School Vaccination Requirements as Preventive Care Infrastructure

In health policy, the most effective interventions are not always the most dramatic—some work precisely because they are ordinary. School vaccination requirements belong in that category. They do not depend on a new platform, a breakthrough biologic, or a novel financing mechanism. They depend on a simple fact of civic life: families must enroll children in school, and enrollment creates a predictable moment at which the education system and the health system intersect.

That is why the current pressure on school vaccination requirements in the US matters more than it may first appear to. More than 200 vaccine-related bills have recently surfaced in the states, including proposals touching school requirements.¹ Broad support remains intact: a recent Kaiser Family Foundation poll² found that 83% of adults, including 75% of Republican voters, support public school requirements for some vaccines, with health and religious exceptions. Yet support is not as settled as it once was. A Gallup poll³ found that the share of the US population calling childhood vaccination extremely or very important fell from 94% in 2001 to 69% in 2024, and 20% now say vaccines are more dangerous than the diseases they prevent. The debate is, therefore, not imaginary. It is shifting.

The policy landscape is also less uniform than the word mandate suggests. All states require certain vaccines for school entry and allow medical exemptions for children with clinical contraindications. Nonmedical exemptions, by contrast, are based on religious or personal and philosophical objections and allow refusal even when a child is medically eligible to be vaccinated. These exemptions vary substantially in availability and process. Some states require parent education modules, documentation, or renewal; others make exemptions easier to obtain. California, Connecticut, Maine, and New York allow only medical exemptions.⁴ This variation matters because exemption design is not merely administrative. It shapes whether a recommendation becomes a routine or remains optional in practice.

The central mistake in the current debate is conceptual. School vaccination requirements are often framed as a clash between public health and individual liberty, as though their main function were to force the hand of unwilling parents. That account is incomplete. Requirements do contain legal pressure; they are conditions for participation in a shared institution. But they also structure time, paperwork, expectations, and access. They convert a recommendation into a routine. In practice that may matter less for the firmly opposed minority than for the larger group of families who are busy, behind, uncertain, moving between insurers or clinicians, or navigating the ordinary frictions of life.

Opposition to school vaccination requirements is not 1 thing. For some parents, it reflects safety concerns or misinformation about vaccine risks. For others, it reflects distrust of public institutions, religious or ideological claims about parental authority, or a broader preference for individual choice. Still others are not opposed to vaccination at all but struggle with appointment availability, transportation, forms, records, or time away from work. Lumping these groups together invites bad policy. A durable enrollment standard should answer misinformation honestly, avoid unnecessary symbolic escalation, and reduce logistical barriers for families trying to comply.

Evidence supports this more practical account. Repeal of nonmedical exemptions has been associated with higher kindergarten vaccination rates and only minimal substitution toward medical exemptions—approximately 0.4 percentage points in a recent national analysis.⁵ State-level evidence from California’s elimination of nonmedical exemptions through senate bill 277⁶ is consistent with this pattern, linking exemption tightening with changes in school-entry vaccine status. These findings do not prove that compulsion is irrelevant. Rather, they suggest that the policy works partly through defaults and deadlines, not simply through punishment. Many families appear to respond to the enrollment architecture itself. Conversely, policies or administrative processes that make nonmedical exemptions easier can shift the practical default away from vaccination, even when formal recommendations remain unchanged.

Community protection is the another reason that the individual-liberty frame is too narrow. Two doses of measles vaccine are approximately 97% effective at preventing measles.⁷ But even when vaccinated children are well protected, outbreaks can disrupt schooling, trigger exclusion protocols for unvaccinated classmates, strain local public health departments, and threaten infants too young to be vaccinated and immunocompromised household members. That is the practical meaning of herd protection in schools: not an abstract population threshold, but the ability to keep shared educational settings functioning safely. School vaccination requirements are, therefore, not only about individual biologic protection; they are also about keeping classrooms open and preserving schools as civic infrastructure. The New York City measles outbreak of 2018 to 2019 cost an estimated $8.4 million to contain.⁸ Outbreak response is always more expensive, financially and institutionally, than prevention.

Requirements can also generate benefits beyond the required vaccine. When families come in to satisfy school requirements, clinicians can review records, catch missed doses, and offer other preventive services. In a study of adolescents, school-entry requirements for tetanus-diptheria-pertussis or meningococcal vaccines were associated with higher human papillomavirus (HPV) vaccination coverage, even where HPV vaccination itself was not required.⁹ The likely mechanism is not mystery or coercion; it is convenience. Requirements bring families into contact with clinicians and reduce the marginal cost of delivering other recommended care. Those visits may also create opportunities to identify vision problems, developmental delays, lead exposure, food insecurity, or missed well-child visits. In a fragmented health system, the school-entry encounter is an unusually valuable point of contact.

