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Will the COVID-19 Vaccine Be Mandatory?

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The Food and Drug Administration announced emergency use authorization of the Pfizer COVID-19 vaccine, and the Moderna vaccine will be up for review on Thursday, clearing the way for millions of people to receive the vaccine in the upcoming days. According to a Gallup survey, 42 percent of Americans claim they won’t get a coronavirus vaccine due to fears of it being rushed, along with several other fast-spreading falsehoods surrounding the vaccine’s development.

However, despite reluctance, the big question that remains is: Will the vaccine be mandatory for all Americans? During a live town hall meeting hosted by Healthline, Anthony Fauci, MD, director of the National Institute of Allergy and Infectious Diseases, noted that it is unlikely a COVID-19 vaccine would be mandatory in the United States.

“I don’t think you’ll ever see a mandating of vaccines, particularly for the general public,” said Fauci. “If someone refuses the vaccine in the general public, then there’s nothing you can do about that. You cannot force someone to take a vaccine.”

The federal government cannot mandate a vaccination for all Americans because the Constitution leaves public health matters to be governed by the states. However, there are some exceptions that could still require you to get vaccinated.

Some state mandates could be put in place

States have the right to establish vaccination requirements for the coronavirus. According to C. Buddy Creech, MD, director of the Vanderbilt Vaccine Research Program, we could potentially start seeing restrictions of movement or limitations on what we can do as the vaccine is distributed.

This is seen most commonly in the school system. All 50 states have legislation in place that requires students to have specific vaccines for school or daycare entry. There are, however, vaccine exemptions that vary from state to state due to medical, religious, or philosophical reasons. But Creech says before any of this can happen, research needs to expand and the vaccine needs to be thoroughly evaluated specifically in children.

“Right now we know data down to about 16 years of age and multiple manufacturers are beginning studies in school age,” says Creech. “We need that information before we could ever recommend it for children or certainly before we could make this a required entry for school.”

Private employers could require vaccination

There are no laws that restrict employers from establishing a vaccine mandate. However, similar to schools, there are some exemptions that can come into play due to guidelines set by the Equal Employment Opportunity Commission, the Americans with Disabilities Act, Title VII of the Civil Rights Act of 1964, and more.

“We can learn a lot from influenza vaccine mandates,” said Creech. “There are businesses, particularly in healthcare, that mandate the flu vaccine for their staff with certain exemptions. That has been a very effective mechanism to reduce the burden of influenza inside hospitals. Whether or not that will be the path taken for COVID vaccines, it’s simply too early to know.”

Due to vaccine exemptions and gray areas, many employers opt to encourage their staff to get vaccinations rather than require them.

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What can you expect?

As of now, the FDA has announced emergency use authorization of one COVID-19 vaccine; others are expected shortly. But emergency use authorization is not the same thing as a full approval, which can take months. According to Creech, there likely won’t be a situation where the vaccine is clearly mandated in a widespread manner solely under the emergency use authorization.

The Pfizer vaccine being distributed now is limited by manufacturing capabilities due to such a high demand with this new virus. This would also make mandating a vaccine difficult without sufficient supply.

“Once we get a substantial amount of our population immune, preferably by vaccine, that will have profound effects on the amount of virus circulating in our communities,” said Creech. “Remember, what we want is for a school, hospital, or place of business to have so many people immune that even if someone brought COVID into that workplace, the virus can’t find footing. So, there’s going to be a tipping point where we stop seeing this rampant disease that we have.”

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