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Confusing rules, loopholes and legal issues: College vaccination plans are a mess

In just the last two weeks, more than 120 of nearly 400 public and private colleges and universities analyzed by NBC News have added vaccination requirements.
Illustration of college-aged students in masks walking on syringes facing opposite directions
Vaccination requirements for college students are confusing, complicated and causing problems.Chelsea Stahl / NBC News; Getty Images

When the coronavirus began to spread around the country last year, most colleges and universities shut their doors. And when they began to reopen in the fall, they did so in piecemeal and convoluted ways.

In some cases, students could live in dorms but had to take classes online. Dining halls were reservation-only. Singing was banned. While some schools avoided major outbreaks, others became hot spots.

The introduction of three Covid-19 vaccines early this year to college populations seemed to present an exit from these patchwork reopenings, which robbed students of a traditional college experience. But an NBC News analysis of rules across the U.S. found that vaccination requirements for students have proven to be just as complicated as the frenetic fall 2020 semester, if not more so.

In Texas, public universities can’t require a vaccination, but private ones can. In Massachusetts, where colleges and universities can mandate Covid-19 vaccinations, 43 of more than 100 had agreed to do so by mid-May. In New York, public universities cannot allow for religious exemptions, while a majority of the state’s private universities can.

That patchwork approach is reflected across the country. An NBC News analysis of more than 800 colleges and universities that are requiring the Covid-19 vaccination found that the vast majority have unclear directives, loopholes or legal complications that are leaving professors frustrated, students unmotivated and a potential public health crisis come fall. To add to the confusion, among all states and jurisdictions, 19 have statewide regulations for public colleges: Eight require vaccinations for students and 11 do not.

Among other findings in the analysis:

  • Schools in 11 states, including Alabama and Florida, which have seen some of the highest numbers of Covid-19 cases in the country, do not require their students to be vaccinated.
  • All of the 11 states that do not currently require vaccinations at their colleges or universities voted for Donald Trump in the 2020 election.
  • Georgia has more than 70 colleges and universities, but only eight of them require vaccinations. Of those eight, five are historically Black institutions.
  • Eighty percent of the schools analyzed allow for religious exemptions from vaccination requirements.
  • In the Northeast, 253 schools are requiring vaccinations, compared to 90 schools in the South.

With no federal guidance and legal boundaries that shift by the week, colleges and universities are struggling to implement plans to safely reopen. And while President Joe Biden has said July 4 will mark a return to normal for the country, university administrations will face a vaccination problem on campus that likely won’t go away anytime soon.

Lorine Najjar, 21, a senior at the University of Colorado Denver, hopes schools find a solution.

“I lost my motivation for school,” she said of remote learning. “I understand why people are scared to get the vaccine, but it will help return us to normal life.”

'Bad public health and bad public policy'

The challenge some schools face in vaccination efforts starts at the top: their state’s governor.

As Republican governors waged wars on vaccine passports — documentation of a Covid-19 vaccination that is required to enter certain spaces — colleges found themselves in the crosshairs. The so-called passports are usually discussed in the context of travel or access to large gatherings, but in states like Wyoming and Florida, officials told colleges that a Covid-19 vaccination requirement fell under the “vaccine passport” umbrella.

Nova Southeastern University, located in Fort Lauderdale, Florida, announced on April 1 it would be requiring a vaccination for all students, faculty and staff prior to returning to campus in the fall. Shortly after, Florida Gov. Ron DeSantis, a Republican, on May 3 signed into law a bill barring schools, government entities and businesses from asking for proof of a Covid-19 vaccination.

Two days later, Nova Southeastern was forced to reverse the requirement, which had become illegal.

“I am frustrated with the state,” said Charles Zelden, a professor of history and politics at Nova Southeastern. “They are getting in the way of my classroom, my purpose to educate my students.”

Nova Southeastern was hoping the vaccination requirement would bring a return to normalcy on campus. Now, the school needs a new plan.

“We are having people self-report on a voluntary basis if they have been vaccinated, and once we hit herd immunity on campus, or 80 percent vaccinated, then we will be able to open campus more so, but still not completely,” Zelden said.

Not everyone objects to the change. Aliyah Gomez, 19, a rising sophomore, is happy vaccination is no longer required.

“I was taken aback when I originally read the school was going to require the vaccine,” Gomez said. “It feels a bit pushy and I’m not the only one who thought this was rushed.” Gomez plans to eventually get vaccinated but wants to wait a little while.

