New Hampshire Democratic lawmakers are pushing to add COVID-19 vaccines to the list of immunizations required for all children provided the vaccines become approved by the U.S. Food and Drug Administration.
In a bill set to be introduced in 2022, eight Democrats, led by newly converted member Rep. William Marsh, aim to add COVID-19 vaccines to the current requirements.
State statute mandates that all children residing in New Hampshire be immunized against diphtheria, mumps, pertussis, poliomyelitis, rubella, rubeola, and tetanus. Children are not allowed to be admitted to public or private schools or child care centers unless they can demonstrate that they have received an immunization or partial immunization, or that they qualify for an exemption, according toRSA 141-C:20-a.
The existing statute allows children to be exempted from the vaccine only if a physician certifies that it would be detrimental to their health, or if their parent or guardian objects because of religious beliefs.
Marshs proposed bill would add COVID-19 to the list. And it would expand the definition of school to include colleges and universities, extending the existing vaccine mandate.
No virus in the history of mankind has ever been brought under control without vaccine mandates, said Marsh, a retired physician, in an interview Monday.
Under Marshs proposed bill, the mandate for children would not apply to all COVID-19 vaccines; it shall only apply to individuals whose age exceeds the minimum for a vaccine fully approved by the FDA, and not just available under emergency use authorization, according to a copy of a first draft shared with theBulletin.
Were not forcing anyone to have experimental vaccines, Marsh said.
The FDA has not formally approved the Pfizer COVID-19 vaccine for children under 16, but it has given emergency authorization for children 12-15. Medical experts recommend children 12-15 get the shot.
Marsh, a Brookfield representative who last week converted from a Republican to a Democrat after criticizing Republican House leadership for its opposition to vaccine and mask mandates, said he would introduce the bill to the Health and Human Services and Elderly Affairs Committee in January.
But the proposal comes at a time of deep division around vaccine mandates and skepticism among Republicans specifically, who currently control the House and Senate.
Some Republican House members have indicated they want to push the states child vaccination laws in the other direction; several bill requests filed last week would prohibit COVID-19 vaccination requirements and broaden the exceptions available to parents.
In that environment, Marsh said he didnt expect the bill to receive support in the Health and Human Services committee. But he said he would put his hopes into winning support for the effort on the House floor, even if the committee recommended the bill be killed.
A series of Democratic wins in House special elections have narrowed the Republican majority in the House which started in January as the slimmest of either partys hold over the chamber in several decades.
I fully expect this bill to be [recommended inexpedient to legislate] by the stacked HHSEA committee, Marsh said. Then it comes to the House floor, and I intend to flip it on the House floor.
It is unclear whether support exists for a COVID-19 school vaccine mandate in the New Hampshire Senate or in the governors office. Speaking to reporters Sept. 15, Gov. Chris Sununu, a Republican, did not explicitly endorse a vaccine mandate for COVID-19, but suggested the Legislature might support it in the future.
If the New Hampshire Legislature says, You know, were gonna mandate the COVID vaccine for school, they have every right to do so, he said. I imagine thatll probably happen at some point.
A non-peer-reviewed retrospective paper, released as a pre-print, analyzed the rate of post-vaccination cardiac myocarditis in children aged 1215 and 1617 years who had received mRNA COVID-19 vaccines.
The researchers did so by searching the Vaccine Adverse Event Reporting System (VAERS) for reports of children aged 12-17 years from January 1, 2021, to June 18, 2021. They searched using the words myocarditis, pericarditis, myopericarditis, chest pain, and a troponin lab, which identifies a heart attack and other heart conditions.
They then inferred a diagnosis of cardiac adverse events (CAE) in these children.
The Centers for Disease Control and Prevention (CDC) announced in June 2021 that it is actively monitoring for the occurrence of myocarditis and pericarditis after the COVID-19 vaccination. The CDC still recommends that everyone aged 12 years and older receive a COVID-19 vaccination.
Researchers stratified the reports they had identified as CAE rates by age, sex, and vaccination dose number. They conducted a harm-benefit analysis based on available literature concerning COVID-19-related hospitalization risk in the age group.
The study identified 257 CAEs in total and reported rates (in cases per million after the second dose) of 162.2 in boys aged 1215 years, 94 in boys aged 1617 years, 13 in girls aged 12-15 years, and 13.4 in girls aged 1617 years.
