With social distancing in mind, student athletes run a drill during the re-opening of a strength and conditioning camp at Arlington Martin High School Thursday, June 18, 2020, in in Arlington, Texas. Credit: LM Otero / AP

When COVID-19 cases proliferated during the first few weeks of this school year, Scott Brabrand, superintendent of Fairfax County Public Schools in Virginia, had to send numerous high school students home while school officials verified their vaccination status and traced their contacts. After further investigation, Brabrand determined that most of the positive cases originated with student-athletes.

That conclusion was a major factor in his decision to require that Fairfax County student-athletes be vaccinated ahead of the winter season no matter the sport, including physical activities such as step teams and dance.

“Our athletic program has driven a large number of kids into having to be ‘paused,’” Brabrand said in an interview. “We knew moving forward with a vaccination mandate for our athletes preserves the instructional program for our school system, but frankly, it preserves the athletic program for our athletes.”

At least 12 states ban schools from requiring vaccines for students. The push to get more middle and high school athletes inoculated ahead of the winter season has rested heavily on local mayors and school leaders. Officials in counties and cities in California, Maryland, New York and Virginia as well as the District of Columbia are mandating vaccinations — with a few exceptions for weekly testing — for student-athletes. Hawaii has a statewide vaccine requirement for public school student-athletes.

School administrators and sports advocates say mandates stop disruptions to instructional time and keep kids safe.

COVID-19 outbreaks from last year and this fall that originated in schools often were traced back to sports, leaders say, which led them to mandate vaccines for athletes as opposed to all students. Many sports involve close contact, which increases the risk of COVID-19 infections. The paramount goal is to keep schools open and extracurricular activities going, the school leaders say, channeling the consensus that last year’s school closures and cancellations of activities wreaked havoc on kids’ mental and physical health.

Some school officials have expanded the mandates to all eligible students, not just athletes.

“In my own district, we’re already mandating vaccinations for students aged 12 and up and adults,” said Quoc Tran, superintendent of Culver City Unified School District in California. “[For student-athletes], many districts [in California] that I am aware of do not contest the mandatory vaccination policy at all because if you did, then you’ve just written off the entire athletic scholastic scholarships for a lot of our students.”

Some parents, however, feel the choice should be left up to them.

In preparation to reopen schools safely this fall, the Biden administration urged doctors and school officials to incorporate COVID-19 vaccines into physicals for sports. The American Academy of Pediatrics and the American Medical Society for Sports Medicine advised medical providers to ask about vaccine status during preparticipation physicals.

And in areas with high community transmission — which is everywhere now — the federal Centers for Disease Control and Prevention recommended that high-risk sports or extracurricular activities be virtual or canceled unless all participants are fully vaccinated.

Sports considered high risk for transmission include close-contact activities such as football, dance, wrestling and cheerleading.

Some parents, however, view the vaccine requirement as an infringement on their rights, said Marsha Lessard, president of Virginia Freedom Keepers, a nonprofit group that says it is opposed to all medical mandates.

Residents protested outside the Loudoun County administration building earlier this month. Elsewhere, critics have expressed concerns about vaccine side effects, though serious side effects from the COVID-19 vaccines are exceedingly rare.

“These are private decisions that need to be made between patients and providers,” Lessard said in a statement. “Legislators, who have no knowledge of a person’s unique bio make up and circumstances, have no place forcing medical decisions on them.”

Public schools have long required that parents vaccinate their children against a whole host of diseases before enrolling them in school.

Kim Putens, a mother of a 12th grader in Fairfax County schools, said she wanted her son to make his own decision, although she emphasized that mandates for student-athletes were nonsensical to her because those children are usually active and fit. Putens’ son, a lacrosse and golf player, decided not to get a COVID-19 vaccine, she said.

“When it comes to student-athletes, number one, they’re young. And number two, they’re probably in the best shape of their lives,” Putens told Stateline.

But young people can transmit COVID-19 to more vulnerable older people. And although they are much less likely to die or be hospitalized from COVID-19, some children have gotten seriously ill. Between July and September, nearly 500 children died from COVID-19, according to a report by the American Academy of Pediatrics and the Children’s Hospital Association, which relies on data from 45 states.

In 49 states and the District of Columbia, children up to 19 years old represented between 0 percent and .25 percent of all COVID-19-related deaths as of Sept. 16, according to the report. During the week of Sept. 16, nearly 226,000 children tested positive for COVID-19, the third-highest number of cases since the beginning of the pandemic.

Per the Fairfax County Public Schools policy, if Putens’ son doesn’t qualify for a religious or medical exemption, he will have to miss his last year of playing sports. Only children ages 12 to 15 have the option of submitting weekly negative COVID-19 tests to participate, in lieu of getting vaccinated.

The Pfizer vaccine has been approved for use in people ages 12 and up. That vaccine is expected to be approved for children ages 5 to 11 in the coming months.

