K-12 schools

Emerging concerns

• State mandates educator vaccination for K-12 schools. NPR, August 19, 2021.
• Some teachers protest teacher vaccination mandate. NPR, October 4, 2021.
• State mandates student vaccination for K-12 schools. CNBC, October 1, 2021.
• Some protest the vaccination mandate for K-12 students. Galt Herald, October 20, 2021; CryptoPress, November 12, 2021.

Ethical principles

• Requirements for mandatory liberty-limiting and social distancing interventions should be imposed only in cases in which voluntary actions seem unlikely to be effective. CDC Ethics in Pandemic Flu
• Public health laws should provide authority for appropriate actions that might be necessary in the event of a public health emergency. WHO Ethics in Pandemic Flu
• Include appropriate publication of the public health law and educate the public on how to comply with both the letter and the spirit of the law. APHA Code of Ethics, 4.6.5.
• A process should be in place for objections to be heard, restrictions appealed, and for new procedures to be considered prior to implementation. CDC Ethics in Pandemic Flu
• The public should be clearly informed that restrictions on personal freedom are anticipated, that these limitations may be important to the individual’s own protection, and that they are also necessary to limit the spread of disease throughout the community. CDC Ethics in Pandemic Flu

Recommendations and practices

• What educators need to know about K-12 vaccine mandates. Tech&Learning, August 16, 2021.
• FAQ for Washington state COVID-19 vaccination mandate. Washington Office of Superintendent of Public Instruction (pdf).

Emerging concerns

• Teachers are burning out and leaving their jobs. Washington Post, October 18, 2021.
• Schools are using tests that are not vetted by the FDA. New York Times, March 30, 2021.
• Schools unable to implement CDC guidelines due to budget concerns, physical space, employee workforce constraints. Washington Post, July 8, 2020; New York Times, July 8, 2020.
• Overcrowding and older buildings pose considerable challenges for districts seeking to safely reopen. New York Times, August 5, 2020.
• Schools lack isolated spaces for staff when not working with children. Washington Post, July 3, 2020.

Ethical principles

• It is legitimate to take costs into consideration in determining whether a particular accommodation is warranted. WHO Ethics in an Outbreak
• Costs and other practical constraints (e.g. logistics, distance, available workforce) may legitimately be taken into account to determine whether a less restrictive alternative is feasible under the circumstances, particularly in settings with severe resource constraints. WHO Ethics in an Outbreak

Recommendations and practices

• The Biden administration has prioritized the vaccination of teachers, school staff, and childcare workers. COVID-19 Vaccines for Teachers, School Staff, and Childcare Workers, CDC
• Mitigation measures for schools to implement include cohorting students, staggering class periods, creating one-way hallways, and eliminating high-touch surfaces as much as possible. COVID-19 Planning Considerations: Guidance for School Re-Entry, AAP
• Options for implementing ventilation interventions in schools can be found here. Operating Schools During COVID-19, CDC
• Lawrence County, Tennessee public schools have used their experience in tornado preparation to innovate unique ways to facilitate the return of children to school. New York Times, October 14, 2020.

Emerging concerns

• School teachers and staff face a disparate risk of COVID-19 compared to children. The Atlantic, June 25, 2020.
• Approximately 1 in 4 teachers are at higher risk for serious illness from COVID-19. Kaiser Family Foundation, July 10, 2020.
• Multisystem Inflammatory Syndrome (MIS-C) is a rare, yet serious pediatric condition related to COVID-19. Journal of Medical Virology, June 25, 2020.
• Underlying conditions were more common among school-aged children with severe outcomes related to COVID-19. COVID-19 Trends Among School-Aged Children, CDC, October 2, 2020.
• The Pfizer-BioNTech coronavirus vaccine was reported to be safe for adolescents ages 12-15, and Moderna has begun a clinical trial of their vaccine for children. New York Times, March 31, 2021; AAP News, March 16, 2021.

Ethical principles

• Information available will change continuously throughout the pandemic, requiring adjustments of response strategies based on ongoing assessments of the risks and potential benefits of interventions. These adjustments, and the justification for them, should be communicated to the public. WHO Ethics in Pandemic Flu
• Reduce or eliminate negative impacts on communities and the environment, particularly as these negative impacts tend to be disproportionately experienced by individuals already faced with health inequities. APHA Code of Ethics 4.5.8.
• Ensure that reasonable alternative options are considered and evaluated and that final public health policies and plans are designed to most effectively accomplish stated goals while minimizing the potential for harm. APHA Code of Ethics 4.5.9.
• No policy can be developed, much less implemented, without an assurance that its justification and rationale have been made clear to those who will be affected by it. Indiana University

Recommendations and practices

• Equity checklist for school reopening plans. Johns Hopkins Berman Institute of Bioethics
• Establish employee assistance programs and other ways to support teachers and school staff. COVID-19 Planning Considerations: Guidance for School Re-Entry, AAP
• Discourage congregating in shared places, consider physical barriers, and other measures to stagger social interactions and de-densify campus. COVID-19 Planning Considerations: Guidance for School Re-Entry, AAP
• Observational studies for in-school transmission have found no instances of adult-to-child transmission. Pediatrics, April 1, 2021; CDC, January 29, 2021.

Emerging concerns

• Risk of within-school transmission is low for both students and staff when schools implement and adhere to prevention measures. Pediatrics, April 1, 2021; CDC, March 26, 2021; CDC, January 29, 2021.
• While the risk of within-school transmission is low when prevention measures are implemented, extracurricular activities such as sports may pose a greater risk. JAMA, January 26, 2021.
• Educators might play a central role in within-school transmission networks, particularly when mitigation strategies are not well adhered to. CDC, February 26, 2021.

Ethical principles

• Policies and procedures should be based on sound scientific evidence or on the best evidence available. In addition, the policy’s measures should reflect the severity of the situation while remaining as minimally invasive as possible. Indiana University
• Incorporate scientifically vetted, research-based data to the fullest extent possible. APHA Code of Ethics, 4.5.2.
• Recognize and acknowledge when evidence is changing or incomplete and when assumptions or contexts change the relevance of evidence. APHA Code of Ethics, 4.10.5.

Recommendations and practices

• Schools should implement flexible operations to accommodate high-risk teachers, staff, and students. Operating Schools During COVID-19, CDC
• Pursue options for extracurricular activities that reduce in-person contact or otherwise reduce the risk of viral transmission. Operating Schools During COVID-19, CDC