Costa Rica has made coronavirus vaccinations a requirement for all people under the age of 18, in what experts say is one of the world’s broadest mandates to immunize children against the virus.

The Health Ministry in the Central American nation said Friday that the vaccinations would be included with other mandatory shots against chickenpox, polio and the human papillomavirus, or HPV.

It said that the measure was taken to “safeguard” the best interests of the children and that parents and legal guardians were responsible for ensuring minors are vaccinated in a “timely manner.”

The republic of about 5 million people is the first in the world to include coronavirus vaccines in its list of required immunizations for children, according to Arachu Castro, a professor at Tulane University who specializes in public health in Latin America.

Such a directive “helps normalize the vaccine,” Castro said, adding that it is also an acknowledgment that “covid may become endemic.”

Many health experts say that the coronavirus will never be completely eradicated and that it will instead continue to circulate among the global population much like the seasonal flu.

Costa Rica already requires government employees to be vaccinated and also allows companies to impose their own vaccination mandates.

The country began administering the Pfizer-BioNTech coronavirus vaccine to children over 12 years old last month. Nearly three-quarters of 12-to-19-year-olds in the country have already received at least one dose, according to the Health Ministry.

In a statement, the ministry said vaccine doses for children under 12 will be acquired by next year and guidance for the immunization of 5-to-11-year-olds would come as doses for that age group become available.

The U.S. Food and Drug Administration recently authorized the Pfizer-BioNTech vaccine for emergency use in children ages 5 to 11.

Last month, California Gov. Gavin Newsom (D) announced a similar requirement that made coronavirus vaccines among the mandatory routine immunizations for children attending public or private school in person. In San Francisco, children as young as 5 will need to show proof of vaccination to enter places like restaurants and sporting events.

In contrast to the United States, however, where vaccine mandates have faced political resistance, Costa Rica has maintained trust in the public health system, Castro said.

“Access to public health care in Costa Rica is a matter of national pride,” she said. “It’s seen in a positive nature.”

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