John P. Bailey, a nonresident senior fellow at the American Enterprise Institute, a conservative-leaning think tank, said there is too little data on specific school cases to pinpoint the exact number of cases from athletic programs. When the North Carolina Department of Health and Human Services announced Sept. 9 that middle and high school sports accounted for 45 percent of case clusters, Bailey said, this sounded the alarm for local schools to implement mandates.

Bailey, whose research focuses on COVID-19 and reopening schools, said the conflicting and evolving guidance, mixed with misinformation and politics, caused confusion for some parents.

“As the role of a parent, you are bombarded with different opinions and information, and whenever you see disagreement, most parents … are always going to take the conservative approach and that largely means holding off on [decisions] until they can see the scientific debates resolved,” Bailey told Stateline. “[You think], ‘Oh gosh, the CDC looked at this and issued this guidance, it’s settled.’ That’s not the way a lot of parents end up receiving or processing information and assessing risk.”

Abrar Omeish, an at-large school board member for Fairfax County Public Schools, said school boards are in a tough position because policies must be inclusive. This includes students who remain skeptical and don’t trust the government and individuals who may have personal and religious beliefs that counter the science.

“I did ask the superintendent to look into other options to make sure we’re not marginalizing particular groups,” Omeish said in an interview. “Just because we’re moving forward doesn’t mean we have to forget or leave behind [people] who need other accommodations.

“We look at the data, numbers, what the CDC is telling us, then the science that says these mitigation tactics work. We take that guidance and move forward knowing there’s no perfect solution.”

In Hawaii, the state Department of Education delayed the start of the fall sports season and announced that student-athletes, athletic staff and volunteers across the state should be vaccinated by Sept. 24. The mayors of New York City and Washington, D.C., made the call for schools in their cities. Discussions in City Schools of Decatur (Georgia), Portland (Oregon) Public Schools and Sacramento City (California) Unified School District may result in vaccine mandates for all students.

Efforts to require vaccines for student-athletes haven’t been successful everywhere. In North Carolina’s Orange County Public Schools, the school board voted against a vaccine requirement for students involved in high-risk sports. The North Carolina Department of Health and Human Services and the Orange County Health Department advised the district to halt sports until Sept. 30 to slow the spread of COVID-19. The board ignored the guidance, instead limiting the number of guests allowed at the games and prohibiting concession sales, the Daily Tar Heel reported. In addition, athletes must wear masks on and off the field.

In higher education, some students at universities with vaccine mandates face severe consequences for not abiding by the rules. In August, the University of Virginia disenrolled nearly 240 students for failing to get a COVID-19 vaccine. And in other instances, undergraduate students at the University System of Maryland and Rutgers University sued their university and college for mandating vaccines. A federal judge sided with Michigan students Sept. 9 and blocked Western Michigan University from carrying out its vaccine mandate for student-athletes.

School leaders say vaccine mandates should not be seen as a punishment, but as a way for student-athletes to enjoy sports safely, after missing games last year.

Advocates for student-athletes note that sports play important roles in kids’ lives. Without sports, some student-athletes can’t receive college scholarships, and others can suffer mentally, emotionally and physically from not playing. Over the past year, COVID-19 safety restrictions have had just that effect, said Karissa Niehoff, executive director of the National Federation of State High School Sports Associations, an Indiana-based national sports membership organization that writes rules and guidance for high school athletics and performing arts programs.

About 31 percent of surveyed high school athletes reported that COVID-19 had a negative impact on their mental health, according to an article published in July in the Journal of Scientific and Technical Research. A study published in May by the Journal of Athletic Training found that adolescents who played sports during the pandemic reported fewer symptoms of anxiety and depression and higher levels of quality of life and physical activity than those who did not.

“All of those symptoms of disengagement are as important as the good that engagement brings,” Niehoff said. “We can’t forget what that was like when we didn’t have the opportunity to play. If we can keep that perspective that those considerations — as we debate whether or not we want to support getting kids vaccinated — it’s going to be helpful because the alternative when kids are not playing is as troubling.”

The National Federation of High School Sports Associations, which encourages student-athletes to get vaccinated, launched a campaign in August to spread awareness to students, coaches and staff about the safety of vaccines.

Dr. Jason Matuszak, a family sports medicine physician in Buffalo, New York, added that pauses and quarantines can affect athletes physically because they aren’t able to condition or exercise, which can cause injuries.

While he sympathizes with parents who support vaccines and those who oppose them, Matuszak urged an approach that considers the shots from a community perspective instead of an individual one, he said.

“As much as people have made this particular vaccination at this particular time a parents’ rights issue for their kids or a political issue, we don’t need to view vaccination as being anything other than a public health issue,” Matuszak said. “And we really need to be very aware that certain individuals are disproportionately affected by [the coronavirus pandemic].”

Story by Aallyah Wright, Stateline.