In US, experts make case for vaccine mandates
WASHINGTON: As the divide between the country’s pro- and anti-immunisation regions widens, and the dangerous Delta variant keeps gaining ground, experts are calling for more mandates in jurisdictions, colleges and businesses.
The idea has sparked controversy in a nation that cherishes individual liberty, but these concerns need to be weighed against collective well-being, Gregory Poland, a professor of medicine and infectious diseases at Mayo Clinic in Minnesota told AFP.
“What happens when the world’s on fire? Do you allow people to stand there with matches and gasoline? What happens with the disease where the decision you make not only affects you, but affects people around you, or that you’ve come into contact with?” he asked
The administration of President Joe Biden stated at the end of March it would not create a federal vaccination database and there would be no federal mandate. The decision might have been calculated to avoid dissuading people on the fence – but it ultimately means that the question has been delegated from the national to state level, and to the private sector.
The national vaccination campaign has stalled since hitting a high-water mark in mid-April. Barely 600 000 a day are being vaccinated, down from a peak of more than four million, despite widened eligibility to everyone older than 12.
A clear divide has emerged across the country, with cases increasing rapidly in communities that have low rates of vaccination.
Although they pose the greatest risk to themselves – about 99 percent of the 27 000 deaths since May have been among the unvaccinated – the threat to the vaccinated is not zero.
“In the US we have 10 to 20 million people who are immunosuppressed,” said Poland. “Do we allow them to remain at risk?”
Georgetown global health law professor Lawrence Gostin said “no”. He anticipates that businesses and universities enacting mandates would face a flood of lawsuits but would win because of a favourable legal landscape.
More than 500 colleges and universities have already taken the step, the Chronicle of Higher Education said. So too has the city of San Francisco for its municipal employees, financial firms, and a Houston hospital which won a lawsuit against employees opposed to the measure.
Professional sports venues and musical performances are asking patrons for proof of vaccination.
For Gostin, the major ethical argument against vaccine mandates was equity.
Since ethnic minorities and people of lower income found it more difficult to access vaccines earlier on, it would have been unfair to impose penalties on them. That is no longer the case, with walk-up vaccination sites every few miles and open until late.
Technology poses another challenge for vaccination passes, said I Glenn Cohen, a Harvard law professor specialising in bioethics and law.
“All our data is collected on these little paper cards, and that makes tracking much more difficult.”
Experts agree there should be exemptions. For example for people with a history of anaphylactic shock to vaccine ingredients, or who recently had myocarditis.
Poland said it was particularly critical for key positions.
“If you want to join the military, if you want the privilege of taking care of patients …then I think it’s quite fair as a number of organisations have said, ‘you don’t get the vaccine, we’re not going to hire you, or we’ll fire you.’ ”
Ultimately, the biggest challenge will be political – 17 states, most with low vaccination rates, have banned proof-of-vaccination requirements.
While these measures are “extraordinarily reckless and unwise”, those that passed their laws by statute will probably withstand legal challenge, Gostin said. |