FDA Approval Of Pfizer Shots Opens Door To More COVID-19 Vaccine Mandates

Following the Food and Drug Administration’s full approval of Pfizer-BioNTech’s two-dose coronavirus vaccine this week, it remains to be seen how many more Americans will get vaccinated.

Some public policy analysts and surveys indicate that FDA approval will lead to more jabs.

Among those who have been “fearful of something that has not received the full imprimatur of the FDA, some percentage of that group will now go ahead and get the vaccine, especially as the Delta variant drives up the case, hospitalization and death numbers among the unvaccinated,” said Mark Peterson, professor of public policy, politics and law at the University of California-Los Angeles.

Among unvaccinated adults, 31 percent surveyed in May said they would be more likely to get a coronavirus vaccine following full FDA approval, a Kaiser Family Foundation survey found. Other studies found similar results, according to Gabriel Sanchez, a political science professor and founder of the Robert Wood Johnson Foundation Endowed Chair in Health Policy at the University of New Mexico.

He cites the American COVID-19 Vaccine Poll from the African American Research Collaborative, which “found that 28 percent of unvaccinated Americans noted that they were concerned that the Biden administration was pushing the vaccines too quickly without proof that they are safe.”

“This was one of the top five sources of hesitancy across the national sample. The news that the FDA has provided full approval to one of the main vaccines will help encourage more Americans to get vaccinated.”

President Joseph R. Biden for many months has been urging Americans to get vaccinated.

After the FDA issued formal approval on Monday of Pfizer-BioNTech’s vaccine for people ages 16 years and older, Biden continued his campaign:

“Let me say this loudly and clearly: If you have — if you’re one of the millions of Americans who said that they will not get the shot when it’s — until it has full and final approval of the FDA, it has now happened.  The moment you’ve been waiting for is here, and it’s time for you to go get your vaccination and get it today,” the president said on Monday afternoon.

The mRNA vaccine, which will now be marketed under the name Comirnaty, had been approved only under the FDA’s Emergency Use Authorization. It will remain under that authorization for children ages 12 to 15.

Signs opposing mask mandates are posted at a board of education meeting for Kalamazoo County Schools in Schoolcraft, Michigan, on Aug. 23. (Matthew Hatcher/Getty Images)

The endorsement of the Pfizer vaccine could also clear the path for schools and businesses to mandate vaccination, Peterson said.

Until now, “many universities, colleges, government agencies and employers have deferred implementing vaccine mandates … given the resistance that would emerge on both psychological and legal grounds,” he said.

FDA approval also decision removing the legal hurdle for mandatory vaccinations, under the U.S. Equal Employment Opportunity Commission.

In addition to the federal government, many businesses already have vaccine requirements for employees, including Netflix, Microsoft, Tyson Foods, United Airlines and Walt Disney. After the FDA’s announcement on Monday, the Pentagon stated it would require all active-duty troops to get vaccinated; other big businesses followed suits, including Chevron and CVS.

A 12-year-old receives a first dose of the Pfizer COVID-19 vaccine at Harborview Medical Center in Seattle, Washington, on May 13, after the FDA gave emergency authorization for the vaccine’s use on 12- to 15-year-olds. (David Ryder/Getty Images)

An increasing number of educational institutions are requiring vaccines.

“I think it’s close to 700 [public universities] now across the country that are requiring students to get vaccinated before they come back to school,” said Hemi Tewarson, executive director of the National Academy for State Health Policy, a nonpartisan forum of policymakers.

Within hours of the FDA’s announcement, the State University of New York system and the New York City school system stated they would enforce vaccine mandates for students, faculty and staff. The University of Minnesota System and Louisiana State University also said they are planning mandates. Public and private school employees in New Jersey will now be required to get vaccinated or tested weekly for COVID-19 .

Tewarson said some of the colleges and universities that decide to move ahead with requiring students to get vaccinated may do so because of the outbreaks of the Delta variant of the coronavirus..

The spread of the highly transmissible Delta variant has accelerated a rise in cases, particularly in states where vaccination rates remain low. Daily cases on Aug. 18 reached their highest point since January, with nearly 170,000 new infections reported nationwide. The country is averaging around 700 COVID-19 deaths per day, and some hospitals are again struggling to provide enough beds for coronavirus patients.

Biden, in his remarks on Monday, implored employers to require vaccines.

“If you’re a business leader, a non-profit leader, a state or local leader who has been waiting for full FDA approval to require vaccinations, I call on you now to do that — require it.  Do what I did last month and require your employees to get vaccinated or face strict requirements,” the president said.

Some state leaders have taken a similar approach. Former Virginia governor and now-gubernatorial candidate Terry McAuliffe, a Democrat, encouraged every employer in the state to require vaccination. His opponent, GOP nominee Glenn Youngkin, labeled McAuliffe’s message an attempt to bully residents into compliance, saying it should not be the government’s decision.

Some states had previously banned mandates for COVID-19 vaccines administered under emergency approval. Ohio had prohibited schools from doing so. Utah banned public entities from taking that step. Texas outlawed any public or private entity that receives public funds from requiring a COVID-19 vaccine approved only for emergency use.

“As a technical matter, those bans will no longer apply,” Tewarson said.

A sign in a restaurant window in New York City on Aug. 20 informs patrons that they will need to show proof they are at least partly vaccinated against COVID-19 to be served indoors. (Spencer Platt/Getty Images)

Vaccine advocates hope that requirements by employers and schools will help drive up the vaccination rate across the country. Just over 51 percent of the population is fully vaccinated;  roughly 60 percent has received at least one dose, according to the Centers for Disease Control and Prevention.

When a deadly smallpox epidemic spread through the northeast in 1902, the Boston and Cambridge, Massachusetts, boards of health required all residents to be vaccinated or face fines. The move was upheld by the Supreme Court in 1905, setting a precedent for mandates.

Tewarson says state governments today will be reluctant to introduce vaccine mandates.

“We haven’t had any state governments mandate for state residents yet,” she said. “I’m not sure if states are going to take that next step. I would guess you probably won’t see that as an immediate move unless there’s some really, really high transmission that there’s really a concern about.”

Edited by Alex Willemyns and Judith Isacoff



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