The lesson is not that requirements should be abandoned. It is that they should be designed for legitimacy. That means tightening nonmedical exemptions where appropriate, standardizing medical exemptions, and requiring periodic renewal and clinician documentation. But it also means pairing requirements with access: school-located vaccination, pharmacy partnerships, evening and weekend clinics, interoperable immunization records, transportation support, and reasonable grace periods. If almost one-quarter of parents seeking exemptions cite logistics rather than ideology, then access is not a side issue.¹⁰ It is part of the policy itself. Strict enforcement without paired access improvements can function less as prevention than as a structural penalty on families with the least flexible schedules and the weakest links to care.

The language matters too. “Mandate” invites a culture-war script. “School immunization requirement” or “school enrollment standard” better describes what these policies are: ordinary conditions for safe participation in a shared institution. Public health often errs by defending sound policy in tones that make it sound exceptional. School vaccination requirements should instead be defended as mundane, because their mundanity is their strength.

The real question is not whether the US can afford school vaccination requirements. It is whether it can afford to lose one of the few pieces of public health infrastructure that still operates at scale, predictably, and with broad public consent. In an era of polarization, policymakers should be wary of discarding policies that reduce preventable outbreaks, keep children in classrooms, and create routine touchpoints with care. Quiet workhorses are easy to overlook. They are also hard to replace.

References

1.

National Conference of State Legislatures. State Public Health Legislation Database. Updated April 24, 2026. Accessed April 29, 2026. https://www.ncsl.org/health/state-public-health-legislation-database

2.

Kaiser Family Foundation. KFF Tracking Poll on Health Information and Trust: January 2025. Published January 28, 2025. Accessed April 29, 2026. https://www.kff.org/health-information-trust/kff-tracking-poll-on-health-information-and-trust-january-2025/

3.

Jones  JM. Far Fewer in U.S. Regard Childhood Vaccinations as Important. Gallup. Published August 7, 2024. Accessed April 29, 2026. https://news.gallup.com/poll/648308/far-fewer-regard-childhood-vaccinations-important.aspx

4.

National Conference of State Legislatures. State Non-Medical Exemptions From School Immunization Requirements. Updated January 22, 2026. Accessed April 29, 2026. https://www.ncsl.org/health/state-non-medical-exemptions-from-school-immunization-requirements

5.

Bald  A, Gold  S, Yang  YT.  State repeal of nonmedical vaccine exemptions and kindergarten vaccination rates.   JAMA Pediatr. 2026;180(1):56-63. doi:10.1001/jamapediatrics.2025.4185
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Delamater  PL, Pingali  SC, Buttenheim  AM, Salmon  DA, Klein  NP, Omer  SB.  Elimination of nonmedical immunization exemptions in California and school-entry vaccine status.   Pediatrics. 2019;143(6):e20183301. doi:10.1542/peds.2018-3301PubMedGoogle ScholarCrossref

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US Centers for Disease Control and Prevention. Measles Vaccine Recommendations. Updated March 3, 2026. Accessed April 29, 2026. https://www.cdc.gov/measles/hcp/vaccine-considerations/index.html.

8.

Zucker  JR, Rosen  JB, Iwamoto  M,  et al.  Consequences of undervaccination—measles outbreak, New York City, 2018-2019.   N Engl J Med. 2020;382(11):1009-1017. doi:10.1056/NEJMoa1912514PubMedGoogle ScholarCrossref

9.

Moss  JL, Reiter  PL, Truong  YK, Rimer  BK, Brewer  NT.  School entry requirements and coverage of nontargeted adolescent vaccines.   Pediatrics. 2016;138(6):e20161414. doi:10.1542/peds.2016-1414PubMedGoogle ScholarCrossref

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Seither  R, Calhoun  K, Knighton  CL,  et al.  Vaccination coverage among children in kindergarten—United States, 2014-15 school year.   MMWR Morb Mortal Wkly Rep. 2015;64(33):897-904. doi:10.15585/mmwr.mm6433a2PubMedGoogle ScholarCrossref

Usability, feasibility, and acceptability of a professional learning series on early learning practices

 

