Education Week - September 22, 2021 - 4

Can They Do That? Questions Swirl Around
COVID-19 School Vaccine Mandates
By Mark Walsh
Vaccines-and the legality of
mandating them-are once again at
the center of the debate over public
health measures. Opponents already
have vowed legal challenges to the
Los Angeles Unified School District's
vote to require COVID-19 vaccines for
all students 12 and older who attend
school in person, among a handful of
few districts nationwide to take such
a steps so far.
Some courts have already refused to
block vaccine mandates for workers
and for college students, ruling that
challengers are unlikely to succeed on
the merits of their claims under U.S.
Supreme Court precedents.
So, let's look at the legal landscape,
especially for vaccines requirements
for students.
How long have school
vaccination mandates been
around?
Historians say Boston, in 1827,
became the first U.S. city to require
children entering its public schools
to show evidence of vaccination for
smallpox. School vaccination laws
spread across many states in the latter
half of the 19th century.
When did the U.S Supreme
Court first rule on vaccine
mandates?
More than a century ago. Here's how
it came about.
In 1902, Massachusetts gave municipalities
the authority to adopt
penalties for the unvaccinated. That
same year, the board of health in
Cambridge, Mass., required all inhabitants
to be vaccinated for smallpox,
which was epidemic in that area.
Henning Jacobson, a Lutheran minister
who had had an adverse reaction
to a smallpox inoculation in the
past, refused to follow the mandate.
He was fined $5, about $140 to $150
today, and he appealed all the way to
the U.S. Supreme Court, arguing that
the mandate violated the due-process
clause of the 14th Amendment.
In its 1905 decision in Jacobson v.
Massachusetts, the court upheld the
state law based on the state's " police "
power, its general authority drawn
from English common law to legislate
in many areas. " The police power of a
state must be held to embrace, at least,
such reasonable regulations established
directly by legislative enactment
as will protect the public health and the
public safety, " Justice John Marshall
Harlan wrote for the court. " A community
has the right to protect itself
against an epidemic of disease which
threatens the safety of its members. "
Harlan suggested the vaccine requirement
could not be enforced against an
unvaccinated person for whom a " particular
condition of his health or body
would be cruel and inhuman in the last
degree. "
Has the Supreme Court ruled
on a vaccination mandate
specific to schoolchildren?
Yes. In a 1922 decision, Zucht v.
King, the court upheld a San Antonio,
Texas, city ordinance that required
public and private schools in the city
to provide a list of pupils, teachers,
and other personnel and whether
they had complied with a requirement
for a vaccination for smallpox.
The ordinance was challenged on behalf
of a student, Rosalyn Zucht, who
was expelled from a public school
when her parents refused to provide
a certificate of vaccination. Their suit
argued that smallpox had not been
much of a problem in San Antonio for
some 10 years, and that other children
had gone unvaccinated but were not
expelled. The suit raised 14th Amendment
equal-protection and-due process
claims.
In a short decision, Justice Louis
D. Brandeis reinforced Jacobson,
saying that case and others made it
clear that a state could delegate to its
municipalities the authority to adopt
measures such as vaccination requirements.
" These ordinances confer not
arbitrary power, but only that broad
WHAT THE
RESEARCH SAYS
Here's One Way to Improve Students' Reading Scores: Get Them Eyeglasses
By Sarah D. Sparks
After more than a year of significantly increased screen
time and disrupted vision testing for many students, new
research shows how learning could improve if schools help
identify and swiftly correct students' developing vision
problems.
A new randomized clinical trial of a vision screening and
eyeglasses program at the Baltimore City public schools
finds providing rapid eye exams and glasses, in addition to
standard vision screenings, uncovered significantly more
vision problems and improved reading performance for
participating students over three years.
Nearly 7 percent of U.S. children under 18 have a
diagnosed vision problem, according to federal data. But
school closures and social distancing in the last year have
disrupted routine campus-based vision screenings in many
districts. Even before the pandemic began, nearly a third of
children had not had a vision screening in the last two years.
(The American Academy of Pediatrics and the American
Academy of Ophthalmologists recommend children get an
eye exam every two years if they have never been diagnosed
with a vision problem, and annually if they require vision
correction.)
" Providing a child who can't see clearly [with] a pair of
glasses is a very simple and straightforward intervention,
but there are multiple layers to that process happening,
and there are a lot of equity issues that make it less likely
to happen in a more-disadvantaged community, " said
Megan Collins, a pediatric ophthalmologist and assistant
professor at the Wilmer Eye Institute at Johns Hopkins
School of Medicine in Baltimore, who co-authored the study
published this month in the Journal of Ophthalmology.
The Vision for Baltimore initiative provided a full vision
screening to every student in grades 3 to 7, every three
years. Students who failed the screening were also given
full eye exams and glasses if needed at no cost to their
families.
Because only a third of schools in the district participated
in any given year, researchers from Johns Hopkins
University compared the performance of more than 2,300
students in grades 3 to 7 in schools who received eye exams
and glasses in each school year from 2016 to 2019 to those
whose schools did not participate in the program that year.
After a year, they found students who received the
Around 40 states require some sort of vision screening in
K-12, but prior studies have found low-income students and
students of color are disproportionately less likely to have
regular vision screenings and correction than higher-income
and white students.
She noted that a third of the mostly low-income students
screened with the Baltimore program ended up needing an
exam and vision correction. The district serves more than
75,000 students, about 76 percent of whom are Black and
14 percent are Hispanic. Nearly 60 percent of the district's
students are low-income.
" Historically kids who failed a vision screening before this
program existed may never have gotten to an eye doctor, "
Collins said. " Anecdotally, we know for a lot of these kids, it
was their first pair of glasses. "
Maryland only requires students to receive vision
screenings at kindergarten, grades 1 and 8, or the first
year a student enters school. The state does not require
schools to follow up with students who fail the screening
to make sure they get a full eye exam or vision correction.
exams and glasses performed better on the i-Ready test
in reading. The overall gains in reading were .09 of a
standard deviation, or enough to move a student scoring at
the 50th percentile up to the 54th percentile. Students who
saw the biggest improvements were those who initially
performed in the lowest 25 percent of readers and those
with disabilities who each saw improvements of .25 of a
standard deviation or more. Female students improved by
a slightly smaller amount. All the participating students
also improved to a lesser extent on the math tests, but only
in elementary school.
Collins said the findings suggest schools should provide
more follow-up for children who fail regular vision
screenings, to ensure they actually get support to correct
vision problems.
" A vision screening ... is done usually by a technician
or a school nurse, sometimes a teacher, " Collins said.
" It's not diagnostic; it's not done by an optometrist or an
ophthalmologist. If a kid is referred to an eye exam, it's
usually done by an optometrist or an ophthalmologist;
it is a medical exam that helps ascertain whether or not
From remote learning for young children to playground infection risks, schooling under the pandemic is raising a lot of questions for teachers and education leaders. This new research column aims to help
readers understand what the research says-and doesn't say-about our new context for learning. If you have a question, please send it to ssparks@educationweek.org.
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