Keeping Schools Open: Whatever Happened to School Vaccination Clinics?*

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Getting COVID-19 shots into the arms of children has now emerged as a critical piece in the seemingly never-ending struggle to banish the virus from our midst. When it comes to that front in the public health war, one province leads the pack, Newfoundland and Labrador. Three-quarters (74.7 per cent) of that province’s children, ages 5 to 11, have already had their first shot, with Nova Scotia second at 61.4 per cent and the others trailing behind.

Barely one-half (52.9 per cent) of New Brunswick’s kids had been vaccinated when Maclean’s magazine reported on Newfoundland’s success in getting kids vaccinated. While our eastern-most Atlantic neighbour has always been more vaccine friendly, the single biggest reason is the critical role played by school-based immunization clinics. Provincial officials in NL estimate that some 40 per cent of those shots have been administered in schools, a far higher rate than in New Brunswick and other provinces and territories.

Schools have been closed to in-person learning in New Brunswick all of January and are scheduled to reopen January 31. With Omicron surging, closing K-12 schools was deemed critical as a so-called ‘circuit breaker,’ and – in large part – because of the low vaccination rates among young children. It also meant that schools were essentially out-of-bounds for vaccination-on-demand shots in the one place where 98,000 children and teens gather each day.

With schools closed, New Brunswick did manage to push the vaccine shot rate for children up marginally to some 54.5 per cent during the past two weeks of the school shutdown. If getting shots into children’s arms in now the name of the game, the needle is finally moving. Given the urgency of the situation, and the significant time and resources being spent on ‘health-proofing’ school facilities, it’s fair to suggest that NB Health and NB Education might have been better advised to plan and implement a more comprehensive in-school vaccination program. There’s no question that child vaccination rates would have been far higher and staff still unvaccinated been given a convenient opportunity to get fully vaxxed or boosted to further advance mass immunity.

Minister of Education Dominic Cardy is, as is well known, a man of action, especially when it comes to campaigning for vaccine mandates. A month ago, when Omicron first reared its ugly head, his first reaction was instinctive. Gazing forward into 2022, his fertile mind was drawn to, what else? but the prospects for “mandatory vaccinations” for children. Instead of bringing vaccinations to every school, he was fixated on making compliance a condition of attending school.  That makes common sense, of course, if your overarching goal is to address all manner of childhood diseases through school-access vaccine requirements.

Minister Cardy and his Comms officer, Flavio Nienow, produced a helpful briefing note on January 25, 2022 on the province’s education sector immunization approach and record. Students identified as at higher high-risk of exposure and education staff were the priority, starting in late March and early April 2021, focusing on the 4,500 staff in high schools province-wide.

School-based vaccination clinics were run, on a limited basis, from September to December 2021. According to the NB Education and Early Childhood Development Department, they were “private clinics run by pharmacies” in collaboration with the Department. Only 24 such clinics were actually held, a limited reach when one considers that K-12 education is delivered in 294 school sites across the province.

The Omicron surge caught everyone off-guard, so let’s try to be fair.  What is clear, however, is that back in November when shots for the 5 to 11 population were authorized, New Brunswick was slower off the mark and ruled out mass inoculation, on a voluntary basis, through the schools. “The low take-up” in the initial fall 2021 was the reason given by Minister Cardy. Maybe so, but the scale of the Omicron surge and the vulnerability of children should have triggered a reassessment of the fastest, most efficient way of getting first shots into children’s arms.

Minister Cardy and his Department seem to have been laser focused on taking advantage of the January school shutdown to produce a return-to-school safely plan that ticked all the boxes and went one-better than some other provinces. Provincial teachers’ union leadership, vocalized by NBTA co-president Connie Keating, were a major factor in shaping the whole approach. Masks for all teachers, hiring more supply teachers, restoring classroom bubbles, and installing HEPA filters topped the NBTA ask list. Pushing for school vaccine clinics did not figure prominently in those health-protection representations.

When Keating spoke out about teacher concerns over the health and safety of members returning to in-person teaching, Cardy reacted swiftly, on social media and CBC News, defending the Department’s plan, emphasizing the change-of-position on installing portable HEPA filter units. Calming the anxieties of, and reducing the risks to, in-school personnel weighed heavily in the balance and so did limiting the number of supply teachers needed to cover elementary and secondary school classes. Eventually, the Department produced a report favourable to installing portable units and some $3-million materialized to outfit the 60 schools currently without proper air circulation systems. To its credit, the Department also did a more thorough assessment of the relative effectiveness of the competing HEPA filter units.

            The old adage of ‘the carrot and the stick’ applies to the campaign to boost vaccination rates at all ages. Scaring people with horror stories about COVID-19 and its after-effects, including ’long-COVID’ worked in securing much higher vaccination rates than usual for prevention of the seasonal flu.  A minority of the populace, including a relatively small proportion of parents, will likely never accept the need for, or effectiveness, of the shots. It may be a mistake to focus on clamping down with mandates in an effort to stamp out the resistance.

            The Pandemic is full of unexpected twists and turns – and it tests the agility of health and education policy-makers as much as ordinary citizens like us. We have just been taught a lesson by Newfoundlanders and that message even made the news in central Canada. School-based clinics can work if the focus is on expanding the points of vaccine delivery, making it more easily accessible for kids and, incidentally, their parents and families. School-based clinics may soon be coming to your school community. Looks like Ontario will be next, following the pioneering work done in Newfoundland and Labrador.

*Adapted from Education Beat, Telegraph-Journal, January 28, 2022.

Whatever happened to delivering vaccinations to children through the public schools? Why did it fall out-of-favour when the practice was critical in immunization campaigns that stamped out common childhood diseases? Shouldn’t we be providing vaccination access in local communities, closest to where kids and staff spend their weekdays?

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