Colleges with high vaccination rates must now decide if they'll require boosters

This week, Wesleyan University in Connecticut held its first booster vaccine clinic on campus. CJ Joseph, a first-year student still figuring out what to major in, wasted no time signing up.

"I was like, 'Heck, yes, I will be the first person to get it' " says Joseph, who was one of the first students to get the shot at Wednesday's clinic at Beckham Hall.

Convenience was a major selling point. "I have a lot of work to do," Joseph explains. "Being able to walk like a good four minutes just to get my COVID vaccine made it so much easier for me and I didn't have to spend money to get an Uber to go over to Walgreens or to CVS."

The liberal arts campus, which serves about 3,000 students, will require COVID-19 booster shots for those on campus this spring. It is one of the first colleges to do so.

"There's no good reason to hesitate," says Michael Roth, the president of Wesleyan University. "Some people don't like to be first. But in this case, being first for public health doesn't seem to be a particularly risky place to be."

More than 1,000 colleges across the country required COVID-19 vaccines for students and staff this year, according to data from the Chronicle of Higher Education.

With the CDC recommendation that all adults get booster shots, colleges now must weigh how to incorporate the additional dose into their pandemic response plans.

For now, many schools are simply encouraging students and staff to get the extra dose. Among them are Duke University, an early adopter of a campus vaccine mandate last spring. Rutgers, largely cited as the first U.S. university to require COVID-19 vaccinations, issued a statement saying "we have no impending plans to require boosters for any community member." But administrators are encouraging "everyone to take advantage of booster shots as a way of increasing their personal protection against the virus."

For one small college, a booster requirement was an easy decision

At Wesleyan, Roth says there were some colleagues who questioned making it a requirement, insisting that compliance would be high anyway among a student population that was already nearly all vaccinated.

He says requiring the booster makes it a social norm rather than an individual decision. "The majority of our people would have gotten the booster without the encouragement," he says, "but we want to get the rate up as high as possible."

He points to other vaccine requirements on the college campus, like meningitis and measles, mumps and rubella, noting that much of the ambivalence he sees comes from the politicization of the COVID-19 vaccine. "It just seemed like our obligation," he says.

Joseph, who is at high risk due to asthma, is grateful for that clear message.

"I really appreciate the fact that it is required that we get our booster shots," Joseph says, "because I feel like there are people who kind of view next step shots as a 'Oh, whatever. I don't really have to get it.' "

The mandate, Joseph says, plus the ease of access, makes the campus feel safer.

About an hour after Joseph got the booster, Hallie Sternberg, a junior studying history and French, waited in line to get hers. She saw friends in line; she caught up with them to talk about Thanksgiving break and the upcoming needle they were bracing for.

"People are excited and ready to have it over with," she said after she'd gotten the shot. "Everyone's like, 'I'm just going to manifest that I will not be sick [with side effects] because we don't have time. We have finals.' I have presentations next week and papers to do the week after that, so I'm just trying to get it out of the way."

Will more campuses require a booster shot?

One question that colleges and universities still need to answer is, will the CDC update the definition of what "fully vaccinated" means, given that boosters are now encouraged for all adults? "Fully vaccinated, that term is extremely important to determine what that means for the community," explains Gerri Taylor, co-chair of the American College Health Association's COVID-19 task force. "If, in fact, the CDC says that fully vaccinated means having a booster within six months of getting your vaccine, as an example, then the colleges may put that into their requirements."

Her organization will issue guidance to colleges once that happens, but in the meantime, she recommends that colleges set up booster clinics on campus and encourage their communities to get an extra shot.

"Colleges are well prepared to do boosters," she says. They "have a captive population, and the stakes are there: We want students to be back in school and we've heard that over and over from the American Academy of Pediatrics and from students."

She points to two complicating factors: staffing and timing. A recent survey by the American College Health Association found the top two concerns for college health centers were staffing and burnout, because of the intensity and the duration of the pandemic.

When it comes to timing, there's not much left of the fall semester before finals and winter break. "Timing is so critical and has been throughout this pandemic," says Taylor. "So, do you start a booster clinic now? Or do you do it in January or February when students return for this spring semester?"

Those, she says, are decisions colleges are making right now.

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