As Stanford plans to require COVID-19 vaccinations for students, faculty and staff on campus in the fall, public health and bioethics experts largely agree that the vaccine mandate is reasonable and necessary for a safe, gradual return to normalcy. But, concerns about the unpredictability of reopening and vaccine hesitancy still remain.

Stanford is one of over 200 colleges across the nation to implement a vaccine mandate. Such mandates have been a topic of debate across higher education, but researchers say that immunization requirements are crucial for campus safety — and these requirements are not entirely new.

“Stanford has previously required that all students have measles, mumps, and rubella vaccinations to prevent the spread of disease on campus and protect students in case of any outbreaks,” epidemiology and population health associate professor Michelle Odden wrote in an email. “The COVID-19 vaccine requirement has the same purpose — to prevent the spread of disease and protect students.”

Epidemiology and population health associate professor Julia Simard echoed these views, saying that the vaccine requirement is the safest way to reopen campus in the fall.

Ahead of a potential reopening in the fall, several other California colleges have also announced vaccine requirements for the fall, including the University of California campuses, California State University campuses and Santa Clara University (SCU).

“One of SCU’s guiding principles from day 1 of the pandemic has been to protect the health and safety of our students, faculty, and staff — vaccines do that and will allow us to return to campus — how great is that?” Margaret McLean, the SCU Markkula Center for Applied Ethics associate director, wrote. 

McLean, who is also a member of SCU’s COVID Resilience and Recovery Campus Operations Team, said that the vaccines can guard against severe illness and death, unclog emergency rooms and allow for a gradual, coast-to-coast reopening. She explained many might need incentives to get the shot, but ultimately mandates that “protect people and save lives are beneficial to everyone.”

Some schools have implemented alternative “soft mandates” that incentivize students to get the shot, such as granting exemptions from testing and masking, but stop short of enforcing any vaccine requirements. In states like New Jersey, Utah, Texas and Florida, some lawmakers have attempted to prevent colleges from mandating COVID-19 vaccines. 

“A ‘soft mandate’ is better than no mandate but is likely to be less effective — or totally ineffective — in allowing campuses to reopen and stay opened,” McLean wrote. “Stanford and SCU have the approach most likely to succeed. We will still need testing but not everyone, every week.”

Vaccine accessibility and hesitancy

With the vaccine mandate comes questions of availability and hesitancy.

Simard wrote that she is hopeful that access will be improved in the near future because many states are working to increase the accessibility of vaccines beyond mass vaccination sites. Nationwide vaccine availability is trending upward, and Stanford Health Care has started offering drop-in vaccinations.

Setting up pop-up vaccine sites near congregate living areas like university dorms or neighborhoods with limited healthcare access are potential steps toward addressing student accessibility issues, McLean wrote, and SCU is providing free transportation to vaccination sites to increase access.

“We have encouraged individuals to seek vaccination appointments as soon as they are eligible and continued to update the community about the resources available for obtaining vaccination,” University spokesperson E.J. Miranda wrote.

Vaccine confidence may be another challenge that remains even after shots become more available.

“I am empathetic to students who may be nervous or fearful of the COVID-19 vaccines, especially since misinformation is so widespread,” Odden wrote. “I would urge them to review information from the CDC or another trusted source, which are clear that the COVID-19 vaccines are safe and effective.”

McLean said that although she believes the vaccine mandate is fair and reasonable for students, “there needs to be time for conversation and understanding why students — and others — are hesitant to roll up their sleeves.”

With the required vaccinations, researchers are hopeful about the gradual return to in-person activities in the fall, though there will likely still be safety measures in place, such as testing and travel restrictions to areas with active outbreaks, according to Odden.

“There are still a lot of unknowns, and this virus is sneaky,” McLean wrote. “The risk of reopening is unpredictable but real — think variants; consider the crushing outbreak in India.”