The Institute of Education Sciences released “Usability and Feasibility of the Leading Early Childhood Achievement and Development Professional Learning Series in Oklahoma” (REL 2026–015). Conducted by Regional Educational Laboratory (REL) Southwest in partnership with the Oklahoma State Department of Education, this study examines the usability, feasibility, and acceptability of Leading Early Childhood Achievement and Development (LEAD), a professional learning series designed to support school leaders’ and prekindergarten and kindergarten teachers’ use of play based learning and high quality interactions.  REL Southwest piloted LEAD with two cohorts of school leaders and teachers in Oklahoma during the 2023/24 and 2024/25 school years. Using interviews, observations, participation records, and exit ticket surveys, the study documents educators’ experiences with the professional learning series, identifying strengths, challenges, and opportunities for refinement. Findings provide practical guidance to inform ongoing improvement of the series and support future evaluation of its effectiveness.  Summary slides and accompanying technical appendixes present key findings and include detailed documentation of the study’s data sources, methods, instruments, and supplemental analyses. These materials offer researchers, policymakers, and practitioners insight into how professional learning on early learning practices can be designed and implemented to better meet educators’ needs.  To access the materials, please visit: https://ies.ed.gov/use-work/resource-library/report/descriptive-study/usability-and-feasibility-leading-early-childhood-achievement-and-development-professional-learning.

Postsecondary Institutions, Awards Conferred, and Enrollment

 

Between academic years 2024–25 and 2025–26, the total number of Title IV institutions declined by approximately 1 percent, from 5,760 to 5,711. During that period, the number of public 4-year institutions grew by roughly 2 percent (from 845 to 859), while the number of public 2-year institutions fell by about 2 percent (from 832 to 818). The National Center for Education Statistics released a new set of data and web tables that includes fully edited and imputed data from the Integrated Postsecondary Education Data System (IPEDS) fall 2025 collection. This collection included three survey components: Institutional Characteristics for the 2025–26 academic year, Completions covering the period July 1, 2024, through June 30, 2025, and 12-Month Enrollment for the 2024–25 academic year. Other findings include: During the 2025–26 academic year, there were about 5,700 Title IV institutions in the United States and other U.S. jurisdictions. Of this total, approximately 2,700 were classified as 4-year institutions, 1,400 were 2-year institutions, and the remaining 1,600 were less-than-2-year institutions.   Of the approximately 5,600 Title IV institutions in the United States in the 2025–26 academic year, about 3,800 were degree-granting institutions and 1,800 were non-degree-granting institutions. Among the degree-granting institutions, 2,500 offered associate’s degree programs, 2,400 offered bachelor’s degree programs, 1,900 offered master’s degree programs, and approximately 800 offered doctor’s degree–research/scholarship programs.   Of the 3.8 million students completing degrees or certificates at 4-year Title IV degree-granting institutions in 2024–25, about 52 percent earned a bachelor’s degree. This share differed by control of institution: approximately 55 percent of the 2.4 million students at public institutions earned a bachelor’s degree, compared with 49 percent of the 1.2 million students at private nonprofit institutions and about 37 percent of the 249,000 students at private for-profit institutions.   Across all Title IV institutions, about 5.6 million awards were conferred to students of varying races/ethnicities in 2024–25. Of the three largest race/ethnicity groups, White students were conferred the most awards (2.6 million), followed by Hispanic or Latino students (1.1 million awards), and Black or African American students (648,000 awards).   Institutions reported a 12-month unduplicated headcount of students enrolled full-time totaling approximately 14.2 million in 2024–25. Of these students, 11.9 million were full-time undergraduates and approximately 2.3 million were full-time graduate students.   Of the 22.5 million students reported in the 2024–25 12-month unduplicated undergraduate headcount enrollment, approximately 21.9 million students were enrolled at degree-granting institutions and approximately 640,000 were enrolled at non-degree-granting institutions.   Institutions reported a 12-month full-time-equivalent (FTE) enrollment of approximately 16.8 million students in 2024–25. This total included approximately 14.0 million undergraduates, approximately 2.3 million graduate students, and around 506,000 doctor’s–professional practice students.   In 2024–25, the 12-month unduplicated headcount enrollment of undergraduate students enrolled exclusively in distance education courses totaled approximately 6.2 million. Of these students, around 4.3 million attended public institutions, 1.2 million attended private nonprofit institutions, and 689,000 attended private for-profit institutions.   Of the 3.1 million high school students enrolled in college courses for credit that were included in the 2024–25 12-month unduplicated headcount enrollment of undergraduate students, approximately 1.5 million students were enrolled at 4-year institutions, around 1.5 million enrolled at 2-year institutions and approximately 10,000 were enrolled at less-than-2-year institutions.

