By Shannon Pettypiece - NBC News
The United States could see a surge in COVID-19 vaccine mandates as soon as the Food and Drug Administration (FDA) grants
full approval
to one or more of the vaccines, public health experts said.
All three vaccines cleared by the FDA for emergency use against coronavirus -
Pfizer, Moderna, and Johnson & Johnson -
have been shown to
be safe and effective
under this accelerated review process and in the real world.
Likewise, doctors and the country's top public health officials have said there is no need for anyone to wait to get inoculated.
[Follow our full coverage of the coronavirus]
But as the pace of vaccinations slows and concerns grow over the highly contagious delta variant,
official approval of the regulation would remove a significant
public relations and
legal barrier
for businesses and government agencies wanting to require vaccination from its employees and clients, said former health officials for the President's Administrations, Joe Biden, and former President Barack Obama.
"I think once vaccines go through full FDA approval, everything should be on the table
, and I think everything will be on the table in municipalities, in states, with employers and government agencies," he said. Andy Slavitt, who stepped down as the president's COVID-19 response coordinator last month and remains in close contact with Administration officials.
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Many institutions, including
colleges and universities, have long required certain vaccinations.
However, the suggestion to impose the vaccine, either by local governments for schools, or by businesses for their clients, has met with stiff resistance so far, mainly from conservative legislators and activists. .
At least
20 state legislatures have passed bills
or are studying measures that would prohibit companies and state and local governments from imposing restrictions on unvaccinated people.
Even so, some universities, concert halls and employers have already started to demand the vaccine.
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But the
expedited vaccine review process has been seen as a safety concern
by some people who have not yet been vaccinated and as a legal hurdle for organizations that have been hesitant to make it mandatory.
Institutions that have established vaccination requirements have already faced lawsuits: Opponents argue that authorization for their emergency use indicates that people should have the option to refuse treatment.
One of these lawsuits, filed by healthcare workers at Houston Methodist Hospital, was rejected last month.
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But with the spread of the delta variant and the saturation of hospitals, public health officials have renewed their sense of urgency to find ways to reach the nearly 1 in 3 eligible Americans who have not yet received their first dose.
Pfizer,
maker of the first vaccine licensed for emergency use in the country, said Friday that it
expects the FDA to grant full approval no later than January 2022.
Acting FDA Commissioner Janet Woodcock has said that the decision should come much
earlier.
Health officials said they believe the vaccine requirements could be that last push for people who have not made it a priority or have been unresponsive.
"It would be a shame if we sat here in July and we don't do something to increase vaccination rates
and then we can't open schools or we have a situation where, God forbid, the economy takes another hit because companies have to to close again, "said Kathleen Sebelius, who served as Secretary of Health under former President Barack Obama.
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The Biden Administration has so far resisted imposing any vaccination requirements, opting instead to offer incentives.
But Slavitt said he hopes that will change with full FDA approval.
In his view, some federal agencies should start requiring the vaccine from their employees, including
members of the Army, health workers in Veterans Affairs hospitals and nursing homes,
and other federal workers in close contact with the public. like airport security inspectors.
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"I think all government agencies should rethink what is appropriate,"
Slavitt said.
"There are a number of people in the polls, by the way, who say precisely these words: I am not going to wear it, unless I have to."
White House press secretary Jen Psaki declined to say on Friday whether the Administration was considering making the vaccine a requirement for the military or the federal workforce.
The federal government already requires members of the Army to be vaccinated.
Immigration applicants must also be vaccinated against a number of diseases.
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It is unclear what authority the Biden administration might have when it comes to requiring vaccines beyond the federal workforce.
No federal immunization mandates have been tested in court and none have ever been issued to the general population.
Instead, much of the power to enforce vaccination has fallen to
state and local governments
following a 1905 Supreme Court ruling that upheld a city health board law requiring all adults to be vaccinated. against smallpox.
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Only a handful of large companies, businesses, and locals have launched any vaccination mandates so far.
Delta Air Lines and United Airlines
are among the few companies that require new employees to be vaccinated, but the policy does not apply to current employees.
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Other companies, such as
BlackRock,
have said that only vaccinated employees can return to the office, but have not yet said what will happen to the unvaccinated.
Madison Square Garden and
Yankee
Stadium
have limited their events to vaccinated attendees,
but many other venues have only encouraged guests to get vaccinated.
Even hospitals and nursing homes have been hesitant to make vaccinations mandatory for employees.
Among nursing home employees, the vaccination rate is lower than that of the general population and in some states, such as Florida and Georgia, the vaccination rate is less than 50% of workers, according to data from the Centers for Nursing. Medicare and Medicaid services.
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"I think it is a responsibility of employers and others who have the ability to enforce it in their facilities,"
said Zeke Emanuel, a health adviser in the Obama Administration, about the requirement for vaccinations for health workers.
"It's not that it's easy, but this is a time of leadership and sometimes when you're a leader, you have to do difficult things," he
added.
Slavitt said that one compromise employers could offer to those staunchly opposed to getting vaccinated would be to require them to get tested several times a week.
The Biden Administration has supported private companies setting vaccination requirements and its top medical adviser, Dr. Anthony Fauci, said on July 11 that he believes there should be more vaccination mandates at the local level.
The government's strategy has largely focused on trying to make vaccines more accessible, disseminating information about them and warning about the risks of not getting vaccinated.
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Last week, the White House turned to pop star Olivia Rodrigo to try to reach the very young, who have the lowest vaccination rates. The surgeon general also released a report on the influence misinformation on social media has had on vaccination efforts. Biden said Friday that those social media platforms, including Facebook, were "killing people" by allowing lies about vaccines to spread on their websites. On Monday, Hewal refuted the criticism, saying the culprits were those who published the false information.
The vaccination rate has been cut in half since June 1,
when the Administration declared a "month of action" to redouble efforts against the spread of the delta variant.
By the end of last week,
new cases had risen 70% in the past seven days,
with the bulk of infections in four states having relatively low vaccination rates, and the number of deaths had risen 26%, to 211. a day, according to the CDC.
"We have the opportunity to really continue the incredible progress that has been made since January," said Sebelius.
"But we also have some real red flags around the world that we need to pay close attention to," he said.
