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A Case for Mandatory COVID-19 Vaccination in College Students

Leanna M.W. Lui, HBSc

Disclosures

July 29, 2021

There has been considerable debate regarding mandatory vaccine uptake among the general population, excluding those who have medical exemptions. The World Health Organization  states that "policy-makers should consider specifically whether vaccines authorized for emergency or conditional use meet an evidentiary threshold for safety sufficient for a mandate." Ontario's chief medical officer, Dr Kieran Moore, put out a "call for arms" to younger individuals who are more likely to socialize and become hosts for widespread infection.

Currently, the Government of Canada has not enforced mandatory COVID-19 vaccine uptake. However, as universities and colleges prepare for full-time in-person learning, educators and planners have questioned whether full, or at least partial, vaccination status is necessary as well as feasible. Schools such as the University of Toronto and Western University of Ontario are requiring vaccination for all dormitory residents. Other universities such as Seneca College have mandated vaccination for all students returning to in-person learning.

Why should universities and colleges require students to be vaccinated?

To date, over 193 million cases of COVID-19 and 4 million deaths worldwide have been recorded. An increasing number of individuals are reporting symptoms of long COVID syndrome (also known as post-acute sequelae of SARS-CoV-2 and post-COVID-19 syndrome).

Currently, Health Canada has approved four vaccines (Moderna, Pfizer-BioNTech, AstraZeneca/Covishield, and Janssen), which have demonstrated sufficient efficacy. They've also demonstrated efficacy in decreasing caseload and community spread. Taken together, the benefits of vaccination to the individual and community at large are associated with little cost (eg, rare side effects). Additionally, increased vaccination rates and decreased caseload mean that healthcare facilities will be able to better manage their services.

Overall, there's a strong cost-benefit profile to COVID-19 vaccination when compared with the alternatives, such as social distancing, lockdown, and masking, which are unsustainable approaches to controlling the spread of the virus.

Let's be honest: It's quite easy to break these preventive measures and cause another wave. It's unwise to believe that all of these measures would continue to be enforced by the population.

It's also unwise to believe that individuals would come forward to receive their vaccine if it were not mandatory (or if non-vaccination status meant exclusion from social events such as concerts and indoor dining). With the advent of the anti-vaccination movement, as well as general uncertainty around the long-term safety profile of the vaccine, many have become hesitant.

There's large concern that not mandating vaccination among university and college students will create campus hot spots that are primed to become breeding grounds for high case positivity rates.

I believe it would be prudent for universities to enforce mandatory COVID-19 vaccine uptake for in-person learning. As someone who has elderly parents, I always felt uncomfortable visiting them during the pandemic prior to vaccination. In general, I was always on high alert when I was going to work or running errands because I did not want to be infected nor be the reason for infection.

With this in mind, returning to in-person learning is great but it also comes with concerns. I wouldn't be comfortable sitting in a half-crowded hall for a couple of hours not knowing whether the building was up-to-date on ventilation standards, and knowing that not every student in the class was adhering to public health guidelines or at least being considerate of those around them.

I do not dispute those who are uncomfortable receiving the vaccine. However, returning to in-person learning should be a matter of safety and concern for the community at large. Many students live with family and/or friends; some also commute. As a student hoping to return to in-person learning, I would be worried going back and forth wondering if I were "patient zero" of the university community. That's not to say that in-person learning should require vaccination going forward for an undefined period of time, but perhaps in the next year, this should be a standard enforced by universities.

For many, higher education is not simply about getting a degree but also about getting an experience. I don't think many of us would have envisaged our university/college years to be sitting alone watching lectures at 2x speed while seeing the world pass by. However, if we continue to play this game of cat-and-mouse with COVID-19 cases, Zoom university may be here to stay.

All in all, vaccination should be mandatory in these social settings if we want to return to normalcy.

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About Leanna Lui
Leanna M.W. Lui, HBSc, completed an HBSc global health specialist degree at the University of Toronto, where she is now an MSc candidate. Her interests include mood disorders, health economics, public health, and applications of artificial intelligence. In her spare time, she is a fencer with the University of Toronto Varsity Fencing team and the Canadian Fencing Federation.

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