President Joe Biden made the case in a national address Thursday that vaccine mandates are essential for economic recovery and ending the pandemic, pushing back on concerns amid a culture war controversy.
“I’ve tried everything in my power to get people vaccinated,” Biden said, naming lotteries, time off from work and providing the vaccine for free as incentives. “But even after all these efforts, we still had over a quarter of Americans eligible for vaccinations who didn’t get the shot. And we know there is no other way to end the pandemic than to get the vast majority of Americans vaccinated.
“So while I didn’t race to do it right away, that’s why I’ve had to move toward requirements. . . . That wasn’t my first instinct,” Biden added, an acknowledgement of prior statements that he wouldn’t impose requirements.
The president appeared near Chicago, where he applauded United Airlines and Clayco, a Midwestern construction company, for implementing vaccine mandates for workers ahead of an expected Occupational Safety and Health Administration regulation requiring vaccines or routine testing at businesses with 100 workers or more.
Before the speech, Biden met workers at one of Clayco’s construction sites.
“700,000 people dead in the United States,” Biden noted, according to the pool report.
The vaccines have saved roughly 100,000 lives, say White House officials. But the unmoved population of unvaccinated Americans has taken a toll. Roughly 192,000 people have died in the seven months since all three COVID-19 vaccines became available to the general public in the U.S.
Biden said mandates could help relieve some of the pressure that unvaccinated people sick with COVID-19 are putting on the health care system.
“Doctors and nurses, I mean it, they’re running dry,” Biden said.
Experts agree that COVID-19 vaccines are safe and effective, citing safety data collected from 187 million fully vaccinated Americans.
Given the drumbeat of thousands of deaths per day, and the demonstrated safety of the vaccines, many health experts emphasize that vaccine mandates are the right course of action.
“There's a societal good, a societal priority, that has to take precedence here to try to stop this transmission,” said Michael Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota.
OSHA is currently hammering out an emergency temporary standard that will require businesses with more than 100 workers to vaccinate employees or conduct weekly testing. An emergency temporary standard lays out safety standards businesses must put in place to protect workers and employees in a crisis.
A draft could reach the White House’s Office of Management and Budget for a final review as soon as next week, according to an activist close to OSHA. An earlier emergency temporary standard on masks and ventilation in workplaces, which was ultimately scuttled under industry opposition, was drafted in about six weeks. Biden announced the upcoming vaccine mandate almost a month ago.
Meanwhile, some Republicans and Fox News pundits have cast vaccine mandates as a threat to individual freedom, even an authoritarian policy.
“This vaccine mandate is not about public health or science,” Sen. Roger Marshall, R-Kansas, said last week when he proposed an amendment to prevent implementation of a vaccine mandate. “If it were, we’d recognize natural immunity as a highly effective way to combat the virus.”
Marshall is vaccinated but says it's a personal decision.
Fox on-air personalities have repeatedly described defying vaccine mandates as “civil disobedience,” according to a report by Media Matters for America, a liberal research group that investigates misinformation on conservative networks. Fox pundits’ characterizations defy a public opinion poll by Fox that suggests 56 percent of people support vaccine mandates in businesses, and the network’s own company policy requiring vaccination.
Contrary to how the controversy is often portrayed on Fox, vaccine mandates are far from ubiquitous: 25 percent of businesses, 40 percent of hospitals, and universities and colleges representing 37 percent of students have implemented them, according to the White House.
Lawrence Gostin, a Georgetown Law global health law expert and an advocate for vaccine mandates, says those numbers will likely rise once the formal OSHA rule is in place.
“This will require large businesses to mandate vaccines but will also encourage mandates in small businesses, cities and states, and colleges and universities,” he said in an email.
So far, mandates have shown signs of success: Since Biden announced the nation’s first vaccine requirement for federal employees in July, the number of unvaccinated Americans has declined from 95 million to 67 million.
A White House report aims to normalize Biden’s vaccine mandate by putting it in historical context, drawing a parallel to required smallpox shots in George Washington’s Continental Army.
Experts also expect once the FDA authorizes the vaccine for children under 12 years old, some school districts will begin mandating the vaccine as well.
The White House’s report also seeks to show school vaccine mandates as routine, citing required smallpox vaccinations in Boston Public Schools in the early 1800s.
Every state has required immunizations for school attendance for the last 40 years. Vaccine mandates brought down the rate of measles from 500,000 infections each year to dozens.
The report also highlights support from economists and business lobbies.
An economic analysis by Goldman Sachs estimates higher vaccination rates could return jobs to 5 million unemployed Americans.
In September, about 4.6 million workers were not working because they or someone they cared for had COVID-19, while another 4.7 million Americans had been laid off or furloughed because of the crisis. A further 2 million Americans said their jobs were temporarily halted because of the pandemic, with another 1.5 million reporting their employer had gone bankrupt.
Forecasts for the future
Experts hope the last-resort measure will bring an end to the thousands of deaths a day and usher in a new post-pandemic phase.
Infectious disease experts say vaccine mandates — along with a rising number of people who have acquired immunity after recovering from the highly contagious delta variant and anticipated vaccinations of children 5 to 11 years old in November — bring cause for optimism. Pfizer finalized its application for emergency use authorization for children under 12 earlier Thursday. A decision by FDA is expected at the end of the month.
Some experts are split on whether cases will keep falling.
Osterholm pointed to the 65 million or so eligible Americans who have not gotten vaccinated.
"It could be that some of those people will have some protection from having been previously infected. But that still leaves a lot of susceptible people out there,” said Osterholm. “And that's why we're gonna see more surges. This surge is not the last.”
Monica Gandhi, an infectious diseases expert with the University of California, San Francisco, was more optimistic, predicting this surge as the final big one.
“Our population immunity is increasing steadily,” Gandhi said by email.
“I think the mandates have been essential to help contain the virus, which could happen as early as spring,” said Gostin. “But there will continue to be surges among unvaccinated populations, but those surges will be much smaller than in the past and also will wane over time as more people get vaccinated.”