And while I’m on the subject can someone explain to me why no state has enacted a vaccine mandate for its residents? There are states with mandates for healthcare workers; there are states that ban vaccines. To the best of my knowledge no state however Blue mandates vaccination against COVID-19 for its residents.
All 50 states mandate vaccinations of various kinds for school children. Doing so has been upheld by the Supreme Court. Clearly, the states have the authority to enact such mandates. I believe that all 50 states had mandates for smallpox vaccinations.
The federal government on the other hand does not appear to have that authority, at least based on the recent Supreme Court decision.
So, why do no states have COVID-19 vaccine mandates?
“no state however Blue mandates vaccination”
Many blacks also resist vacination. A blue state with a low black population might mandate it.
I think the biggest sectors of the economy are healthcare and education. (When I say education I mean everything from daycare for babies to PhD programs.) They both receive federal money and subsidies . The federal government could require everyone eligible in those sectors be vaccinated.
Because they can’t get away with it politically. And that’s what really matters in l’affaire covid.
There has been no clear voice of reason around the need for vaccine mandates in this country. Mainly, mandates have been pushed and implemented by bully/scare tactics – government trying to strong-arm people into taking them, by humiliating them and/or taking away livelihoods.
Unlike small pox, which has around a 30% IFR with the malignant, hemorrhagic forms usually being fatal, 99%+ usually recover from bouts of COVID. Children have even better rates of survival, with death being almost nil in those with no co-morbidities. So, to compare the need for small pox vaccines with COVID is silly.
Furthermore, many on this site seem to brush aside any risk/benefit analysis between taking the shot vs not taking it. The idea of their short term “safety†seems to have been embossed, in otherwise heads of reason, blocking any cautionary regard for long term side effects. The fact that clinical trials have fallen way short in testing all areas that might be at risk for taking these vaccines, before they were distributed under EUAs, is mind boggling to me. The continuous stream of stories from healthcare workers, doctors, ordinary citizens indicating a higher rate of deaths and injuries from these vaccines, than from other vaccines, should provoke red flags, not checkered “go ahead†ones.
Consequently, there is really no voluntary consensus in the U.S. about these vaccines. Many who have taken them were forced to do so and have become angry. Others just followed orders without giving it much thought. And, some put their faith in government assurances, and Fauci’s “science expertise,†and gladly fell in line. A smaller faction, like myself, are going with our own instincts, and waiting out this virus – maybe until something better, less experimental and toxic comes along. Yes, states may have the authority to pass laws mandating vaccinations. However if enough citizens resist, it will not be easy to pass or implement such laws. And, on the 23rd of this month an internationally organized “Defeat the Mandate†rally will be held in DC. Such protests seem to be gaining steam, and are not going away, making vaccine mandate madness even less likely.
It would be clearer for the discussion to define “vaccine mandate for its residents”.
The post already cites States have mandated COVID-19 vaccines for health care workers, and other vaccines for the right to attend public school. For COVID-19, some States/localities mandate vaccines for the right to eat at restaurants, or attend other “non-essential” gatherings.
The Supreme Court only ruled the OHSA was not granted the power by Congress to mandate vaccinations at workplaces. It did not rule that the Federal Executive does not have the power to mandate vaccines (through another statute) or that Congress cannot grant the power (through a new statute) or Congress mandate it directly. Indeed the ruling seems even more limited to that, the Supreme Court seems to leave open the possibility a more tailored rule going through the normal notice and comment process is within the authority of the OHSA.
If Illinois is any example, a state with a Democratic governor and supermajorities of Democrats in the legislature, the difficulty comes not from the idea of requiring vaccinations, but in imposing consequences.
The Illinois Governor was able to use emergency powers to impose vaccine mandates, but when legislation was needed to make them work, he initially could not get the votes needed from the black caucus. In particular, in order to get employers to enforce mandates, they needed liability protection from their employees (otherwise, they just rubberstamp religious / medical exemptions). The legislation needed to remove any express reference to termination of employment, which is the most likely scenario in which a lawsuit would be brought. Similarly, the Illinois Attorney General met with members of the black caucus to assure them that a needed change to a healthcare freedom of conscience law would not impact conventional religious objections that their constituents might have.
So it appears that broad support only exists for mandates without consequences.
