State Vaccine Mandates for COVID-19 – An Emerging Disparity between Childcare Providers and School Teachers

To determine which states had issued legislative and/or regulatory directives requiring vaccination of childcare and/or school personnel (as of November 1, 2021), we reviewed official archives of executive orders for all 50 states and the District of Columbia (DC) and COVID-19 state databases maintained by the National Conference of State Legislatures and the National Academy for State Health Policy. For each state with legislative or regulatory directives, we collected information on issue date and compliance deadline, type (e.g., executive order, public health order), issuer (e.g., governor, public health officer), availability of vaccine exemptions and testing alternatives, and acceptable proofs of vaccination.

While ten states (including DC) have issued directives requiring either COVID-19 vaccination or routine testing among school teachers, only half include childcare providers. This emerging trend suggests an unwarranted disparity between childcare and school settings in states’ efforts to promote vaccination, as the argument in favor of vaccinating the former is at least as strong as that of the latter for several reasons. First, both staff and children in childcare programs may be at higher risk for contracting COVID-19 than those in schools, given the congregation of infants and young children who are both ineligible for vaccination and possibly less effectively adherent to nonpharmaceutical interventions (e.g., masking, social distancing, handwashing). Second, childcare providers have a lower COVID-19 vaccine uptake compared to school teachers (78% versus 90% as of late Spring 2021). Finally, childcare providers skew more heavily minority, and therefore may be at greater risk for COVID-19-related morbidity and mortality (17.3 and 19.3 percent of childcare personnel are Black and Hispanic versus 12.1 and 13.0 percent of school personnel, respectively). To ensure equitable consideration for the health and safety of childcare providers and school teachers alike, states should consider expanding directives to include childcare providers—as has been done by both New Jersey and Illinois—to bridge the COVID-19 vaccination gap between childcare providers and school teachers.