President Biden’s new coronavirus vaccine mandates will have sweeping ramifications for businesses, schools and the political discourse in the United States. But for many scientists, the question is a simpler one: Will these measures turn back a surging pandemic?
The answer: Yes, in the longer term.
It has become clear that the nation cannot hope to end the pandemic with some 37 percent of Americans not having received a single dose of Covid vaccine, several experts said in interviews. Cases and hospitalizations are only expected to rise as Americans move indoors in homes, schools and offices in the cooling weather.
The administration’s new plan should stem the flood of infections and return the country to some semblance of normalcy over the longer term, the researchers said.
“It’s going to fundamentally shift the arc of the current surge,” said Dr. Ashish Jha, dean of Brown University School of Public Health. “It’s exactly what’s needed at this moment.”
The vaccine mandates will protect millions more people, particularly against severe disease, and relieve pressure on the health care system, said Natalie Dean, a biostatistician at Emory University. “It also sets a precedent for other organizations to make similar decisions” about mandates, she said.
But some experts cautioned that the results from the aggressive plan would take many weeks to unfold. Immunization is not an instant process — at least six weeks for a two-dose vaccine — and the administration did not emphasize the measures that work more quickly: masking and widespread rapid testing, for example.
The nation has been overtaken by the contagious Delta variant, a far more formidable foe than the original version of the virus. The optimism of the spring and early summer gave way to dread as experts observed the variant’s march across Asia and Europe, sending rates soaring even in Britain, which had successfully protected most of its older adults.
The variant became the dominant version of the virus in the United States only in mid-July, and the consequences have been beyond anything experts predicted. Reassuringly low numbers of cases and hospitalizations in June have risen inexorably for weeks to nearly 10-fold their levels. About 1,500 Americans, the vast majority of them unvaccinated, are dying each day.
The mandates arrived on Thursday after weeks of arguments from public health experts that the federal government must do much more to raise vaccination rates.
The administration’s mandates will affect nearly 100 million Americans. Among them are health care workers. The administration will require that any provider receiving Medicaid or Medicare funding impose a vaccination requirement on staff.
This is the measure mostly likely to have an immediate impact, experts said, because health care facilities are high-risk settings for transmission. And there is ample historical precedent for the decision to hold hospitals to certain standards — notably, the historical directive to desegregate patients by race, said Dr. Jha said.
“We have a real dearth of leadership from health care systems that have not mandated within their own organizations, and it is imperative that the president require that patients be protected,” he added.
The requirement may drive some health care and nursing home workers, particularly many who are close to retirement age, to leave the profession. Even so, there is more to be gained than lost by the mandates, said Dr. Nahid Bhadelia, founding director of Boston University’s Center for Emerging Infectious Diseases Policy and Research.
Understand Vaccine and Mask Mandates in the U.S.
- Vaccine rules. On Aug. 23, the Food and Drug Administration granted full approval to Pfizer-BioNTech’s coronavirus vaccine for people 16 and up, paving the way for an increase in mandates in both the public and private sectors. Private companies have been increasingly mandating vaccines for employees. Such mandates are legally allowed and have been upheld in court challenges.
- Mask rules. The Centers for Disease Control and Prevention in July recommended Advertisement
- College and universities. More than 400 colleges and universities are requiring students to be vaccinated against Covid-19. Almost all are in states that voted for President Biden.
- Schools. Both California and New York City have introduced vaccine mandates for education staff. A survey released in August found that many American parents of school-age children are opposed to mandated vaccines for students, but were more supportive of mask mandates for students, teachers and staff members who do not have their shots.
- Hospitals and medical centers. Many hospitals and major health systems are requiring employees to get a Covid-19 vaccine, citing rising caseloads fueled by the Delta variant and stubbornly low vaccination rates in their communities, even within their work force.
- New York City. Proof of vaccination is required of workers and customers for indoor dining, gyms, performances and other indoor situations, although enforcement does not begin until Sept. 13. Teachers and other education workers in the city’s vast school system will need to have at least one vaccine dose by Sept. 27, without the option of weekly testing. City hospital workers must also get a vaccine or be subjected to weekly testing. Similar rules are in place for New York State employees.
- At the federal level. The Pentagon announced that it would seek to make coronavirus vaccinations mandatory for the country’s 1.3 million active-duty troops “no later” than the middle of September. President Biden announced that all civilian federal employees would have to be vaccinated against the coronavirus or submit to regular testing, social distancing, mask requirements and restrictions on most travel.
“This is an important step to get us out of the pandemic,” she said. “The very people who are taking care of the vulnerable coming into the hospital need to be our first line of defense.”
The Labor Department will require all private-sector businesses with more than 100 employees to require that their workforces be fully vaccinated or be tested at least once a week. Employers will be required to give paid time off to employees to get vaccinated.
That move alone will affect 80 million Americans; it’s not clear how many are already vaccinated. In any event, the effects will not be immediately evident.
Given the time required between the first two doses of the vaccine, and then for immunity to build up, the effect of all these mandates is unlikely to be felt for many weeks, said Bill Hanage, an epidemiologist at Harvard University.
And Dr. Hanage was skeptical that the mandates would be successful in inoculating millions more people than have already opted for the vaccine. Some of the people who most urgently need to be protected are older adults who will not be affected by workplace requirements.
“I’m sure that the anti-vaxxers are already prepared to be up in arms about this,” he said. (Republican governors in several states have decried the mandates as unconstitutional and say they plan to file suits to stop them.)
By insisting that vaccination is the way out of the pandemic, officials in both the Trump and Biden administrations have de-emphasized the importance of masks and testing in controlling the pandemic, several experts said.
“It’s a lot quicker to put on a mask than it is to get a bunch of people vaccinated,” Dr. Hanage said.