Dickinson State University in North Dakota has a plan to encourage students to get their Covid-19 vaccinations: Students who have been fully vaccinated will receive a pin or a bracelet that will exempt them from the campuswide mask mandate, university administrators announced this week.
The Dickinson vaccination incentive is voluntary. On Thursday, Rutgers University in New Jersey said it would require its more than 71,000 students to be vaccinated to attend fall classes on campus. Students who are studying only remotely won't have to be vaccinated, and there will be medical and religious exemptions, the university's president, Jonathan Holloway, said in a statement.
Rutgers may be one of the first large universities to mandate Covid-19 vaccinations, if not the first, and other colleges are likely to follow.
"I'm just starting to hear discussion about mandating vaccines, and everyone I've talked to has said that they are leaning in the direction of mandating vaccines not just with the students, but with faculty and staff, as well," said Lynn Pasquerella, president of the Association of American Colleges and Universities.
Some universities reached by NBC News said they don't yet have clear plans for vaccination requirements.
A spokesperson for the University of California president's office said that "at this time, we do not anticipate making the Covid-19 vaccines mandatory." The University of Notre Dame said "no decision has been made" about a mandate for students returning in the fall. The University of Michigan won't require vaccinations for students "at this time." At the University of North Carolina, Chapel Hill, vaccinations aren't required "at this time."
"The University encourages eligible students, faculty and staff to receive a Covid-19 vaccine as soon as it is available to them," Robert A. Blouin, UNC-Chapel Hill's executive vice chancellor and provost, said in a statement.
But encouragement may soon change to something stronger as vaccine supplies increase.
Crowds of young spring break partyers have put a renewed and urgent focus on the role college-age and young adults are going to play in getting the pandemic under control in the U.S. On Wednesday, Chicago's health commissioner, Dr. Allison Arwady, said people ages 18 to 39 are driving the city's most recent surge in cases, reminiscent of the fall surge.
Vaccinating older teens and young adults is important, experts said, even if the age group is at low risk for severe Covid-19. Already, Alaska, Arizona, California, North Dakota, Ohio and a growing number of other states have expanded or will soon expand vaccination eligibility to everyone 16 and older.
Death is not the only outcome for Covid-19.
But vaccine hesitance among younger adults presents a challenge.
A recent Pew Research survey found that younger adults are less likely than older people to intend to be vaccinated.
There are already vaccination requirements at most colleges, which require students to be immunized against measles, mumps and rubella; meningitis; and hepatitis B.
Younger people may not get as sick, but they can be major drivers of viral transmission, said Angela Rasmussen, a virologist at the Center for Global Health Science and Security at Georgetown University in Washington, D.C. While the death rate is low among young adults, a significant number of people still end up being hospitalized. Others who have had mild illnesses could go on to develop lingering symptoms.
"Death is not the only outcome for Covid-19," Rasmussen said. "There are a number of other very unpleasant outcomes that can have lasting impacts on your health. So to make sure that you're not going to suffer any of those things, a younger person with no pre-existing risk conditions should definitely get vaccinated."
Tara Smith, a professor of epidemiology at Kent State University in Ohio, agreed that young adults should get vaccinated and said some might develop lingering effects from the virus should they get sick.
"Even if they don't die doesn't mean they would come out unscathed," she said.
Dr. Adam Gaffney, a critical care physician and instructor at Harvard Medical School, has treated critically ill younger patients with Covid-19.
"I've taken care of patients in the ICU across the age spectrum, including young adults," he said. "If you have an opportunity to potentially avoid a deadly condition, no matter how uncommon it is, why not take that?"
Even people at low risk of serious illness need to be vaccinated to protect the population from more contagious coronavirus variants, said Paul Bieniasz, a professor of virology at Rockefeller University in New York.
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"The less virus replication that is going on in the population at large, the smaller the chance of new and more dangerous variants' arising," he said. "It's that simple."
As colleges and universities plan whether to have in-person classes in the fall, they are also determining whether to mandate vaccinations for returning students.
Ultimately, having vaccinated students on campus will greatly improve their ability to learn in a comfortable and safe environment, Pasquerella said.
"I think it will certainly help to mitigate against spreading the disease, especially as we look at the variants that are appearing in particular parts of the country," she said. "And it will also help to create a learning environment in which students can thrive."