The study estimated that CAE incidence was between 3.7 and 6.1 times higher than their 120-day COVID-19 hospitalization risk (August 21, 2021) in healthy boys aged 1215 receiving their second mRNA dose. They estimated that the CAE incidence was 2.13.5 times higher in healthy boys aged 1617.
The paper appears on the pre-print server MedRxiv.
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Inflammation may occur in the heart due to infections, medicines, autoimmune diseases, or environmental factors, which may cause damage and lead to health problems. Inflammation may occur in the heart muscle (myocarditis) and tissue that forms the sac around the heart (pericarditis).
Cases of myocarditis and pericarditis reported to the VAERS occurred mainly in male adolescents and young adults, usually within 7 days following the second dose of an mRNA COVID-19 vaccine (Pfizer-BioNTech and Moderna), with most resolving after conservative management.
VAERS is a post-marketing safety program in the United States that collects reports of adverse events after vaccination from patients, family members, healthcare providers, vaccine manufacturers, and the general public in the U.S.
in an interview with MNT, Dr. Danelle Fisher, pediatrician, and Chair of Pediatrics at Providence Saint Johns Health Center in Santa Monica, CA, explained: All myocarditis causes symptoms, including chest pain, difficulty breathing, and palpitations [and] we usually [admit] children who have myocarditis [to] the hospital to monitor them.
However, theres no specific treatment for myocarditis we use supportive care which means things such as ibuprofen for chest pain or discomfort, intravenous fluids [for hydration], and just watching and waiting and these kids get better.
She added, Now, there is a small subset of myocarditis patients that will go on to have cardiac dysfunction, but it is incredibly rare. The [number] of cardiac issues that [we see] from COVID-19 disease [will] probably outweigh the [number] of kids who got the vaccine and ended up with vaccine-associated myocarditis.
The study has limitations regarding the inappropriate use of VAERS reporting data to calculate the CAE rate. VAERS serves to rapidly detect safety signals or unusual or unexpected patterns of vaccine-related adverse reactions, but the publically available database has some fundamental limitations:
Dr. Fisher commented about the studys limitations: The first thing that jumped out to me is that this is an evaluation of the VAERS database. [] I look at this data as being [] self-reported or [] not necessarily reviewed by physicians.
Using unverified VAERS data to calculate the incidence of heart inflammation is not recommended in the VAERS data disclaimer, limiting the accuracy and applicability of the studys findings.
She added, Now, on top of that, the instance of myocarditis that has been seen after the Pfizer vaccination is still a very rare number. []. So, Im not exactly sure that Im ready to draw conclusions or tell my patients that Im very concerned about myocarditis after [the] Pfizer vaccine if they are in the risk group of 1218 years old; this is not the study that Im going to hang my hat on as a physician.
Scott Pauley, Press Officer, News Media Branch, Division of Public Affairs, Office of the Associate Director for Communications for the CDC, commented to MNT: [The] CDC was not involved in the study, which used reports with limited information from a publicly accessible VAERS database [and] is not able to verify the validity of [the] methods used or the results obtained.
However, a CDC analysis of reports to the VAERS of myocarditis after COVID-19 vaccines is currently under review at a major peer-reviewed journal.
He added, This analysis describes reports that have been verified to meet the CDC working definition for myocarditis or myopericarditis, by an interview with a provider involved in the patients care, as well as a review of available medical records associated with these reports.
Dr. Fisher commented:
I have a young child myself who is a boy; hes 9.5 years old. [] Im not worried about my son getting the Pfizer vaccine if it is indeed released by October 30 or 31. Im still going to [] get him the vaccine because I still feel that the vaccine is truly the safest thing we can do to protect our children and our adult population from COVID disease.
She elaborated, I am so much more concerned about COVID disease than I am about [the] COVID vaccination, and I want to be sure that when people look at studies, they know what theyre looking at.
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As more employers require their workers to get vaccinated against COVID-19, more workers are finding religion. Or rather, sincerely held religious beliefs that, they say, prevent them from getting the shots.
