Make no mistake: The University of Minnesota is committed to ensuring the health and safety of all members of its community and thus wants its students, staff and faculty vaccinated against COVID-19 ("U must lead, not lag, on vaccine campaign," Opinion Exchange, June 17).
Vaccination is the very best way to protect oneself and one's community against the scourge of COVID-19. The question is, how can the university most effectively and quickly achieve its goal? Is it with a policy of "educating, offering and encouraging" or "mandating and excluding"? In other words, carrots or sticks?
Yes, some vaccines are required for students. Since 1989, Minnesota Statute 135A.14 mandates that students in public or private postsecondary educational institutions (i.e., technical schools, colleges and universities) be immunized against measles, rubella, mumps, diphtheria and tetanus. That law establishes a procedure for the Minnesota Department of Health to add a new vaccine requirement to that list, but absent MDH action, there is some doubt over the ability of a state university to do so on its own. No matter whether a COVID mandate is added, however, exemptions are permitted for medical reasons or with a notarized statement asserting a student's conscientious objection to the vaccine(s). The upshot is that when there are vaccine mandates (under a statute or school rule), there will be exceptions. This is true whether the mandate is for students, as with this state statute, or for faculty or staff.
Vaccine verification also presents a challenge. Currently, there is no good way to ensure that those who claim to have been fully vaccinated are so. There is no credible vaccine registry system in place for students from around the world that can provide reliable information on one's vaccine status. Personal attestations and honor systems go only so far. What is more, the university is a public campus, where the coming and going of many contributes to the vibrancy of the community.
Thus, having the university require COVID-19 vaccine may seem like a simple solution, but exemptions, verification and public spaces undermine this approach. The simple solution is complicated by basic epidemiology, social science and the law. A mandate will give a false sense of safety, which only increases risk. This is exactly what we experienced last fall with mandated student COVID-19 testing. A number of universities that mandated routine student testing had campus-related outbreaks because students had a false sense of safety that testing, not reducing risky behavior, protected them. We did not mandate routine testing at the University of Minnesota; rather, we emphasized reducing risky behaviors. Despite being criticized for this approach, we also avoided campus-related outbreaks.
Research on vaccine hesitancy matters. Today, there are three general categories of students, staff and faculty with regard to their willingness to be vaccinated against COVID-19. There are those — the vaccine-affirmative — who have been vaccinated or are in the process of being vaccinated. The second category, the vaccine-hesitant, includes those who are hesitant because of a lack of understanding of COVID risks or vaccine science, or those who have legitimate medical concerns. Finally, the vaccine-hostile reject the medical and epidemiological research on COVID-19, deeply mistrust COVID-19 vaccine research, and/or don't trust scientific authority or the government. A vaccine mandate is not needed for the first group, may or may not marginally increase the rate of the second group, and will surely create great opposition and backlash from the third group, which in their opposition actively undermines vaccination efforts in the vaccine-hesitant group.
Who are in these three groups? Not surprisingly, many members of the university community are already in the first: vaccine-affirmative. Best estimates come from a recent internal survey of 12,500 university members. Some 93% of respondents indicated that they had received one or more doses of vaccine. Undergraduate students have a lower rate of vaccination (87%), but 53% of the unvaccinated students indicated they planned on getting vaccinated, which would bring their rate up 93%. Faculty led the three groups, with 99% vaccinated. Only 2.3% of respondents do not plan on getting vaccinated, and 1% are unsure.
We recognize the shortcomings of these data, especially the fact that the response rate is just 51%. One could assume that the 49% of the sample who didn't respond represent only the hesitant and hostile. But known relationships between the characteristics of members of the university community and other issues associated with vaccination status suggest that these observed yet imperfect estimates are credible.
