Some universities across the state have announced that they will be requiring the COVID vaccine for students returning to campus. UNC System public universities are not requiring, but encouraging, the vaccine. Some private schools, including Duke and Wake Forest, are requiring it.

Wake Forest issued a warning letter to students last week.

“As previously communicated, Wake Forest University requires all students enrolled in the Fall 2021 semester to be fully vaccinated against COVID-19,” the letter read. “For those of you who have not yet provided the required documentation, on August 1, the University will begin the process of removing you from enrolled courses and assigned housing.”

The COVID-19 vaccine is currently approved under an Emergency Use Authorization from the U.S. Food and Drug Administration.

COVID infection is statistically milder in young people, like college students, than in older people. During the height of the spread last year, the Centers for Disease Control released a data analysis that found while adolescents and young adults do become infected with COVID-19, chances of serious complications were slim.

“Among children, adolescents, and young adults with available data for these outcomes, 30,229 (2.5%) were hospitalized, 1,973 (0.8%) required ICU admission, and 654 (<0.1%) died,” the CDC reported on data from March 2020 through December 2020.

The UNC System says it will not mandate a vaccine for returning students, saying that there is not a clear legal authority for the university system to do so and deferring to the authority of the Commission for Public Health.

“Outside an amendment to existing law, the Commission is the only entity clearly authorized by state law to mandate immunizations for college students in this state,” reads a memo to UNC chancellors from UNC President Peter Hans. “The University respects the Commission’s historic and modern-day, expert role in determining which immunizations to require.”

The Commission for Public Health is the group authorized by the General Assembly to make rules to protect public health. Of its 13 members, nine are appointed by the governor and four are elected by the N.C. Medical Society. Most recently the commission extended a requirement that health care providers and labs report all COVID-19 diagnostic tests, positive and negative, to the state.

The N.C. Medical Society has not advocated for a vaccine mandate but has encouraged vaccination.

“The COVID-19 vaccine has proven safe and effective and is largely responsible for the return to normalcy we’ve been experiencing thus far this summer,” said society president Dr. Philip Brown in a press release. “It is crucial that anyone 12 years old and older who has not yet been vaccinated against COVID-19 get vaccinated so they can return to learning and socializing in an environment safe from the virus and beneficial to their intellectual and social development.”

Now, as college students start winding down internships and summer jobs, the personal decision about whether to take the vaccine may depend on where students attend college. In Virginia, public universities like Virginia Tech and the University of Virginia have mandated it for returning students unless they have a religious or medical waiver. UVA students who are not vaccinated are not even allowed on campus after July 1. However, UVA is making vaccination optional for employees.

In North Carolina, it is unlikely that the UNC System will mandate the vaccine for returning students unless the Public Health Commission acts, which is also unlikely while the COVID vaccine is still under Emergency Use Authorization from the FDA. If the FDA grants the vaccines full approval, requiring broader more long-term testing, the policy on mandates may change.