College and university students are low on the list to receive COVID-19 vaccines, according to recent estimates.

Unless students are classified as essential workers — such as medical, nursing, medtech or student teachers — or have a health condition — such as human immunodeficiency virus or cancer — they are not likely to receive the COVID-19 vaccine until at least April, according to Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases.

An assessment by the National Academies of Sciences, Engineering and Medicine (NASEM) of who should receive the vaccine and in what order placed younger people at a low priority compared with older recipients or people with health issues that make them more vulnerable to COVID-19 complications.

NASEM created the assessment at the direction of the U.S. Centers for Disease Control and Prevention (CDC) in Atlanta and the U.S. National Institutes of Health (NIH) in Maryland in October 2020. While the CDC recommends vaccination rollout procedures, states determine how to implement vaccine distribution.

Students say they are eager for campuses to reopen and classes to resume in person, and that inoculating students with the COVID-19 vaccine will hasten a return to education.

But distribution efforts have been disorganized, with delays, a lack of supply and appointment cancellations, compounded by varying policies in each state.

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Imani Bell, a senior at the University of Delaware, is one of the few college students eligible for the vaccine through her teaching program. But despite trying to sign up for vaccinations in Delaware and her home state of New Jersey, she has had no luck scheduling an appointment; there are not enough doses of the vaccine available, she said.

“I hope that the rollout starts to pick up and that everyone has access,” said Bell. “It doesn’t make sense that we’ve been in this pandemic for a year and it’s still taking so long. It’s frustrating to me that there are [few] companies making the vaccine when it could go so much faster.”

Eduardo Castellet Nogués, a sophomore from Spain at American University in Washington, said he’s seen some European universities open without complete vaccination.

“They’re finding ways to do it,” Nogués said. “I think this is the safest way to start that. If the entire campus is immune, then there’s absolutely no risk of anyone getting COVID.”

Some campuses — like Rowan University in New Jersey, Worcester Polytechnic Institute in Massachusetts and Lasell University in Massachusetts — are serving as vaccination sites, according to Gerri Taylor, co-head of the COVID-19 task force at the American College Health Association (ACHA).

The vaccination sites are available only to prioritized groups, such as those older than 65. But they will serve college students when doses become available, Taylor said.

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While it would “be ideal,” Taylor said, to have campus-based vaccinations, vaccinating students near campuses would suffice.

“And I would hope that schools will do a good deal of advertising about where those locations are, make them convenient for students and also give a lot of information about the vaccine,” she said.

Taylor argues that vaccinating students before they leave campus and travel home would be a huge help to stopping the spread of the coronavirus by college students who routinely go between school and home into the community.

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“We all, students included, still have to pay strict attention to wearing masks, physically distancing, avoiding crowds and washing hands, all of those public health measures that we have had in place throughout still need to be put in place,” she said.

There have been nearly 400,000 coronavirus cases on more than 1,900 college and university campuses since the start of the pandemic more than a year ago, according to the most recent tracking data from the New York Times. At least 90 students have died of coronavirus-related complications.

Joshua Goodart, a 22-year-old student at University of New Haven in Connecticut, died from coronavirus on February 6, the Hartford Courant reported. While Goodart had asthma, he was not considered high-risk for COVID-19 complications.

But some college students say they’re wary of coronavirus vaccinations. A study conducted at Eastern Connecticut State University of 592 graduate and undergraduate students showed that about half of students surveyed said they would get the vaccine, and half would not or remained uncertain.

Institutions of higher education are debating whether to require students to be vaccinated before returning to school, raising legal questions.

“Many colleges and universities can and do require that students be vaccinated against certain diseases,” such as human papillomavirus (HPV) and meningococcal disease, said Suzanne Rode, a counsel at Crowell & Moring, a law firm in San Francisco.

“The COVID-19 vaccines differ in that they have been authorized by the Food and Drug Administration under an Emergency Use Authorization, making the vaccines available sooner than they normally would due to the current public health emergency,” she explained.

Other challenges for not getting the vaccine might include “valid medical, disability, and sincere religious reasons can serve as a basis for declining the vaccine,” said Rode.

International students will be eligible for the vaccine as other students in their priority group, former Surgeon General Jerome Adams confirmed in December. Specific vaccination guidelines for those living, working and studying in the U.S. can be found on the government websites of the states where they reside.

Some international students are deciding whether to receive the vaccine in the U.S. or in their home countries. Nogués plans to get his dose of the vaccine wherever it becomes available first.

“From what I know, it is very likely that I will get it in the U.S. before I get it in Spain because the rollout in Spain has been slower than a lot of European countries,” Nogués said.

Benjamin Ola. Akande, president of Champlain College in Vermont, says that college and university leaders have a duty to protect the health of international students on campus during this pandemic.

“Coming to the college in the U.S. today is a life and death decision, and we need to recognize that,” said Akande, who came to study in the U.S. from Nigeria in 1979. “It’s a very conscious decision and therefore, there’s a responsibility on leaders of academies to ensure the safety and health care of students.”