Biden’s vaccine mandate is long overdue – but it’s not a panacea

Recently, President Biden announced mandatory vaccines for private-sector employees with more than 100 employees as well as healthcare workers and federal contractors. This sweeping new mandate will affect close to 100 million Americans and require them to be fully vaccinated or submit to weekly testing.

These mandates will definitely boost vaccination rates, for no other reason than the fact that people don’t want to either lose their jobs which could happen if they refuse or because people don’t want to submit to weekly testing which can be both intrusive and annoying. But will this change the course of the pandemic? Let’s be clear: with 50 different states, there are 50 different pandemics in America. So, mandating vaccinations will definitely change the course of the pandemic but it will have a greater impact in jurisdictions where current vaccination rates are low. The effect of these mandates will be uneven. You might not notice anything in Vermont, but in Mississippi you will.

And because not all of these 100 million people will immediately run to the nearest vaccination centre, I expect that the impact of this mandate won’t have a meaningful effect for a few months. Let’s not forget that there is a minimum 21-day gap between the first and second shot if you’re receiving the Pfizer/BioNtech vaccine, and a 28-day gap if you’re receiving the Moderna shot. And then, you’re really not fully protected until 14 days after the second shot of whichever vaccine you received. This means that a single person requires somewhere between five and six weeks to be fully protected. So, when you take those time frames into account, in addition to the fact that people are not super-eager to run out and get vaccinated, it will be a few months at minimum and could reasonably stretch into 2022 before we see a change in the numbers that we’re monitoring so closely (cases, hospitalisations and deaths).

Some have suggested that this mandate is toothless since the majority of people whom it covers are already vaccinated. Really? According to the published data, only 54% of Americans are fully vaccinated, so one would expect that in this cohort the number would be around the same. One could even make the case that there might be a slightly lower level of vaccination in this group of people who are covered by President Biden’s mandate simply because these are the most entrenched, hardcore holdouts. This group of people has had more than ten months to get their vaccinations and they still haven’t done so. Why would any of us expect that, in this specific group, there would be a higher vaccination rate than what we see in the national average? I suspect that easily half, if not more, of this group is unvaccinated.

Whatever your position on mandates, they are not a panacea.

First of all, these mandates are being framed incorrectly. Suggesting that this is similar to mandates requiring the use of seatbelts or helmets when we ride a motorcycle are false equivalencies. Seatbelts and helmets are not mandates that require you to put something into your body. This is partly why we see tremendous pushback from those who don’t want to get vaccinated. On the other hand, there are those who use organ donation, birth control and blood transfusions as health-related examples of an individual’s right to do what they want with their own body, thereby building the case for not getting vaccinated. This, too, frames the mandate incorrectly. Refusing to donate a pint of blood or a kidney does not directly harm someone; refusing to get a vaccination for a respiratory virus that can kill someone does. It’s this tug-of-war between ‘protect thy neighbour’ and ‘it’s my body; I have a right to do with it as I choose’ that is at the heart of this debate. And we have much work ahead of us if the majority of this 100 million group are going to roll up their sleeves.

Additionally, who is going to be responsible for enforcing these mandates? I am less concerned about the public sector (ie, the US Armed Forces), In the private sector (employers with >100 employees), I wonder whether the human resources manager at a company or maybe an employee’s direct supervisor is going to be charged with ensuring that an employee has gotten vaccinated. This is fraught with complications. I suspect many people don’t want to do this job and that they won’t.

My last thought on these mandates is about exemptions. I recently read that almost 25% of the Los Angeles Police Department plans to apply for a medical or religious exemption to vaccine mandates. Who, exactly, is going to adjudicate these requests (particularly in a private employer setting)? Is it going to be the human resources manager or direct supervisor again? And what exactly qualifies as a proper religious exemption? For that matter, what qualifies as a proper medical exemption? We’ve been so focused on the mandates and, to a lesser degree, their enforcement that we’ve lost sight of the fact that there is an entire swathe of these 100 million people who will ask for an exemption to this new Federal vaccine mandate. This will only serve to exacerbate the spread of the virus as this group of ‘exemption seekers’ continue to remain unvaccinated.

Are vaccine mandates the right call? Yes. Are they a guaranteed solution? Not even close.