Hundreds of Los Angeles firefighters have sought exemptions from the citys vaccine mandate for religious or medical reasons, and thousands of Los Angeles Police Department employees are expected to do the same. And they may be the leading edge of the wave of workers seeking exemptions, as the federal government is preparing to require employers with 100 or more workers to order vaccinations or weekly coronavirus testing for all employees. Federal employees are already required to be vaccinated even if they work from home, with no testing alternative, and a similar requirement is being developed for federal contractors and subcontractors.
Nicholas De Blouw, an employment attorney and partner at Blumenthal Nordrehaug Bhowmik De Blouw in Los Angeles, said hes getting calls every single day from people facing a vaccine mandate including three in about 20 minutes on Wednesday morning.
But what are the rules surrounding religious exemptions? What constitutes a sincerely held belief? And how much leeway do employers have when faced with a torrent of exemption claims based on religion? The Times talked to experts in employment law and religious rights, and here are their answers to these and other questions.
The Supreme Court upheld the constitutionality of vaccine mandates more than 100 years ago, but has made it clear that employers cant run roughshod over their workers religious beliefs. The protections for religious objectors are in California law, the U.S. Constitution and federal law, particularly Title VII of the Civil Rights Act of 1964, which requires private companies to make reasonable accommodations for workers who have sincerely held religious beliefs that conflict with vaccination.
Employers hoping to stand on firm legal footing need to look at each employees request and go through an interactive process with the employee to seek a reasonable accommodation for sincerely held beliefs.
That process is really key, said Mark Phillips, a partner at the Reed Smith law firm in Los Angeles. Employers cant dismiss a request for a religious exemption out of hand, even if it may initially seem ridiculous, Phillips said. The employer has to engage with the worker not only to find out the nature of the request, but also to find out if accommodation is possible and reasonable.
Angel James Horacek, an attorney in Culver City, said Californias ban on religious creed discrimination applies not just to beliefs based on an organized religions teachings, but also to beliefs, observances, or practices, which an individual sincerely holds and which occupy in his or her life a place of importance parallel to that of traditionally recognized religions.
Theres still a limit to what constitutes a religion, Horacek said in an email. In a 2002 decision holding that veganism was not a religious belief, a California appeals court laid out three factors: a religion addresses fundamental and ultimate questions, consists of a belief-system as opposed to an isolated teaching, and often can be recognized by the presence of certain formal and external signs.
Employers can ask for the details of the religious conviction behind the request for an accommodation and explore whether the objection is based on politics, ideology or medical concerns. And if the employer denies the request and the worker sues, the burden will be on the worker to establish that he or she was motivated by a sincere religious belief.
Nevertheless, said Phillips, its not a good idea to question the sincerity of somebodys religious belief. Horacek agreed, saying theres very little an employer can do to test whether a workers claim is sincere.
Nor does it matter whether the person is following the teaching of his or her faith leaders of the vast majority of organized religions have endorsed at least some of the COVID-19 vaccines that are available. You dont go by what their organized religion believes, Phillips said. An individuals personal religious conviction can differ from their organized religion.
Added Douglas Laycock, Robert E. Scott distinguished professor of law at the University of Virginia, Courts are in no position to adjudicate the official teaching of the church anyway. There are lots of issues on which members of a church disagree, and lots of cases in which the objector takes the teaching further than the church does.
The issue here is what it would take to minimize the risk posed by an unvaccinated employee. Could the person work from home, or do the job in a private office, or otherwise maintain minimal contact with other workers and the public? Is there another, similar job that the person could do remotely?
For private employers, the accommodation isnt reasonable if it imposes an undue financial or operational burden on the company. Thats an ill-defined standard, so the answer will depend on such things as the nature of the accommodation and the size of the company.
Its important to bear in mind that if your employer mandates COVID-19 vaccinations, your religious objection, no matter how sincerely held, is no guarantee that you can keep your job. The employer is obligated to try to find a way to keep you at work unvaccinated, but whether thats possible depends on what you do.
For example, if you cant work from home, cant socially distance from co-workers or customers, and cant be tested frequently enough to assure the safety of those you come into contact with, your employer may have reason to replace you. If you cant perform the essential functions of the job even with accommodation, then theres no accommodation thats going to help you, Phillips said.
Two other factors are the extent to which workers interact with co-workers and the public and the nature of those interactions, he said. Another is the rate of coronavirus transmission among people in that workforce the higher the rate, the greater the argument against an exemption.
