Lancaster, Pennsylvania 

After surviving more than a decade in a Tanzanian refugee camp where learning was limited, Riziki Elisha, 11, wanted nothing more than to attend the elementary school just a few hundred yards from her front door. 

Though she could see the playground from her porch, she wasn’t permitted to partake: Paperwork delays left her sitting at home for weeks, spending long afternoons watching CoComelon, a cartoon created for babies and toddlers.

“I was very frustrated,” she said with the help of a translator on a recent afternoon. “I felt bad.”

It’s been nearly nine years since the School District of Lancaster was for denying or delaying enrollment for young refugees — or for sending them to an off-site, for-profit alternative school focused on behavior management. The case was settled in  

But families, staff and advocates say the district, which serves kids in an , is once again erecting barriers that have left dozens of newcomer children idle in the past few years — some for months. A major contributing factor, they say, is Lancaster’s insistence on tuberculosis testing. 

Other Pennsylvania districts with sizable multilingual learner populations have chosen not to require a test for the infectious lung disease, including Philadelphia, Reading, Norristown, Harrisburg City, Pittsburgh, Lebanon and Chambersburg. Upper Darby does require TB testing. State officials told Â鶹ľ«Ć· schools “should not delay a student’s enrollment while TB test results are pending” and that parents or guardians concerned about this issue should .

Another holdup, newcomer families note, is the district’s need for birth certificates. They can be hard to obtain quickly, and, according to federal guidelines, their absence Proof of address, they say, has also been an obstacle as some families initially struggle to secure permanent housing. 

Immigrant advocates, including staffers inside the district, say these students should be seated immediately while their families are given time to produce the requisite paperwork. The new arrivals, many of them behind their American-born peers, would be able to make fast gains, they argue, if granted speedy enrollment.  

Â鶹ľ«Ć· presented its findings to the district, which said it wants students to be enrolled “as quickly as possible when all requirements are met,” — and those include TB testing for some kids.

It said the district’s clinic provider contacts families directly to schedule the tests and that it recently added a full-time bilingual enrollment navigator to identify and work with families “who are slow to complete the process.”

State officials said schools have been able to opt-out of student TB testing since 1997 — and many do. But not Lancaster.

It asked the state to keep its TB testing requirement for a specific group: newly enrolling students who have been outside the U.S. within the past six months. The district cited recommending testing for those who are at higher risk of exposure, including people “who are born in or frequently travel to countries where TB is common, including some countries in Asia, Africa, and Latin America.”

The state is clear that enrollment should not be held up pending results.

Riziki’s father, Elisha Sumaili, who hails from the Democratic Republic of the Congo, told Â鶹ľ«Ć· through a translator that he was confused by the delay, which stemmed from his inability to immediately produce a lease. The family tried to enroll October 25, 2024, but his daughters were not admitted until November 22. 

Sumaili wants his children to hold tight to their education so they might one day become doctors. Instead, Riziki and her high school-age sister were kept out of the classroom.

“When the kids were home, it was really bad,” their father said in Swahili. “It was bringing the family a lot of distress.” 

Carolin Cruz, 29 and from the Dominican Republic, has always prioritized education, both for herself and her daughter. Cruz completed more than two years of college — she dropped out because of the cost — and wants 10-year-old Ferolin to go even further, which is what prompted the pair to move to the United States last fall, she said. 

“I want to see her become a great professional so she can have what I cannot,” Cruz said. 

Public education in her home country is and expensive, she said: She’d have to pay for her daughter to learn English. Plus, her local school was overcrowded. 

“If there are 30 or 40 students, there is no way a teacher can pay attention to any one student,” she said. 

She hoped for much better in the United States, but her daughter’s start date was delayed by two months, primarily because of the TB testing requirement. When she tried to schedule the shots, Cruz said she was told the only available appointments were weeks out. 

On two occasions, she said, the appointments were cancelled. 

Ferolin, a fourth grader who loves mathematics, said she felt sad sitting at home. 

“I was not doing anything,” she said through a translator. “I wanted to go to school so I can learn more. I would get up, help my mother around the house, and then I would be on my mother’s cell phone watching TikTok and YouTube.”

Fifteen-year-old Kevin, whose family asked that their last name not be used because of immigration-related concerns, suffered the same fate — except his went on for several months. 

His family fled Cuba because the country lacked a “functioning economy,” Kevin’s mother Neydis told Â鶹ľ«Ć·. They arrived in the U.S. in March 2024. 