Targeted school closures can improve pandemic response

 New research led by UMC Utrecht shows that school closures during a pandemic outbreak are most effective when they are carefully targeted. The study, published in Nature Communications, demonstrates that the right strategy depends on which age groups are driving transmission at different stages of an outbreak. This study provides guidance for authorities, allowing them to make smart and informed decisions regarding school closures in case of a pandemic outbreak.

Closing schools is one of the most difficult decisions during an infectious disease outbreak. While it can help reduce the spread of a virus, it also adversely affects children's education and wellbeing. Researchers from UMC Utrecht, the University of Lisbon and Tilburg University developed a mathematical model to reconstruct how SARS-CoV-2 spread through the population of the Netherlands, including Dutch elementary and secondary schools during the COVID-19 pandemic. By combining epidemiological data with transmission modeling, they were able to evaluate how different school closure and reopening strategies influenced the course of the pandemic.

Transmission changed during the pandemic

The study shows that the age groups responsible for spreading the virus changed over time. At the start of the pandemic, adults contributed most to virus transmission. Later, teenagers became the main drivers, while younger children played a larger role in 2021.

This shift was linked to growing immunity. By 2021, many adults and teenagers had already been infected or vaccinated, making younger children the group that was most susceptible to infection.

As a result, closing secondary schools had the greatest effect on reducing COVID-19 hospital admissions in 2020. At the end of 2021, closing elementary schools became more effective. The findings show that a single approach does not work throughout an outbreak. Instead, interventions should change as the situation changes.

Supporting better public health decisions

The researchers say the study highlights the value of mathematical models for public health policy. During an outbreak, governments often have to act quickly while information is still limited. Models can help predict which measures are likely to have the greatest effect before decisions are made.

"School closures can reduce virus transmission, but they also have major social and educational consequences," says mathematical modeler Ganna Rozhnova PhD, associate professor in the Infectious Disease Modeling Group at UMC Utrecht and senior author of the study. "Our findings show that policymakers can make better decisions by identifying which age groups are driving transmission at different moments during an outbreak. This allows interventions to be more targeted, reducing infections while limiting disruption for children and society."

Preparing for future outbreaks

The researchers will now extend their model to investigate the broader effects of school interventions, including their impact on children's learning and development, and to study how social and demographic differences influence disease spread.

This study is part of the UMC Utrecht modeling group's long-standing research program aimed at improving outbreak preparedness and providing policymakers with robust scientific evidence to support responses to future public health emergencies.

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Journal

Nature Communications

DOI

10.1038/s41467-026-73344-1 

Preschool before starting school: children are significantly more likely to arrive ready to learn

 according to a major Curtin University study of more than 123,000 Western Australian children.