De Blouw noted that employers have a legal obligation to maintain a safe and healthy workplace. If they dont require vaccinations and an employee gets infected at work and dies, De Blouw said, they could be held liable.
Laycock, who described himself as one of the strongest academic defenders of religious exemptions in the country, nevertheless argues that Los Angeles officials would be on solid legal footing if they rejected all exemptions from the vaccine mandate except those needed for medical reasons.
It has a compelling government interest in requiring vaccination against a deadly infectious disease. The court cases are essentially unanimous about that, he wrote in an email. The unvaccinated are overwhelming our hospitals and depriving other folks of needed medical care, and because no vaccine is 100% effective, they are spreading the disease to folks who are vaccinated, causing minor problems for many of them and killing a few of them.
Other attorneys disagree, arguing that like any other employer, the city would have to meet individually with each of the hundreds of employees seeking exemptions to determine whether they could be reasonably accommodated.
In addition, the Biden administration has muddied the waters when it comes to what employers need to do to protect the public, mandating vaccinations for federal workers and contractors regardless of their size, but allowing a testing alternative for private employers with 100 or more workers, and requiring neither testing nor vaccinations for workers at other private companies.
When it comes to fighting vaccine misinformation online, does calling it out actually work? Pool/Getty Images hide caption
When it comes to fighting vaccine misinformation online, does calling it out actually work?
A now-infamous tweet by rapper Nicki Minaj is the latest example of false messaging about the COVID-19 vaccines.
It's reignited a conversation about how to fight vaccine misinformation online and whether calling it out actually works.
And it's not just those outside the medical establishment who are hesitant or actively spreading false information. A small percentage of doctors are, too.
According to The Washington Post; Facebook, YouTube, and Twitter have all enacted stricter rules against coronavirus misinformation. This includes posting outright lies about vaccines. But much of the misinformation is spread by those who say they are simply asking questions, something the platforms have been hesitant to police.
We talk with experts about the tangled web of vaccine misinformation online and how to fight it.
Ben Collins, Dr. Sonja Rasmussen, Neil Johnson, and Lauren Culbertson join us for the conversation.
Like what you hear? Find more of our programs online.
Researchers at Harvard University, Tufts University, and Brigham and Womens Hospital all three institutions based in Massachusetts argue that COVID-19 vaccination priorities in the state are an example of institutional racism.
In their research letter, which appears in the JAMA Health Forum, they assert that disparities in vaccine coverage highlight ongoing inequities in the approach to COVID-19 and imperil efforts to control the pandemic.
Scott Dryden-Peterson, M.D., M.Sc., the studys lead author, is an assistant professor of medicine at Harvard Medical School and an associate physician at Brigham and Womens Hospital in Boston, MA.
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Dr. Dryden-Peterson and his team analyzed SARS-CoV-2 testing and vaccination data from early 2020 to the middle of 2021.
The data was compiled anonymously from over 6.5 million individuals in 293 communities throughout Boston and Massachusetts.
The researchers created a vaccination-to-infection risk (VIR) ratio to assess how vaccinations aligned with the risk of SARS-CoV-2.
They took cues from a 2018 study covering a regimen for HIV prevention. In an interview with Medical News Today, Dr. Dryden-Peterson explained:
We noticed that among our patients, those living and working in settings with increased COVID-19 risk were facing the largest challenges accessing vaccination, whereas those able to have lower risk were accessing easily. This paradox reminded us of our efforts to make HIV preventative therapy available.
The researchers used each communitys cumulative confirmed SARS-CoV-2 infections as their best indicator of future infection risk.
They also used Lorenz curves to gauge equity in vaccine distributions. Variable predictors included the:
Dr. Dryden-Peterson and his co-authors observed 649,379 SARS-CoV-2 confirmed infections among 6,755,622 individuals. This total included 3,880,706 fully vaccinated people.
They reported, Cumulative incidence of confirmed SARS-CoV-2 infection (minimum, 1.6%; maximum, 24.1%) and complete vaccination (minimum, 26.5%; maximum, 99.6%) varied considerably between communities.
Communities with higher socioeconomic vulnerability correlated with lower VIR ratios. This indicated a disparity in vaccinations relative to infection risk.