Neydis’s husband, a medical doctor in his home country, wanted his son to enroll in eighth grade right away. Kevin tried to register for school on April 16, 2024, but wasn’t seated until the next school year on August 26 — mostly because of immunizations and the TB test. His mother said they sent the TB results to enrollment staffers several times and assumed they would call back with a start date, but the call never came. The family was forced to restart enrollment because the process had dragged on for so long.

Kevin spent those months at home surfing the internet and watching nature programs. 

“It was boring, I would just sit on that sofa,” he said through a translator, pointing to a cream-colored couch in the living room. 

By the time the district admitted him, he had missed the rest of his eighth-grade year and had to go right into high school.

Born in a forest

Such delays are not unique: Rwamucyo Karekezi, who served as Â鶹ľ«Ć·â€™s translator with the Sumaili family, is a refugee and immigrant community organizer with Church World Service. He estimates that he’s helped more than 100 children register in Lancaster public schools between 2021 and 2024. 

Karekezi, who noted that he was not speaking on behalf of Church World Service, said month-long delays are common — most of the children he worked with experienced them — and stressful on the families. 

Vaccinations play a key role in the delays, he said, as does proof of address. Many families initially live in temporary housing — Airbnbs and hotels — and can’t quickly prove they reside in the district, he said. 

“Sometimes it takes months to find a house,” he noted. “This becomes a challenge for registration to go smoothly.”

As for birth certificates, some children around the world aren’t issued such formal documents upon their birth — or their families might lose them in their chaotic journey to safety. Karekezi, 30 and who is also from the Democratic Republic of the Congo, understands their plight.  

“I never had a birth certificate,” he said. “I was born in a forest, not a hospital. In Congo, they don’t register kids like that. And even when you bring a birth certificate, they don’t recognize it: It’s a scrap of paper in another language.”

Karekezi said he sent the district follow-up emails on students’ behalf, but they did little to expedite the process. 

While Lancaster has its own history of refusing or slow walking newcomer students’ registration, related issues are now playing out on the national stage: President Donald Trump pledges to deport undocumented families — — and opened schools to immigration enforcement actions. 

His conservative allies in multiple states seek to in a direct challenge to the Supreme Court’s landmark 1982 Plyler v. Doe decision.

Likewise, federal budget cuts have crippled the agencies that help immigrant families most, including , a faith-based group founded just after World War II that resettled more than 100,000 people in the United States in its first decade. Trump recently and even though that move was blocked in the court, he said it will . 

Lancaster’s local Church World Service office has recently shrunk in size and capacity. Once located inside a massive building on a well-traveled block, it’s now squeezed into an alleyway hidden by parking garages. It had to drastically cut services when it was forced to furlough 40 of its 67 staff members for three months at the end of January. Valentina Ross, its director, said she hopes to call some of those staffers back into the office soon.

After lost learning, big gains

Riziki Elisha has made great strides since starting elementary school just days before last year’s Thanksgiving break, her English language development teacher Laura Kanagy said. 

“In three months, Riziki went from knowing three- or four-letter sounds to reading and writing short sentences,” the educator noted. “She can identify the hydrosphere, biosphere and geosphere. She can add and subtract triple digits and fractions. Imagine what she’d be doing if we had been able to work with her for those extra months?”

Kanagy, who has taught at the district for 14 years, said she and her fellow educators “want the most time possible” with these new students. 

“Each day that they sat at home in front of their TVs was a lost day of learning: 10 new vocabulary words, a few letter sounds closer to reading, a math skill important to navigating the grocery store, a social phrase to connect with peers,” the teacher said. 

Enrollment also means these students — and their families — have access to myriad services, including English and GED classes for their parents, help obtaining eye glasses, clothing, food, dental care and other necessities.  

“The sooner they have access to English and literacy/math skills, the sooner they — and, therefore, their families — can make more of their own choices about how to live and participate here,” she said.

Once admitted, Neydis’ mother said her son, Kevin’s experience at the school was excellent.

“The teachers are nice and just go out of their way using different teaching strategies — a game or whatever they could come up with — to help him learn,” she said. “He would come home very excited, very, very content. And this was a huge relief for me.”

When Ferolin Nunez Cruz finally enrolled — she started the process on December 2, 2024, and wasn’t seated until January 27 — she thrived in the classroom. Since then, she’s begun using simple phrases in English around the house, her mother said, including “yes,” “hi” and “good morning” and shares what she’s gleaned with her mom and other relatives, helping them crack the language divide. 

“She is more focused in regards to her learning,” Cruz said of her daughter. “She is very motivated. And I want to say that I have received a lot of support from the teachers. They are paying attention to my daughter. I appreciate that very much because I really needed that.”

