As college students start to pack for the new school year, some will need to include proof of their COVID-19 vaccinations along with their extra-long twin bedsheets and posters.

Although many U.S. colleges and universities are requiring students, and in some cases employees too, to submit proof of vaccination, others are just strongly advising it.

Catholic colleges and universities fall into this same mix.

A list frequently updated by The Chronicle of Higher Education shows that 592 campuses, as of July 22, have a COVID-19 vaccine requirement. These schools are primarily in the Northeast, upper Midwest and West Coast. Although the number seems large, it is just over 10% of the roughly 5,300 colleges and universities in the country.

Complicating matters are differing state regulations. In Texas, public universities can't require students to show proof of vaccination, but private universities can. In New York, public universities cannot allow for religious exemptions to the vaccine, while most of the state's private universities can.

In mid-July, a federal judge upheld Indiana University's COVID-19 vaccine requirement, which a group of students had filed a lawsuit against.

In Ohio, Republican Gov. Mike DeWine signed a bill to bar public colleges and universities from requiring the COVID-19 vaccines until the U.S. Food and Drug Administration gives them final approval.

Similarly, Arizona Republican Gov. Doug Ducey issued an executive order barring public universities and community colleges in the state from requiring students to get the COVID-19 vaccination, be tested for the coronavirus or wear face masks.

For the most part, college students are in favor of schools requiring proof of COVID-19 vaccinations. A poll in May by Inside Higher Ed and College Plus showed that 69% of college students support (somewhat or strongly) vaccine requirements and 85% of these respondents had received at least one dose of the vaccine or planned to do so.

The majority (66%) of Catholic students said they either strongly or somewhat supported a campus vaccine mandate.

Of the students opposed to a vaccine mandate, 40% said they would "definitely" or "probably" leave their school if it required them to be vaccinated.

St. Edward's University in Austin, Texas, was one of the first colleges to announce in late March that it was requiring students and faculty to be vaccinated for COVID-19. It said it would provide an exemption for students and employees "related to religious beliefs, underlying medical conditions" and concerns associated with the vaccine's emergency-use authorization granted by the FDA until the vaccines are formally approved.

Other colleges that were quick to join this list were: Georgetown University in Washington, Holy Cross College in Worcester, Massachusetts, Loyola University Chicago and Seattle University, to name a few.

Students at The Catholic University of America in Washington will not be required to be vaccinated but instead "strongly encouraged" to do so.

Similarly, Barry University, a Catholic college in Miami, is not requiring but strongly encouraging its school community to be vaccinated. Those who are not vaccinated need to wear face masks and do a daily symptom self-check, the school's website says.

North Carolina's Belmont Abbey College also is not requiring students to get COVID-19 vaccinations and it will not require face masks or social distancing.

In a July 21 message to the school community, the college provost, Travis Feezell, said: "As you might expect, our preparations for the coming school year have included deep conversations around COVID management and protocols for the year, even as local, state and federal regulations shift with some regularity."

At Creighton University, a Jesuit-run school in Omaha, Nebraska, all students are required to submit proof of COVID-19 vaccination by Aug. 1.

The school website points out that students can request a medical exemption or an exemption due to the vaccines' emergency-use authorization but that they will be required to be vaccinated once the vaccines are granted full FDA approval.

Varying responses to vaccine requirements have stirred school communities.

In July, The Pilot, newspaper of the Boston Archdiocese, published a story by The Associated Press that said some Boston College students and their parents were upset by the Jesuit-run school's refusal to grant religious exemptions to those who didn't want to get the vaccine.

The school is requiring all students, faculty and staff members to receive a COVID-19 vaccine before the fall semester, unless they are granted religious or medical exemptions.

"A religious exemption may be granted if vaccination goes against the fundamental tenets of a faith," said school spokesperson Ed Hayward in a statement. He added that since Pope Francis, Boston Cardinal Sean P. O'Malley "and millions of Catholics worldwide have been vaccinated, it is difficult for Catholics to make an argument against a COVID-19 vaccination."

M.C. Sullivan, ethicist for the Archdiocese of Boston, told AP that the Pfizer and Moderna vaccines "do not contain any immorally illicit material." She added that the pope and the archbishop of Boston have said the "remoteness of the abortion act" in the vaccines "is so far removed to the current public health crisis."

Right now, "there's a positive moral obligation to save lives" by getting vaccinated, she said.

Discussion about college vaccine requirements also is taking place in newspaper columns and editorials.

An opinion piece in The Wall Street Journal this June written by Dr. Aaron Kheriaty, a professor of psychiatry and director of the medical ethics program at the University of California, Irvine, and Gerard Bradley, a law professor at the University of Notre Dame in South Bend, Indiana, said college vaccine requirements were "unprecedented and unethical."

"These coercive mandates violate basic principles of medical ethics. Even if the vaccines receive full FDA approval, no sensible understanding of herd immunity can justify forcing vaccinations on healthy young adults who are at minimal risk of hospitalization or death from COVID, especially those who already had COVID," they wrote.

And Father Tadeusz Pacholczyk, director of education and ethicist at the National Catholic Bioethics Center in Philadelphia, wrote on the group's website that Catholic university and college leaders "would do better to share and explain to students the benefits and risks of vaccinations -- scientific and ethical -- to help them decide" if they wanted the vaccine instead of requiring them to do it.

"By offering evidence-based information and moral principles, rather than mandates," he wrote in an April 30 article, "college students will be helped to clarify their own processes of intellectual and personal discernment and acquire the habit of making more prudent and informed choices."

A. Gabriel Esteban, president of DePaul University, said the university was requiring its students to be vaccinated for COVID-19 for the fall semester "in the spirit of caring for each other and for our surrounding community." To that end, the school provided a vaccination clinic on campus.

Now, like other schools across the country with vaccine requirements, DePaul has launched an incentive program to urge students to get vaccinated and submit their paperwork.

The contest, for students who complete forms with their COVID-19 vaccine records or the proper documentation for an exemption by Aug. 19, makes them eligible to win an Apple AirPods Pro; a gift card to the campus bookstore; a suite for the winner and up to five friends to attend a men's or women's basketball game at Chicago's Wintrust Arena; or a $2,500 scholarship grant.

Several colleges have similar incentive programs, raising for some another set of ethical questions.

Erin Bronchetti, an associate professor of economics at Swarthmore College in Pennsylvania, told Inside Higher Ed in June that these incentives "seems like a perfectly ethical and fair thing to do" because they are "rewarding people for this contribution to the public good."

But for larger incentives, she said, universities need to consider that students -- especially low-income students who could use the money -- might be swayed to make a medical decision they would not otherwise do, which is more ethically questionable.

She said campus leaders need to "strike a balance between what will move behavior" and cause people to overcome procrastination or some uncertainty "while not offering an incentive that's so large as to feel coercive."