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Despite a surge in new coronavirus cases, schools are preparing to welcome students back to class this week with vaccination clinics and strict safety protocols as 49% of the student body is still ineligible to get a COVID-19 shot and many adults are unwilling.

Many people fear the spread of a highly contagious variant of the virus, but education officials have committed to reopening campuses after more than a year of distance learning took a heavy emotional and academic toll on children.

Health officials also note that while the number of infections in children is rising, the number of pediatric hospitalizations remains low.

“Remember, what we worry about is severe illness and we’re not seeing any increase in kids receiving hospital care,” said Melinda Ashton, a pediatrician and executive vice president of Hawaii Pacific Health.

“We’re trying to weigh risks and benefits always in this pandemic,” she said. “It would appear currently that the benefit comes from having kids in person, in school.”

One of the main concerns is that some 216,000 kids in Hawaii are under 12 years old and still not eligible to get a COVID-19 vaccine since the Food and Drug Administration has only given emergency authorization for ages 12 and up. Availability of the vaccine for kids under 12 isn’t expected until .

, 46% of the 97,148 children aged 12 to 17 are fully vaccinated and 58% have received at least one dose.

Former Superintendent Christina Kishimoto — whose tenure ended on Saturday — said roughly 80% of the DOE’s 22,500 employees, including some 13,500 teachers, are vaccinated though no precise figure is available.

Teachers are worried about the high number of unvaccinated students, but they’re still enthusiastic about officially starting the new school year on Tuesday.

Vaccine Mandates?

“Not vaccinated? That’s a tough one — it would be better if they were and if parents were on board, just for peace of mind for myself,” said Kevin Agtarap, a fourth grade teacher at Kaimiloa Elementary School in Ewa Beach.

Agtarap takes comfort in the fact his school will enforce masking, social distancing and hand-washing. Students also will keep their own supplies in their desks and cubbies to minimize contact.

Additionally, instead of passing out paper and pencils, he plans to assign things through Google Classroom to minimize physical contact.

The DOH on Monday released updated guidance for schools, urging vaccinations, mask-wearing indoors and in crowded outdoor situations, frequently washing hands, keeping students in small groups when possible and staying home when feeling unwell.

DOH director Libby Char said in a press conference Friday that children need to be back in school, even with the surging case count.

“There is risk involved in everything, but I think we also have to be cognizant that there is a cost to not having children in school and having them fall further behind in learning and the continued social isolation,” she said.

In addition to customary safety measures like masking and 3 feet of spacing, Washington Middle School in central Honolulu will implement daily health checks for students and ask about recent large family gatherings. The school is turning to an online app this year so kids can fill it out at home first, said principal Michael Harano.

“We feel pretty good about our protocols as long as people stick to them,” he said. “We have some kids who cannot get vaccinated. It is a worry but we feel our protocols can make up for that.”

The Hawaii Department of Education has not made it mandatory for eligible students or employees to get vaccinated before coming to campus, although the DOH has recommended that schools at least know the vaccination status of their staff and students.

“Right now, we don’t have a mechanism for verifying the vaccination status of students or employees,” said DOE spokeswoman Nanea Kalani.

When asked about vaccination mandates for schools on Friday, Gov. David Ige said his administration is evaluating how the federal government is handling the issue with federal workers and that he is “having discussions about state and county employees.”

State officials have been arranging school-based vaccination clinics since May to reach more students and their family members. From this effort alone, roughly 26,400 individuals have been vaccinated across 109 school sites, according to DOH spokesman Brooks Baehr.

“It’s specifically to target kids, but if you have a child coming in with a parent, brother or sister, and you can get them vaccinated, we’ll do it,” he said. “We’re pulling out all the stops.”

Carl Hinson, the lead coordinator for Hawaii Pacific Health’s mobile vaccination clinics, said the school-based efforts were highly successful in the early months but interest diminished, reflecting a nationwide trend.

“Not unlike anyone else, we started to see a drop-off as we got through the initial surge,” Hinson said. “I think with the current wave we’ve seen a little bit of an increase, now hovering between the 100 to 150 range, each time that we go out.”

The DOE has said these school-based vaccination clinics will continue into the new academic year. And once the vaccine becomes available to those under 12, Hinson said health care providers are expected to see “another sizable increase in demand.”

And while Lt. Gov. Josh Green, an emergency room physician, said more young people are catching COVID-19 with the new variant in play, he also said “extremely few” have been hospitalized.

“Schools will have to be smart, keep kids in cohorts, have them wearing masks. We know it’s difficult to get a 5-year-old to wear a mask all day but we’ll do our best,” Green said on the earlier this month.

“It’s a real challenging situation. I just don’t think you can go through 2021 and 2022 and once again leave children at home, parents unable to work,” he said.

In the private school sphere, Punahou School is asking all eligible families and employees to upload their vaccination status via the school’s website, according to spokesman Robert Gelber.

Any student who is eligible but not yet fully vaccinated by the Aug. 18 start of the new school year will be required to test for COVID-19 on a weekly basis, he said, adding that nearly all employees have been vaccinated.

The Honolulu K-12 school had “zero cases of COVID-19 transmission on campus last year,” he said.

In a survey conducted by the last month, 85% of the private schools that responded said they would not require vaccinations for eligible students, and 81% said they would not require vaccinations for staff.

However, 73% of respondents said they would require masking at all grade levels, while 85% said they would conduct regular COVID-19 testing for students.

Temperature checks will be less common, with only 47% of schools saying they would require those.

“Because each independent school is a private nonprofit business, it can set whatever conditions for participation/access to its services that it wishes as long as these do not violate federal non-discrimination laws,” said Phil Bossert, the association’s executive director.