By Glenn Ellis
After almost the entire year of 2020 spent dealing with the ravages of COVID-19, in some ways, sadly, the most difficult challenges are yet to come. This doesn’t mean that we no longer need to worry about becoming infected with the virus, and to stop following the safety precautions.
We should get ready to face some challenges as we move through the year with the promise of hope that the vaccine rollout represents. For the first time in our history, we are going to have to deal with some issues that we’ve always heard about, but now they are here – up close and personal: potential vaccine mandates. Trust me, we are all going to be impacted in one way or the other by this issue in 2021, so it is in all of our best interests to get as much credible information, because when the time comes, you want to make an informed decision. Here’s a start:
Potential vaccine mandates: Whether we like it or not, vaccine mandates are going be at the center of many conversations as the nation, and the world, attempts to attempt to return to some degree of normalcy. The important benefit of most vaccines is that they provide both individual as well as community protection from a virus. This is because (as you probably know by now) most of the diseases against which we are vaccinated for are transmitted from person to person. That means when enough individuals in a particular community are vaccinated, those persons serve as a protective barrier against the likelihood of transmission of the disease in the community, thus indirectly protecting those who didn’t, for whatever reason, get vaccinated. That’s herd immunity.
Make no mistake – vaccines save lives; and herd immunity is essential to safeguarding public health. The connection to vaccine mandates? Like I said, vaccines benefit is to protect the “individual and the community.” This puts integral parts of our society like airlines; cruise ships; sports and entertainment venues, theaters; schools; even hospitals: all of them will be put in the position of having to decide how to best “protect” their respective communities.
Back on 2016, Congress gave the Federal Aviation Administration (FAA), which regulates the airline industry, the authority to “prescribe regulations and minimum standards for practice, methods, and procedures the administrator finds necessary for safety in air commerce and national security.” Even though the FAA has never required vaccines for passengers to travel, it seems pretty clear that they do have the authority to impose such a travel restriction.
Understand those folks have a “community” to think about protecting. They have to put some serious consideration into instituting a vaccine mandate. The federal government is well within its rights to require international travelers to be vaccinated, because it has the power to control the borders.
I think it’s safe to assume that if there is a vaccine mandate, it is likely to come with a medical exemption. Forty-five states already allow unvaccinated students to attend school if their parents object to immunization for religious reasons, and 15 states permit philosophical objections. In 1905, in the Supreme Court’s Jacobson v. Massachusetts decision, the court ruling in a case that set a 115-year precedent that says individual liberty in the case of a vaccine doesn’t trump the need to protect the public. That means don’t expect a letter from your religious leader to pass the muster. If mandates are implemented, it’s going to pretty hard to get around them in this country. Research data shows that the easier it is to obtain an exception, the more exceptions there are.
In terms of your job, even though employers can require vaccinations, there are reasons they might not want to:
Tracking compliance with mandatory vaccination would be a costly, administrative burden. Employers would also have to figure out how to manage and track exemption requests – not to mention lawsuits and legal claims that are sure to arise. For years, public health experts have recommended that all health care workers be immunized against influenza; immunizations for other infections including pertussis, measles, mumps, and hepatitis are encouraged, but few hospitals have mandated such immunizations – instead, most hospitals and medical centers rely on incentives (days off; bonuses; etc.) and continuing education credits. Pandemics (like COIVD-19) present a different set of problems with a demand for vaccines that are in short supply.
Even though Dr. Anthony Fauci, the nation’s leading infectious disease expert, said, “We don’t want to be mandating from the federal government to the general population. It would be unenforceable and not appropriate.” It’s a different story for orders issued by states, cities or businesses, but even then, mandatory vaccination wouldn’t be forced vaccination. Mandates don’t mean forced vaccinations, but rather penalties or denial of services for those who don’t get them.
Most reportable childhood diseases have dropped by 99 percent or more due to vaccines. Polio is almost totally eradicated: the last case in the United States was in 1979. Clearly, talk of mandating the COVID-19 vaccine will be definitely controversial, and the source of many an argument. Learn as much as you can, if its decided the vaccine is to be made mandatory – it is both constitutional and legal. Information is the best medicine.
Glenn Ellis, MPH is a Harvard Medical School Research Bioethics Fellow and author of Which Doctor?, and Information is the Best Medicine. For more good health information visit: www.glennellis.com