Vaccines for children are coming. So does the even fiercer debate over mandates.

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The news Friday that Pfizer’s COVID-19 vaccine is highly effective in children raises hopes that by Christmas, children as young as 5 could be getting their shots and the pandemic could be another big step towards an end. Unfortunately, it also sets the stage for even more emotional and divisive battles over whether to make these injections mandatory for children.

Much depends on the evolution of the pandemic as well as the regulatory process. But if and when federal regulators fully approve COVID shots for children, it would make sense to add them to the list of mandatory vaccinations children must receive to attend school safely.

Some jurisdictions have already required injections for teenagers eligible for the Pfizer vaccine. Los Angeles is mandating vaccination, and the rest of California is also moving in that direction. In New York, Democratic candidate and likely next mayor Eric Adams wants to institute a vaccination mandate for college students there.

As loud as the clamor over adult warrants has been, the uproar over child warrants is likely to be deafening. Already, California politics have sparked protests across the state last Monday. Many objections are ill-founded. It is true, for example, that children rarely die or suffer serious consequences from COVID, but protecting their own health is only part of the reason to vaccinate them; they can still spread the disease to others, including the most vulnerable teachers and staff. Nor is a requirement an unconstitutional infringement of individual liberty; vaccine requirements are clearly legal under century-old Supreme Court precedent. In fact, schools across the country, including in Massachusetts, already require multiple vaccinations for children to enroll in school.

Yet the widespread nature of anti-vax sentiment, however unfounded, raises a legitimate concern about school mandates: If anti-vax parents are the ones who prevent their children from getting vaccinated, why should their children be the ones who should? suffer by being excluded. from school?

In California, the state said it will only phase in the requirement when vaccines receive full FDA approval. Currently, the Pfizer vaccine is only fully approved for adults; teenagers are eligible under special emergency approval. Waiting for full approval means the mandate will not take effect immediately and schools will have time to prepare and address any reasonable concerns parents may have. Although this means some delay, it is reasonable to wait to apply a school vaccination mandate until full approval.

In the meantime, one way to protect at least a subset of students who might be harmed by the mandate would be to lower the age of consent to receive injections. Obviously, first-graders should not be making their own medical decisions. But someone 16 is mature enough to decide whether or not to have a minor procedure like a COVID-19 vaccine. They may well come to a different conclusion than their parents about whether it is worth being kicked out of school because of a vaccine. Some jurisdictions have passed or are considering lowering their age of medical consent laws to cover COVID vaccines. Another approach would be to move from an opt-in model to an opt-out model, to make it harder – but not impossible – for parents to prevent their children from getting vaccinated.

While this discussion may seem premature, this is when school districts and states need to lay the groundwork for school vaccination mandates. Pfizer’s study found its vaccine to be 91% safe and effective in preventing symptomatic infections in children ages 5 to 11. Emergency approval could come as soon as next month, and there are already children’s doses on the shelves waiting for the green light from regulators for immediate shipment. Full approval could come next year. Sooner than most Americans think, their children will be eligible for the vaccines that could help end the pandemic — and all the controversy that comes with them.


Editorials represent the opinions of the Editorial Board of The Boston Globe. Follow us on Twitter at @GlobeOpinion.

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