Asked what she loves about the experience of an American education, Ferolin’s answer was simple: Everything. 

If she could speak directly to Lancaster school administrators, Ferolin said she would ask them to make the enrollment process easier for students like her.  

“Help us,” she said. “They have to help us to make it possible to go to school. They should help me get into school so I can learn many things so I can help my family prosper, to help them when it’s my turn.”

Their shots, delivered as two 25-microgram doses spaced four weeks apart, produced a similar immune response in young children as two larger doses did in adults. In a 6,700-participant randomized trial the vaccines triggered no safety concerns such as myocarditis or multisystem inflammatory syndrome, the company said in a .

“We now have clinical data on the performance of our vaccine from infants six months of age through older adults,” said Moderna CEO StĂ©phane Bancel. “Given the need for a vaccine against COVID-19 in infants and young children we are working with the U.S. FDA and regulators globally to submit these data as soon as possible.”

The update offers a glimmer of hope to many parents frustrated that their young children remain ineligible for immunizations more than two years into the pandemic, and who expressed dismay following a dramatic reversal last month from Pfizer-BioNTech, which withdrew its request for FDA approval of shots for children under 5 just days after submission. 

“As an [infectious disease] doc and dad, I’ve been eagerly awaiting these data for 15 months now — sounds like we’ll see them soon. Fingers firmly crossed,” Roby Battacharyya on Twitter.

Trial data show shots were 43.7% and 37.5% effective in preventing illness among children 6 months to 2 years old and 2 years to under 6 years old, respectively. No immunized children in the study suffered severe disease or death, but neither did any youngsters in the control group who received no vaccine doses. 

Jacqueline Miller, Moderna’s senior vice president for infectious diseases, hypothesized that the lower efficacy reflected the Omicron variant’s ability to evade immune defenses. Regardless, she said, the shots convey a level of protection.

“What I will say is 37.5% and 43.7% are higher than zero,”, . “If I were the parent of a young child, I would want there to be some protection on board, especially if we see another wave of infections.”

The news comes as school mask mandates continue to drop across the country. Some 92% of the largest 500 school districts did not require face coverings as of March 23 compared to only 58% at the beginning of the month and 35% at the beginning of February, according to the .

On Tuesday, New York City Mayor Eric Adams announced that on April 4 the nation’s largest school district will be dropping its mask rule for toddlers 2- to 4-years old, which had stayed in place even after the city lifted its K-12 mandate.

Meanwhile, COVID cases in Europe are , fueled by the more transmissible Omicron subvariant BA.2. Even as infections continue to , many experts warn that the increases across the pond could foreshadow a coming wave in America.

As of March 16, 27% of children 5- to 11-year old and 57% of children 12- to 17-years old had completed their two-dose vaccine series, according to the .

On Friday, Pfizer-BioNTech that they will postpone their request that the Food and Drug Administration authorize their vaccine for children 6 months to 4 years old, saying they will wait for the data on a three-dose series. 

Three doses “may provide a higher level of protection in this age group,” the companies wrote.

In early February, Pfizer and BioNTech sent a rolling submission to the FDA for authorization of a two-dose round of shots, hoping to jumpstart the process of vaccines for little ones as early as the end of the month, while continuing to monitor whether a third dose may eventually be needed. But that timeline will now be halted until after researchers examine data from the three-dose regimen.

The FDA, in turn, pushed back its scheduled Feb. 15 advisory committee meeting to review the companies’ submission. 

“We will provide an update on timing for the advisory committee meeting once we receive additional data on a third dose,” said the federal agency in a .

Pfizer and BioNTech expect to have numbers on the efficacy of a third shot by early April, the companies said.

Younger children bear the lowest COVID risk out of all age groups and, even when unvaccinated, are less likely to fall seriously ill from the virus than vaccinated adults. But whiplash from the Friday announcement may frustrate many parents who were counting on the arrival of shots for some long-awaited relief after the Omicron surge brought on and widespread .

Health experts, too, expressed frustration with the sudden change in plans, worrying that it could undermine faith in the shots. 

“This rollercoaster that parents under 5 (including me) are forced to ride is an absolute, unacceptable disaster,” Katelyn Jetelina, assistant professor of epidemiology at the University of Texas School of Public Health, on Twitter. “Pfizer and the FDA need to get it together so the public knows what the (heck) is going on (and why) so we can continue to be confident in this process.”

Brown University’s Ashish Jha, on the other hand, : “This is good science in action. If we don’t yet have clear evidence of effectiveness, postponing a decision is the right thing to do.” He did, however, acknowledge “I know this will so disappoint parents of kids under 5.”