States are well within their rights to ban mandates, said Patricia Kuszler, the director of the University of Washington’s Center for Law, Science and Global Health, though she said she would prefer to see vaccination requirements at schools across the country.

Kuszler said the Florida law is “bad public health and bad public policy” but perfectly legal, making local opposition to it difficult.

DeSantis’ office defended that decision in an email to NBC News, saying “vaccine passports reduce individual freedom and harm patient privacy.”

Attempts to require the shot have been complicated by the fact the vaccines remain under emergency authorization, leaving some school administrators waiting on the Food and Drug Administration to learn if they can legally mandate it.

Two Texas universities just 6 miles away from each other are in very different positions. At the University of Texas at Austin, a Covid-19 vaccination can’t be required after Gov. Greg Abbott issued an executive order banning organizations that receive state funds from doing so. Just across the river, St. Edward’s University, a small, private Catholic school, is requiring students to get vaccinated.

A St. Edward's spokesperson said the governor’s order “did not impact or change the university's policy.”

KK Villarreal, a parent of a St. Edward’s student and an Austin resident, sees the policy as prudent.

“I really don’t see what the fuss is all about,” Villarreal, 55, said. “I’d strongly prefer that everyone get vaccinated, but I actually believe in the science. No one’s head is exploding because all freshmen have to have a meningitis vaccine.”

What is a religious exemption for the Covid-19 vaccines?

Despite vaccination requirements at hundreds of colleges and universities for returning students, not everyone will end up getting the shots: Most of these schools are providing various exemptions to the rule, ranging from medical to religious and even philosophical reasons.

In New Jersey, a student need only voice a religious objection to vaccinations to bypass the requirement.

It’s much more difficult to get out of a shot in Washington state, where Kuszler lives. “You have to have a physician counsel you before you can argue you have a philosophical exemption, and there’s no exemptions for measles, mumps and rubella,” she said.

Most major religions do not categorically ban vaccinations, and religious exemptions tend to consider a vaccine’s ingredients, such as objections to pig components.

Because laws surrounding religious exemptions are vague, it’s easy for students to take advantage of them, said Eric Feldman, a professor of law, medical ethics and health policy at the University of Pennsylvania Carey Law School.

“In many states, all one has to do is say the vaccine goes against their deeply held religious beliefs and they will qualify for the exemption,” Feldman said, which is why some states have scrapped the exemption.

Maine’s Bowdoin College, where Covid-19 vaccination is required, is only offering students medical exemptions. Faculty and staff, though, can claim “legitimate medical and religious” opposition.

Bowdoin told NBC News that state law requires the school to offer religious exemptions only to staff members, not students.

In California, another state where religious exemptions are not required by law, the University of California and California State University school systems will require the Covid-19 vaccination once one of the shots is formally approved by the FDA, which is expected to occur this summer, while allowing religious exemptions.

Guidance ... TBD

Sandwiched between broad mandates to get a Covid-19 vaccination and states banning such mandates are schools with no direction at all.

In Alabama, the state university system is leaving the choice up to each school.

The University of Alabama, in Tuscaloosa, announced it will not be requiring proof of a shot. The University of Alabama at Birmingham has yet to announce plans. While it deliberates, UAB told students and their families to make their own decision.

In a March poll conducted by NBC LX and Morning Consult, 26 percent of Generation Z — those born approximately between 1997 and 2012 — said they don’t plan on getting vaccinated and another 19 percent said they were undecided.

Suzanne Judd, a professor at UAB’s School of Public Health, is fielding questions from students and their families about the vaccines and encouraging them to get the shots.

Judd promotes the efficacy of the vaccines while acknowledging she “can’t control what people do.”

“Getting that population vaccinated is among the most critical of the public health priorities we have,” she said.

As the fall approaches, first-year students who have already paid their admission deposits have been left in the dark as schools equivocate.

Feldman, of the University of Pennsylvania, thinks vaccination requirements may affect where future students decide to enroll — at least in the short term — as more colleges mandate vaccinations and narrow exemptions.

“There are likely to be many students who are only comfortable being in a classroom where everyone is required to be vaccinated,” he said.

On the other end of the spectrum, students unwilling to get the vaccinated might face a tough choice.

“This is arguably the most important vaccine today,” Feldman said. “Someone who doesn’t want to get vaccinated is going to have to study elsewhere unless they qualify for an exemption.”

Feldman compared it to universities requiring that first-year students live on campus.

"If you don’t want to live on campus, that’s fine," he said. "You don’t have to go here."