(Also, the public sector unions have found these mandates, but I’m not sure whether those issues were ever resolved or they are still litigating)
CuriousOnlooker:
To the best of my knowledge the Court has never ruled that the federal government has that authority. That’s the way our law and government are supposed to work. If not expressly granted the authority, they don’t have it. State governments are not constrained in that way. BTW that’s my main gripe about the “liberal wing” of the Supreme Court. IMO they’re behaving as though we had a civil code system and the authority of the federal government is unlimited.
PD:
Illinois is always a valuable indicator if only as an object lesson. Shorter version: political considerations outweigh public health considerations. We should keep that in mind.
I think the other part of the Illinois experience it took time — orders in August, compliance for October got moved back. The hospitals in my city reached compliance in January, roughly five months. The OSHA emergency rule can only last for six months. Hospitals are pretty supportive of vaccination, have their own vaccine and testing capacity, and most already have experience with requiring flu vaccination. The untargeted OSHA rule was probably going to be chaotic and arbitrarily implemented.
Also, it looks like I was wrong on the Health Care Right of Conscience Act — there weren’t enough votes, so the amendment is not effective until June 1st. The Constitution requires any bill passed after May 31 to not be effective until June 1st of the following year unless it passes by a three-fifths vote. I guess my point here is that six months is not a lot of time, with federal mandates dependent upon the legal ability and good will of state/local government and employers.
That’s one of the many reasons I complained that the OSHA mandate was a waste of time. Trying things that are unlikely to pass muster until you get one that does pass muster doesn’t show much of a sense of urgency. It’s a course of action based on bad assumptions.
The threat of the mandate looks like it had some effects. Recall that the airlines ended up getting most people vaccinated. At this point everyone who wants to is vaccinated. From a public health POV we would benefit from all being vaccinated but it wont be possible without major political problems. I think in this case the politicians made the decision looking at the total picture. It is probably the right one.
What we should be looking at, but its not PC so we wont, is who gets access to limited care. Why should someone who refused to get vaccinated have first priority on MABs or Paxlovid? When there is a bed shortage why should unvaccinated bump vaccinated? I think this surge ends fairly quickly so there are mostly rhetorical and if we have another surge the unvaccinated will just free ride again.
Steve
This comment is an attempt to breakdown the vaccination problem and from that, what can be done.
Lets start with the overall numbers, between 63-75% of Americans are vaccinated. What are the sub-populations that are significantly unvaccinated; lets define that as a vaccination rate significantly lower then overall vaccination rate. There’s a bunch and this is my attempt to group them.
The first category is “low trust in ‘Government’ or sources of authority”. In this bucket would be Republicans (especially the conspiratorial section), and African Americans. Depending on one’s viewpoint, one may view the reason as unjustified (Republicans because of partisan reasons) or justified (African Americans and their historical treatment by Governments), but as Reuben Rodriguez on twitter pointed out, the key bottleneck is trust.
To further support that, Asian Americans have a significantly higher vaccination rate. I will hypothesize a big reason is that “respect/trust sources of authority” is a cultural value in Asian cultures (especially Confucian ones).
The data on vaccination rate by ethnicity is from Kaiser Foundation — https://www.kff.org/coronavirus-covid-19/issue-brief/latest-data-on-covid-19-vaccinations-by-race-ethnicity/ . I use State partisan leanings as a proxy for vaccination rate by party. I discount polling data since the actual data collected by health departments contradict polling which indicate response biases of various sorts in the polls.
The second category is “unwilling to take risks on long-term side effects”. This category includes women who are pregnant, or actively trying to have children, and parents of children 5-17. For pregnant women, it isn’t fear of risk of COVID on the mother, but the unquantified (yet) risk to conceiving and risk to pregnancy — that’s driven the vaccination rate in this group below 50%. For parents, its the unknown long term risk of vaccine weighed against the known small risks from contracting COVID. Vaccination rates among 5-11 is 20% and among 12-17 is 55%
The last category is children from 0-5 where there is no approved vaccines yet. Thats are 6% of the population.
From this angle; the second category requires more studies and time to show minimal side effects. Vaccine mandates are unlikely to successfully coerce parents and pregnant mothers.
The first category is tougher. Ensuring trust may imply delegating or incorporating feedback on vaccination messaging/coercion from sources of authority that these communities do trust. For example, working with churches and civil rights organizations. It may mean taking a far less partisan blame game if the issue is partisan distrust.
That’s right on the money. I would add that, fair or not, changing the guidance on a near-daily basis is not a good strategy for building trust among those not predisposed to trust.