In Western Australia — preschool, commonly known as kindergarten or 'kindy' — is the early learning program offered in the year before compulsory school (pre-primary).
The study found preschool attendance was linked to better outcomes across every area of child development and a substantially lower risk of children starting school developmentally vulnerable.
Researchers say the findings provide some of the strongest population level evidence to date that supports the role of preschool in helping children build the skills they need to succeed at school and later in life.
Lead author and Curtin University PhD candidate Kendalem Atalell said the results showed just how important the year before school can be.
"The message is simple: preschool matters," Mr Atalell said.
"Children who attended preschool were less likely to start school struggling and showed stronger development across every area we measured.
"The early years are when the foundations for learning, health and wellbeing are built. Giving children access to preschool can help set them up for success long before they walk into their first classroom."
The study analysed data from 123,256 Western Australian children who participated in the Australian Early Development Census between 2009 and 2021.
Senior author Associate Professor Gizachew Tessema, from Curtin's School of Population Health and the enAble Institute, said the findings were particularly significant because too many children were still arriving at school without the skills they needed to thrive.
"More than one in five Australian children start school developmentally vulnerable, which can affect their learning, wellbeing and future opportunities," Associate Professor Tessema said.
"Our findings show preschool was associated with better developmental outcomes, helping children develop the social, emotional, physical and communication skills they need before they start formal schooling.
"What is especially concerning is that children from disadvantaged communities were less likely to attend early childhood education programs, despite often standing to gain the most from it."
Associate Professor Tessema said improving access to high-quality preschool programs could be an important way to give every child a fair start in life.
"No child should begin school already at a disadvantage," he said.
"Improving access to preschool is an investment in children's futures. It could help support school readiness, reduce inequalities and create benefits that extend well beyond the early years."
Co-author Professor Gavin Pereira, also from Curtin’s School of Population Health, said the findings added to growing evidence that early childhood education plays a vital role in shaping children's development.
"School readiness is about much more than knowing letters and numbers," Professor Pereira said.
"It's about developing the social, emotional and communication skills that help children engage, learn and flourish throughout their education."
The study also found more mixed results for daycare attendance. Daycare was linked to lower developmental vulnerability in language, cognitive and communication domains, but higher vulnerability in social competence and emotional maturity.
While the exact reason for the daycare result is not known, the authors pointed to several possible explanations for the daycare pattern, including the age at which children start care, how long and how intensively they attend, and differences in family circumstances. For example, starting group care earlier and for longer hours may also reduce opportunities for the stable, responsive interactions that support social and emotional development during a sensitive period.
The researchers said these findings should be interpreted carefully and may reflect differences in children’s attendance patterns, timing and duration of care, family circumstances, and the type of early childhood setting, and should be explored further.
The researchers say expanding access to effective preschool, particularly in disadvantaged and remote communities, could help ensure more Western Australian children start school ready to learn and reach their full potential.
Western Australian Primary Principals’ Association (WAPPA) President Niel Smith said quality kindergarten programs deliver benefits that extend well beyond the classroom.
“High-quality kindergarten programs provide children with the best possible start to their education by balancing play-based learning with the development of pre literacy and numeracy skills. Through structured and free play, children build confidence, learn to socialise, develop fine and gross motor skills, strengthen communication and problem-solving abilities and arrive at school ready to learn, both academically and emotionally,” Mr Smith said.
“Regular attendance at kindergarten is also one of the earliest opportunities to identify children who may need additional learning support or specialist intervention. The sooner educators can recognise potential learning difficulties, developmental delays or disabilities, the sooner families and schools can work collaboratively, to access the support their child needs, giving every student the greatest chance to thrive from their very first day of school.”
The study, ‘Early Childhood Education and Care and Developmental Vulnerability at School Entry’, is among the largest studies of its kind conducted in Western Australia and has been published in JAMA Network Open.
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Gender gap in predicted grades raises questions over their use in university admissions

 A study of more than 350,000 students in England has found that teachers predict higher A-Level grades for girls than boys who go on to achieve the same exam results. The findings raise fresh questions about the role of predicted grades in university admissions.

The research, by academics at the Universities of Cambridge and Bristol, found a consistent “pro-girl” gap in teacher predictions across 10 A-Level subjects. Depending on the subject, girls were between 3% and 11% likelier than boys to have their grades overpredicted, and between 15% and 41% less likely to have them underpredicted.

This does not mean that teachers deliberately favour girls. Instead, the researchers suggest that because girls typically have stronger all-round academic records, teachers may pick up on characteristics like motivation, diligence and classroom engagement when forming expectations about their future performance.

This could create a “halo effect”, where positive impressions about these students spill over into predictions about their academic potential.

Indeed, when the researchers compared students who not only achieved the same A-Level results, but also had similar records of prior academic performance, the picture changed. Within these groupings, boys received higher predicted grades in scientific STEM subjects, while girls retained a smaller advantage in non-STEM subjects, such as English Literature.

The findings, published in the Economics of Education Review, have implications for the UK’s university admissions system. Although university places are ultimately awarded based on students’ final A-Level results, initial offers are made months earlier and rely heavily on predicted grades.

Organisations including the educational charity The Sutton Trust have called for reforms to the system. In 2020, the Government consulted on moving towards Post-Qualification Admissions, where university decisions would be made after students received their final grades – but ultimately decided against the change.

Dr Konstantina Maragkou, from the University of Cambridge’s Faculty of Education and the study’s lead author, said the debate around predicted grades should be revisited.

“It is very unlikely that teachers deliberately predict better results for girls, but they may be relying on an impression of student characteristics which can lead to gendered predictions,” she said. “We need to think carefully about how fair that is for young people when the stakes are so high.”

The study used data from three university application cycles between 2017 and 2019. By comparing boys and girls with the same A-Level outcomes, the researchers identified a substantial gender gap in predicted grades.

On average, girls received predictions between one tenth and one fifth of a grade higher than boys. For example, girls were predicted, on average, around 0.17 of a grade higher in Physics and 0.13 higher in Sociology. “Differences of this size may appear small, but they can be enough to move a student across a grade boundary – for example, from a B to an A, or an A to an A*,” Maragkou said.

