NORTH TEXAS (CBSDFW.COM/CNN) – As the return to school approaches, some states are prohibiting public schools from requiring COVID-19 vaccinations or proof of vaccination for students ranging from pre-K to college campuses.

A CNN analysis found that at least seven states — Alabama, Arkansas, Florida, Indiana, Montana, Oklahoma and Utah — have enacted legislation this year that would restrict public schools from requiring either coronavirus vaccinations or documentation of vaccination status.

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As of June 22, at least 34 states had introduced bills that would limit requiring someone to demonstrate their vaccination status or immunity against COVID-19, according to the National Conference of State Legislatures, which has been tracking legislation related to coronavirus vaccines. At least 13 states — Texas, Alabama, Arkansas, Florida, Indiana, Iowa, Kansas, Missouri, Montana, North Dakota, Oklahoma, Tennessee and Utah — have passed them into law, according to the document, and at least six of those include language pertaining specifically to schools or education.

On May 18 Texas Governor Greg Abbott issued an executive order prohibiting governmental entities in the state — including counties, cities, school districts, public health authorities, or government officials — from requiring or mandating mask wearing.

Such moves leave public health officials worried about the limitations they could place on efforts to control the coronavirus and emerging variants — especially if a health department has vaccination recommendations for schools.

“Anytime there’s legislation that potentially prohibits the health department from trying to prevent the spread of disease, even if it’s putting limits on masks or mandates on vaccination, then it’s another step that local health departments would have to go through should there be an outbreak or a rise in cases,” said Lori Tremmel Freeman, chief executive officer of the National Association of County and City Health Officials.

“It will be concerning that this legislation is becoming more permanent,” Freeman added.

What Each State’s Law Says

The laws take different approaches, but the result is that schools can’t require coronavirus vaccines, or in some cases, proof of vaccination. For some states, that’s the case even as schools still expect students to arrive with other recommended childhood vaccinations, including those against measles, whooping cough, polio and chickenpox.

“It seems to be kind of a mixed bag of all the things going on here — there’s the limiting of requiring proof of vaccine, there’s the limiting of requiring the vaccination itself, the prohibition of the mandates. So, there’s a lot,” Freeman said. “They’re not all uniform.”

In Oklahoma, Senate Bill 658, signed into law in June, prohibits a public school district’s board of education from requiring vaccination against COVID-19 as a condition of admittance to or attendance.

‘Why Would We Want To Take Any Legal Public Health Tools Off The Table?’

Even though the laws aren’t uniform, there’s concern among some public health officials that prohibiting certain vaccine requirements could impact public opinions around both coronavirus vaccines and long-standing school vaccine requirements, said Brent Ewig, a policy consultant for the Association of Immunization Managers.

It’s not clear whether COVID-19 vaccine mandates would help vaccine uptake or create backlash, Ewig said.

“I do think there are a couple of questions that can help guide this debate in the future — and the first is that with more than 600,000 Americans dead, why would we want to take any legal public health tools off the table until we know what it will take to stop this?”

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There is also concern about public safety and what such legislation could mean for the whole of public health.

For instance, some health officials worry that a coronavirus variant could emerge that might be more transmissible or dangerous, or that might directly impact children. Prohibiting vaccine mandates in schools could make it more difficult to implement measures that would help control the virus and prevent another pandemic.

Meanwhile, “we do see a couple of states that, even at the same time they are trying to prohibit some of these mandates, they are adding provisional language to not apply to school immunization requirements,” Freeman said. “They’re trying to walk the line there a little bit.”

One example is Louisiana, where in July, Gov. John Bel Edwards vetoed a bill that prohibited some requirements for vaccination because, according to his office, it would “change Louisiana’s approach to vaccine requirements for schools and educational facilities, which has been in place for decades without significant controversy.”

In new COVID-19 schools guidance released on Friday, the US Centers for Disease Control and Prevention does not address vaccine mandates, but notes that keeping track of students’ and workers’ COVID-19 vaccination status can help inform the prevention strategies used in a school, such as mask-wearing and physical distancing.

The CDC also says its guidance does not replace local guidance and policies.

However, the CDC urges schools take steps to promote COVID-19 vaccination, including offering vaccines on site, providing paid sick leave for employees to get vaccinated and excusing absences for students to get vaccinated.

Coronavirus vaccines are available only for people 12 and older, but vaccines for younger children are being studied.

“Vaccination is currently the leading public health prevention strategy to end the COVID-19 pandemic,” the guidance says. “Promoting vaccination can help schools safely return to in-person learning as well as extracurricular activities and sports.”

So far, most of the discussions around prohibiting vaccine mandates in schools have been in the context of college or university campuses.

In April, the American College Health Association issued a policy statement recommending COVID-19 vaccination requirements for all on-campus college and university students for the upcoming fall semester, where state law and resources allow.

Ewig said the focus has been more intense on the university level because vaccines were available earlier for people 18 and older earlier, and because of the risk of COVID-19 transmission in university living situations.

“I think the other issue is because it is still under emergency use authorization has created some hesitancy about going too far on this debate about mandating,” he said. “My sense is that there are a lot of people that are waiting on the timing of that from when it goes from FDA emergency use authorization to full licensure, which I think we expect sometime in the fall.”

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