Should We Mandate COVID Vaccines for Children?

Arthur L. Caplan, PhD


December 16, 2021

This transcript has been edited for clarity.

Hi. I'm Art Caplan. I'm at the Division of Medical Ethics at New York University's Grossman School of Medicine in New York City.

New York City has just announced that it wants to impose a very tough mandate for vaccination, using employers to insist that everybody be vaccinated. This policy is one that is, I think, tougher than anywhere I know of in the country. Germany, Austria, Italy, and other countries are moving toward vaccine mandates, partly out of fear of new variants appearing that might be more infective to people, and perhaps people who are only partially vaccinated might still get sick — a worry that places like New York City couldn't take another shutdown.

So it’s going to be vaccination. So mandates seem smart to me. I have been strong in arguing that the city should require every city worker to get vaccinated—police, fire, prison guards, social workers, government bureaucrats. They should all, as a condition of employment, need to get vaccinated and it’s controversial.

Mandates, it seems to me, are what you do when persuasion isn't working but you have the threat of new variants and still thousands dying every week from COVID-19. You have to take steps that are tough and you have to take steps that get results even if — and I'm well aware — there are plenty of people in the US and many states who hate the idea of the government forcing vaccination on anyone.

All that said, what about kids? What about those kids under 12 years of age? Should they be part of mandates in New York City? Would I be arguing that we have to mandate vaccination for kids? No, and here's why. Those approvals have been emergency use authorization. Parents are nervous if they worry that they're not fully tested and licensed before they give something to a child.

I'm well aware that public health people say that there's not a big risk of long-term effects from vaccination, and I even understand the science that tells me why. The elements, if you will, of the vaccine get eliminated from the body quickly enough that we have to start talking about repeated shots, so that's not a long-term risk.

Nevertheless, that's not what parents hear when it comes to kids, babies, or infants. They worry whether the experts really know what they're saying. Can I trust this? I don't want to alienate parents from getting their kids vaccinated. Should we try to persuade them? Urge them? Yes. COVID-19 is still a threat to kids. There are still kids dying from COVID or getting long-haul COVID-19, and it's a big enough risk that it's right there with tetanus, measles, mumps, and many other infectious diseases as something we want to try to prevent. It's right there in terms of saying we have safe vaccines that are not risk-free but are almost risk-free.

Until the evidence is accumulated to say this is licensed, whether it's initial vaccines or so-called booster shots, I'm not going to push parents past their comfort zone. I think parents want to protect their kids above everything else and I respect that ethic. They don't want to get into fights all around the country, with some parents saying, "You're going to do something based on incomplete or not full evidence before licensure, telling me I have to mandate vaccination for my kid." I don't think that's worth that battle.

Once licensed, should COVID-19 join the list of vaccines that we ask school kids to get? Yes, because school is one place where transmission happens, and school is a place that we want to keep open. Do we need more testing and masking to go along with vaccination? Sure, but that's a fight that's down the road.

Right now, let's urge parents to do the right thing and try to convince parents to do the right thing. I don't think it is the time to tell parents, "If you want to send your kids to school, it's a mandate. If you want to send your kid to do things in the city, it's a mandate." I think it's premature and will result in unnecessary resistance.

I'm Art Caplan. I'm at the Division of Medical Ethics at the New York University Grossman School of Medicine. Thank you for watching.

Arthur L. Caplan, PhD, is director of the Division of Medical Ethics at New York University Langone Medical Center and School of Medicine. He is the author or editor of 35 books and 750 peer-reviewed articles as well as a frequent commentator in the media on bioethical issues.

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