Communities where more than 20% of the population identified as Black, Latinx, or both had lower vaccinations relative to infection risk. However, communities with higher proportions of seniors showed improved community vaccine coverage.
Additionally, communities with fewer than 7,500 residents also showed higher vaccine coverage.
The researchers estimated that 810,000 full vaccinations would need to go to underserved communities to achieve equity.
The studys authors state that their analysis indicated structural disparity in vaccine distribution.
They emphasize the fact that Massachusetts ignored recommended steps to mitigate structural racism. Instead, the state channeled vaccinations to mass vaccination sites and large hospital systems.
However, the team admits that their research does not directly assess the mechanisms of disparity.
Jason Hall is the managing director at Avalere Health, a leading healthcare think tank. He has been instrumental in developing United States and global policies and strategies to improve vaccine access.
In speaking with MNT, Hall remarked: Its not unexpected to see variations based on race or ethnicity and socioeconomic vulnerability with regards to vaccination coverage.
Hall also pointed to data from the Kaiser Family Foundation and the Centers for Disease Control and Prevention (CDC) showing similar trends.
Did the lack of access to vaccines or vaccine hesitancy pose a greater hindrance to COVID-19 vaccine equity among minoritized groups? Dr. Dryden-Peterson answered this question during his interview:
Our study did not directly examine this, but the Massachusetts experience suggests that access prevents vaccine hesitancy. In the few instances where vaccines were made available to high-risk communities early and by long-standing, trusted community organizations, uptake has been as high as in high-income towns.
Olveen Carrasquillo, M.D, M.P.H., is the Chief of the Division of General Internal Medicine at the University of Miamis Miller School of Medicine. He also heads Floridas statewide component of the National Institute of Healths Community Engagement Alliance Against COVID-19 program.
During an interview with MNT, Dr. Carrasquillo agreed that minority communities were left out of vaccination efforts in the early days of the pandemic. However, the doctor noted that the inequities are shrinking.
He also mentioned that some efforts understandably contributed to vaccination fears:
Lets say you want to reach out to uninsured, undocumented populations getting vaccinated. You dont [want to] have people dressed in army fatigues.
Fortunately, Dr. Carrasquillo said, changes in federal leadership earlier in 2021 have paved the way for greater vaccine access.
Now, experts assert, the greatest challenge to vaccine equity stems from a persistent slew of misinformation.
Hall has found that the reasons for vaccine hesitancy among minoritized groups include:
He stressed: [T]here certainly remains much work to be done with addressing the myths and misperceptions that prevent many people from seeking vaccinations.
Dr. Carrasquillo is working with community partners to counter anti-vax messages that have been very culturally competent [and] very targeted to specific minority subgroups.
Ultimately, the study maintains, disparities in vaccination coverage reflect structural inequities. The authors emphasize: Our approach needs to match this rather than blaming groups for being suspicious of a system that has left them out.
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In partnership with the Monongalia County Health Department, West Virginia University will host weekly COVID-19 vaccination clinics on campus beginning Friday (Sept. 24).
When: Fridays from 1 to 3 p.m.
Where: WVU Student Recreation Center ( upstairs lobby area)
No appointment is necessary. Free parking will be available in lot ST-4.
At this time, the clinics only will offer the Pfizer vaccine. Those who are interested in receiving a vaccine may visit a clinic during operating hours.
Vaccines will be provided on a first-come, first-served basis. First, second and third doses (for individuals who are moderately to severely immunocompromised) of the Pfizer vaccine will be available. Children aged 12 to 17 are eligible to receive a vaccine at the clinic if they are accompanied by a legal guardian.
In addition to the weekly vaccination clinics, WVU Medicine Student Health has the Pfizer vaccine available for WVU students at its clinic in the Health and Education Building. Walk-in appointments are offered during regular business hours (Monday through Friday from 8 a.m. to 8 p.m. and Saturday from 10 a.m. to 4 p.m.).
The Monongalia County Health Department also is offering free vaccinations by appointment on most days at their facility at 453 Van Voorhis Rd. Anyone who wishes to be vaccinated can call the Monongalia County Health Department at 304-598-5119 to schedule an appointment.
Other vaccination opportunities can be found at vaccines.gov. Vaccines continue to be readily available across the country.
