American College Health Association Recommends COVID-19 Booster Shot for All Students, Faculty, and Staff

In April of 2021, the American College Health Association (ACHA) recommended that institutions of higher education (IHEs) require COVID-19 vaccination for all on-campus college students for fall 2021. As of December 10, 2021, 1,123 IHEs had implemented requirements that students or employees be fully vaccinated, which, according to the CDC occurs two weeks after individuals have completed their second dose of Pfizer or Moderna vaccine or two weeks after the single dose of Janssen/Johnson & Johnson (J&J) vaccine. While we are encouraged by the number of IHEs that have a requirement in place, the Mayo Clinic Vaccine Tracker reports that as of December 19, 2021, only 58.2 % of 18-24-year-olds were considered “fully vaccinated” for COVID-19. Given the low vaccination rate, increasing surges driven by the Delta variant and the emergence of the Omicron variant, ACHA once again strongly recommends that IHEs require COVID-19 vaccination for all on-campus college students as the best path toward protecting the campus community.

Recent developments related to increases in breakthrough infections due to waning immunity present a new challenge to IHEs. To best meet this new challenge, IHEs should strongly recommend COVID-19 booster shots to their students, faculty and staff. Schools that have yet to adopt a vaccination requirement should communicate the importance of the initial vaccination series as well as the importance of a booster shot six months after the initial series (two months after J&J). These recommendations apply to all students who live on campus and/or participate in on-campus classes, studies, research, or activities.

In settings that have already achieved high levels of the primary vaccine series, ACHA encourages IHEs to consider all feasible approaches to maximize the receipt of boosters as well, given the evidence that a booster will offer even greater protection and may further reduce the impact on campus resources.

To successfully implement a robust program to encourage vaccination and reduce hesitancy:

• IHEs should strongly urge students to obtain the primary series of vaccinations (if not already vaccinated) as soon as possible.
• IHEs should urge students who have completed the primary series to obtain a booster shot six months after the initial series of Pfizer or Moderna and two months after vaccination with Johnson & Johnson vaccine. Winter recess offers an opportunity to achieve vaccine protection before returning to campus for spring semester.
• IHEs should ensure easy access to vaccine and booster shots through clinics on or nearby campus as resources allow.
• IHEs should provide protected management and storage of COVID-19 vaccination documentation and utilize this data to track campus vaccine coverage.
• IHEs should allocate the appropriate resources needed, including staffing.
• Frontline student health staff should be required to be vaccinated and have received the booster shot. Faculty and non-health service staff should be strongly encouraged to do the same.
• Layered mitigation strategies should be in place as recommended in the ACHA Updated COVID-19 Considerations for Institutions of Higher Education (December 2021).

ACHA supports vaccination as a critical step in creating safe campuses where learning can be actively pursued. ACHA also recognizes that each IHE will make its own decision about a vaccination requirement based upon its unique circumstances, including state, tribal, and territorial restrictions; the campus demographics; vaccine availability; staffing; and available resources. Where state law and available resources allow, ACHA recommends adding COVID-19 booster shots to existing requirements for all on-campus college and university students.