Pfizer-BioNTech shots for kids 6 months to 4 years old contain three micrograms of the vaccine, while the shots for teens and adults contain 10 micrograms and 30 micrograms, respectively.

Just under a quarter of children aged 5 to 11 and 56 percent of youth aged 12 to 17 are fully vaccinated against COVID-19, according to data from the .

In a pivotal development for school coronavirus safety, Pfizer-BioNTech announced Monday that its vaccine was for children ages 5 to 11 in trials.

These are the first such results for this age group in the U.S., and data have not yet been peer-reviewed or submitted to the Food and Drug Administration for emergency use authorization. The pharmaceutical company plans to apply for approval to use the shot in children , the New York Times reports, meaning that millions of 5- to 11-year-olds could be inoculated before Halloween if the regulatory review goes as smoothly for this age group as it did for adolescents.

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The trial included 2,268 participants ages 5 to 11 who were each given a two-dose regimen of the vaccine 21 days apart. Children were given a 10 microgram dose, smaller than the 30 micrograms administered to older children and adults, which the drug company said was a carefully selected dosage for safety, tolerability and effectiveness.

One month after the second dose, the shots produced an immune response and side effects comparable to that delivered by the larger dose in 16- to 25-year-old patients, Pfizer said. A company spokesperson confirmed to CNN that there were in the trial, a type of heart inflammation that has been linked with mRNA vaccines in boys and young men.

The results come at a pivotal time, as children now make up and as the highly contagious Delta variant has sent more children into hospitals in the past few weeks than at any other point in the pandemic.

“Since July, pediatric cases of COVID-19 have risen by about 240 percent in the U.S. — underscoring the public health need for vaccination. These trial results provide a strong foundation for seeking authorization of our vaccine for children 5 to 11 years old, and we plan to submit them to the FDA and other regulators with urgency,” said Albert Bourla, Pfizer’s chairman and CEO.

The trial results are a hopeful indication that shots will be available for young children before the winter months, when low temperatures complicate outdoor activities and ventilation across much of the country.

“We are pleased to be able to submit data to regulatory authorities for this group of school-aged children before the start of the winter season,” said Dr. Ugur Sahin, BioNTech’s CEO and co-founder.

​​Pfizer said it is expecting to release trial data for children as young as 6 months “as soon as the fourth quarter of this year.”

Already in the first weeks of the school year, tens of thousands of students have been forced out of class due to infection or exposure to the virus, oftentimes with sparse learning opportunities while they self-isolate. In Mississippi, where the state does not require that masks be worn in school, more than in just one week and over 20,000 students and staff were in quarantine.

Even as quarantines stack up, worst-case outcomes among healthy children — like chronic illness or death — still remain “vanishingly rare,” health experts told Â鶹ľ«Ć· earlier this month.

But with schools across the country scrambling to regularly test their student bodies as a screening measure against viral spread, the now-likely approval of shots for elementary schoolers before the winter may provide an alternate route for mitigation, and could open the door for more widespread COVID vaccine mandates for students in school.

Earlier this month, Los Angeles Unified became the country’s first major school district to require student vaccinations with a rule dangling full vaccination by the winter holidays as a necessary step to remain learning in person for students 12 and up. Culver City, California and Hoboken, New Jersey made similar moves in late August.

LAUSD officials chose not to comment when asked by Â鶹ľ«Ć· whether they would extend their student vaccine requirement to learners ages 5 to 11, should shots be approved for that age group.

In late August, the FDA gave full authorization to coronavirus shots for individuals ages 16 and up. Health experts are mixed on whether schools should mandate that 12- to 15-year-old students, who are currently approved for doses under emergency use authorization, receive the vaccine, according to interviews Â鶹ľ«Ć· conducted in early September.

Authorization of shots for younger learners “starts to open the door” for wider student vaccine requirements, Benjamin Linas, professor of medicine at Boston University, told Â鶹ľ«Ć·.

“We can and do mandate vaccines (like shots protecting against measles, mumps and rubella) for students all over the place, every day in this country,” he said. “We should treat [the COVID shot] like we treat all vaccines.”

Without mandates, districts may have trouble persuading their younger children to get immunized. Though youth ages 12 and up have been eligible for doses since May, only 43 percent of 12- to 17-year-olds are fully vaccinated, according to the American Academy of Pediatrics. After a high of 1.6 million pediatric vaccinations per week in late May, the rate has since fallen to 273,000 weekly doses in mid-September.

“It’s going to be an uphill battle addressing [vaccine] hesitancy in schools,” said Linas.

Learn more about the vaccine results for 5- to 11-year-olds here: