was recently approved by the county to serve as a provider. And whether school employees currently qualify to receive a COVID-19 vaccine differs by state, affecting distribution efforts, according to a continually updated tracker being maintained by Education Week.
Some groups representing superintendents have argued that states should do away with their tiered distinctions and simply allow school personnel to receive vaccinations.
Chiefs For Change, which counts both district and state superintendents as members, recently called on the Biden administration to release every dose of vaccine, and to send a strong signal that teachers and educators be prioritized for inoculations now.
In Los Angeles, Superintendent Beutner has made much the same point.
“We don’t gain much by having an existential debate comparing a 66-year-old retiree living in a single-family home who can minimize outside contact, [to] a 59-year-old reading teacher working in a classroom with young children from families hit hard by the virus, or a 64-year-old bus driver taking special education students to school,” he said in recent public remarks. “All need to be vaccinated as soon as possible.”
Can expanding vaccinations at schools improve trust in the vaccine?
With the nation’s civic culture teetering on shaky grounds, misinformation about the vaccine widespread on social media, and distrust in the media and in government institutions at all-time highs, some district leaders believe that schools can also improve the general public’s confidence in the vaccination process itself.
“You want schools to open? Stand up hospitals in parking lots, on the playgrounds in schools. Allow parents to go receive a test and a vaccine. The school happens to be the lighthouse, the focal point of a community, no matter where you are,” said Micah Ali, the president of the school board of the Compton Unified school district, in southern California. “We have a significant issue relative to communication and trust, but people trust their local schools, their teachers, janitors, and cafeteria workers.”
In 2013, the district partnered with St. John’s Well Child & Family Health Center, a federally funded community health center that runs a network of clinics in south Los Angeles County and in Compton, to open one at one of its high schools. The clinics have helped build up access to services that had dried up in the 1970s after several hospitals closed.
Now, the district and the health center have reached an agreement to locate vaccination clinics at some of the district’s schools, in what’s believed to be the first such arrangement in the United States. They plan to help vaccinate all of the district’s staff by early March and then continue to use them for other groups, Ali said.
The Anchorage, Alaska, school district is also now vaccinating anyone over the age of 65 as well as health-care workers. And Duval County, Fla., is in discussions with health agencies to begin offering vaccinations to others beyond its school staff.
Some state officials, like Colorado Gov. Jared Polis, are encouraging district leaders to coordinate similar plans with local health officials.
Racism in both health and education could be a sticking point for some
One open question concerns whether such efforts could improve access to the vaccine for communities that have suffered the highest rates of infection and mortality from the pandemic.
At least in the early days of the pandemic, COVID-19 testing locations were often located further away from Black and Latino neighborhoods, said Diana Grigsby-Toussaint, an associate professor of behavioral sciences and epidemiology at the school of public health at Brown University, who has studied the issue. Recent surveys suggest those communities also are proportionally underrepresented among the population of people receiving vaccinations.
You want schools to open? Stand up hospitals in parking lots, on the playgrounds in schools.
The barriers include not just access to heath care but also longstanding distrust among some Black families, Latino groups, and Native American tribes about government health-care programs, for good reason.
Among the best known examples of that broken trust is the Tuskegee Study, in which some Black men with syphilis were never treated as part of a government-sponsored scientific experiment. But lesser-known examples are legion, too, and many affected women in particular, Grigsby-Toussaint said. They include the forced sterilization of Black women over decades in North Carolina and the testing of birth-control pills on low-income Puerto Rican women in the 1960s.
In Compton, Ali believes St. John’s track record working in south Los Angeles county, including with its immigrant and LGBTQ communities, will help overcome some of those concerns.
Still, public schools themselves have also historically engaged in racist practices; many are now reconsidering school police officers and punitive discipline practices that many see as an outgrowth of mass incarceration. Black parents have been notably doubtful that schools could safely educate their children in person during the pandemic.
So locating vaccination sites at schools won’t overcome all parents’ suspicion, the experts noted.
“Maybe the way to think about this is schools should be part of this multipronged approach, as an additional site that people could go to. But you’ve got to be mindful of the relationship certain groups have with schools,” Grigsby-Toussaint said. “Perhaps also think about local churches, or community centers, or Boys and Girls Clubs.”
Harolyn Belcher, the vice president and chief diversity officer for the Kennedy Krieger Institute in Baltimore, agreed that it’s worth exploring schools as vaccination sites. But she seconded the note of caution.
“I think a lot of it depends on the historical partnerships or trauma, the relationships that have been built. It’s all about communications and relationships, that’s number one,” said Belcher, who is also a physician and the senior director for the Institute’s Center for Diversity in Public Health Leadership Training. “And some principals and school systems are very much an integral part of the community. Others do not have that pleasure, honesty, or luxury.”