The researchers tested whether the findings could be explained by other differences between boys and girls and accounted for a wide range of other possible factors, including socioeconomic background, ethnicity, class size and school attended. The results remained unchanged in each case.

The researchers then explored what might explain this gender gap. One possibility is that teachers’ predictions are influenced by a conscious or unconscious perception of girls’ abilities compared with boys. Another is that their predictions incorporate broader information about the students. Previous studies have suggested that teachers could be influenced by observable characteristics such as a student’s work ethic, diligence, engagement, or everyday conduct at school.

To investigate this, the researchers used earlier Key Stage 2 and GCSE results to measure students’ broader academic profiles. Crucially, they looked beyond performance in the subjects they later chose at A-Level, capturing what they describe as “cross-disciplinary competence”. For example, they examined the earlier English performance of students who went on to take STEM A-Levels, and the earlier maths performance of students who chose non-STEM subjects.

This substantially changed the results. When comparing boys and girls with both identical A-Level outcomes and comparable prior academic records, the prediction advantage for girls fell by about 70% in non-STEM subjects and reversed in STEM subjects in favour of boys. “Accounting for prior academic record did not eliminate the gender gap; it just changed it,” Maragkou said.

The researchers also found that the gender gap was particularly pronounced among lower-achieving students, possibly because predictions are more difficult when performance is less certain.

The authors stress that their explanation for the gender differences requires further research. However, they note that official guidance states that “predicted grades should be independent of student behaviour or background.”

The findings may also have implications for other countries where teacher assessments form part of student evaluations, although the UK remains unusual in using predictions in university admission decisions.

Maragkou said that any attempt at reform should involve teachers, policymakers and researchers. “Teachers are not supposed to base predicted grades on students’ character, but they are probably not doing so consciously,” she said. “We also need to ask whether it is always wrong, conceptually, to consider broader qualities that affect academic success. These are difficult questions and they deserve careful consideration.”

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Journal

Economics of Education Review

DOI

10.1016/j.econedurev.2026.102814 

1 in 4 teens report using mobile food delivery at school

Fast foods and sugary beverages are popular options; findings raise concerns about nutrition and classroom distractions

Nearly one-quarter of teens reported using mobile food delivery services during school hours and almost half said they use them after school, according to a national survey of over 1,000 U.S. adolescents.

Among respondents who used such services, almost 60% reported ordering fast foods such as pizza and burgers, and over one-third ordered sodas or other sugar-sweetened beverages. The findings raise concerns about the ability to maintain safe learning environments and support healthy nutrition for students, according to researchers.

“Federal and state school nutrition policies are designed to support access to healthy foods and beverages in school cafeterias and vending machines, but technology has outpaced policy,” said lead study author Mika Matsuzaki, PhD, MS, MPH, assistant professor in the Human Nutrition group in the Department of International Health at Johns Hopkins Bloomberg School of Public Health. “Today, a smartphone instantly brings a food outlet many miles away right to the school gate, fundamentally changing how our children access foods and beverages at school. We can no longer look at school nutrition without looking at the smartphone in a student’s pocket.”

Researchers conducted the survey online during the summer of 2025, garnering responses from 1,027 adolescents aged 13-17 years. In addition to the overall national trends, the results revealed some regional variation. Students living in the western United States were more likely to attend schools that allow mobile food delivery during school hours; however, teens in this region were also more likely to say they avoid using mobile food delivery due to the perceived high costs.

Nearly half of respondents said they support allowing mobile food delivery during school, although many—regardless of their support or opposition—expressed concerns about its implications for the learning environment and factors such as equity and bullying.

“Interestingly, students themselves are divided on whether this should be allowed. Even those who support it openly worry about campus safety and classroom distractions,” said Matsuzaki. “It’s rare to see teenagers raise flags about their own digital habits, which signals to us that they recognize these platforms are a double-edged sword.”

Researchers said schools can be an important venue to teach teens how to navigate digital food environments responsibly rather than impulsively. School administrators and policy makers could use the survey data as they consider campus safety and phone-use policies as well as potential guardrails to limit the influx of unhealthy food during school hours. It may also be possible to collaborate with food-delivery platforms to encourage users to make healthy choices. For parents and teens, researchers said the data could spur more conversations about nutrition and budgets.

“For many school administrators and parents, this study will be a wake-up call as they may not be aware of this relatively new phenomenon. We hope these findings will bring proactive conversations,” said Matsuzaki.

Researchers noted that self-reported surveys have inherent limitations and future studies could help to further confirm the findings.