Vaccine mandate calls fueled by COVID-19’s latest spike

The rise in cases brought on by the delta variant is spurring new calls for employers to mandate COVID-19 vaccines for their workers, and some major entities are starting to follow through. 

There was a flurry of activity around vaccine mandates on Monday, with California and New York City announcing vaccine mandates for government employees, or else weekly testing. The Department of Veterans Affairs became the first federal agency to mandate the vaccine, focusing on its front-line health care workers.

And to start the day, more than 50 health care organizations, including the American Medical Association and the American Nurses Association, called on employers to mandate the vaccine for all health care workers and for other employers, not just those in health care, to “follow our lead.”

The push comes as cases, deaths and hospitalizations from COVID-19 are rising again due to the more transmissible delta variant and as the vaccination rate has slowed significantly.

Many experts think mandates from employers are the key to boosting vaccination rates and slowing the new surge, which is overwhelmingly affecting the unvaccinated. 

Ezekiel Emanuel, a medical expert at the University of Pennsylvania who was a health care adviser in the Obama White House, said that despite vaccines being free and widely available in the U.S., and the president “pleading with people” to get vaccinated, “we’re still just shy of 50 percent of the population vaccinated.”

“We really need to go to the next level, and mandates, especially of health workers, are the next level,” he said. 

Experts are concerned that outbreaks will continue getting worse unless a significantly higher percentage of the population is vaccinated. The risk is overwhelmingly to unvaccinated people, but a small number of vaccinated people will still get sick, and there are society-wide effects like overcrowded hospitals in some parts of the country.  

And the more the virus spreads, the more chance there is for new variants to develop that could evade vaccines. 

“It’s clear that gentle persuasion did not achieve the vax rate we need to defeat Covid,” Bob Wachter, chair of the department of medicine at the University of California, San Francisco tweeted. “Yes, the politics are hard, but dying is worse, as is re-tanking the economy. It’s time for vaccine mandates — nothing else gets us where we need to go.”

Many Republicans have pushed back on efforts to promote or mandate the vaccines. When President Biden spoke of even a voluntary effort to go “door to door” promoting vaccinations, many Republican lawmakers called it government overreach. 

Republican state lawmakers in places like Indiana and Iowa have pushed back on efforts by hospitals or universities to mandate vaccines. 

White House press secretary Jen Psaki on Monday praised the statement from health care groups calling for vaccine mandates but stopped short of issuing a full-throated call for other employers to mandate vaccination. 

“It’s clear that right now the delta variant has the upper hand, and we think it’s time to ask employers to require their employees to be vaccinated as the next step,” Susan Bailey, president of the American Medical Association, said in an interview. 

Backers said they hoped that the series of moves from California, New York City and the VA on Monday would spur more employers and local governments to act. 

California Gov. Gavin Newsom (D) said Monday that it is time to move from choice toward mandates when it comes to vaccinations. 

“We’re at a point in this epidemic, this pandemic, where choice, individuals’ choice not to get vaccinated, is now impacting the rest of us, in a profound and devastating and deadly way,” Newsom said. “That choice has led to an increase in case rates [and] growing concern around increase in death rates.”

Another step that could help boost the country’s vaccination rate is full approval from the Food and Drug Administration (FDA) for the COVID-19 vaccines. While the process for the current emergency use authorizations was rigorous and experts widely say the vaccines are safe and effective, the final step of full approval could help convince some skeptical people. 

Some experts have been calling on the FDA to move faster to fully approve the vaccines. That move could also make employers more confident in mandating the vaccine, though it is not a prerequisite. 

A federal judge declined to block Indiana University’s vaccine mandate earlier this month, for example. 

“We know these vaccines are safe and effective,” Bailey, of the American Medical Association, said of full FDA approval. “We don’t think we need to wait for that administrative action to go ahead and recommend mandates for vaccines.”

The U.S. is now averaging about 50,000 cases per day, according to data from the Centers for Disease Control and Prevention. That is up from around 13,000 at the end of June, though far below last winter’s peak of around 250,000, before vaccines were widely available. Deaths are also ticking back up, to around 240 per day. 

While cases have gone up, vaccinations have fallen. The country is averaging about 580,000 shots per day, down from more than 3 million per day in April, according to Our World in Data. Still, there has been a small recent uptick in vaccinations, as the White House hopes news of the delta variant threat spurs more people to get shots. The number of people getting their first shot is up 24 percent from the previous week, according to the White House. 

“Not enough patients have been vaccinated to keep the case rates from going up,” Bailey said.