At this time, WVU students and employees are not required to be vaccinated. However, those on the Health Sciences Campus involved in patient care, including residents, fellows and students, are required to follow separate WVU Health System policies, including those related to COVID-19, such as masks, PPE and vaccinations.
The University strongly recommends all students and employees be vaccinated for COVID-19.
Anyone with questions about the safety and efficacy of the vaccine is encouraged to speak with their primary care physician or a representative from WVU Medicine Student Health.
This video with registered nurse Joanne Watson and Dr. Lisa Costello explains the impact COVID-19 is having on the health care workers, what they are seeing in the hospital setting and why it is incredibly important to become fully vaccinated.
Ivan Martinez joins Costello and Watson in this video to discuss that COVID-19 vaccines are safe for women who are pregnant, want to become pregnant, or are breastfeeding.
Vaccinated students and employees including those who had received the vaccine from a WVU or WVU Medicine vaccine clinic must verify their vaccine status by entering their information into the Vaccine Verification System.
COVID-19 Testing
Free COVID-19 community testing also is available at the Student Recreation Center ( lower gym):
Mondays 8 a.m. to noon
Tuesdays noon to 4 p.m.
Wednesdays noon to 4 p.m.
Thursdays 8 a.m. to noon
Fridays 8 a.m. to noon
Community testing is open to WVU employees and residents of Monongalia County. No appointment is required.
Students who are symptomatic or who have been identified as a close contact to someone who tested positive for COVID-19 also are welcome at the clinics.
Visit the Return to Campus website for more information and the latest COVID-19 updates. WVU Health Sciences has updated the coronavirus.wvu.edu website to reflect the most up-to-date information on vaccines and the delta variant.
Contact covidvaccine@mail.wvu.edu or returntocampus@mail.wvu.edu with any questions.
OLYMPIA Questions surrounding religious exemptions are pressing for those who dont want to be vaccinated.
But many large organized religions are not opposed to vaccines.
This collision of vaccine mandates, religion and personal choice could leave the issue up to individual employers whether it be government agencies, hospitals or private businesses to determine if a workers belief qualifies them to skip a COVID-19 shot.
Gov. Jay Inslees proclamation declared that those who have a medical accommodation or a sincerely held religious belief can opt out of the vaccine. Thousands of state workers hope to make use of that escape clause.
More than 6% of state workers have filed for religious exemptions, according to initial data released Tuesday. Another 1.5% have requested a medical exemption.
According to Vanderbilt University Medical Center, Buddhism, Hinduism, Islam and Judaism have no prohibition on vaccines. Some Christian denominations have an objection to vaccines, one of the most well-known being Christian Scientists.
But many religious leaders have actually encouraged their members to get the COVID-19 shot.
Pope Francis has urged Catholics to receive the vaccine. Leaders in the Church of Jesus Christ of Latter-day Saints issued a statement last month urging its members to get the vaccine.
Christian Scientists often opt out of vaccines, as many believe prayer can cure disease. Lance Matteson, a spokesperson for the Christian Science Committee on Publication for Washington, wrote in an email that choosing not to get vaccinated is a conscientious choice to seek help through spiritual means.
While the church urges members to make their own choices regarding vaccination, a statement from its board of directors also said it recognizes the importance of cooperating with measures considered necessary by public health officials.
And most of all, we hope that our collective care and effort can promote public health and healing to all affected by disease and contagion around the world, the statement reads.
Matteson said he knows some church members who have chosen to get vaccinated and some who have not. The church does not want any members to feel pressure either way, he said.
Matteson said the church has always appreciated the availability of religious accommodations from vaccine requirements.
But that privilege was never intended to pit the conscientious practice of Christian Scientists as a religious minority against the well-being of society at large, he wrote.
Getting those who are religious and hesitant of the vaccine may take the work of religious leaders and groups, a survey done by the Public Religion Research Institute and the Interfaith Youth Core showed.
The survey found Jewish Americans are the most likely to be accepting of the vaccine, with 85% of respondents at the time saying they accept the vaccines. Hispanic and white Catholics, other non-Christians, other Christians, religiously affiliated and white mainline Protestants all had more than 70% of respondents approve of the vaccine. White evangelical Protestants are the least likely to accept the vaccine with 24% saying they would not get vaccinated.
The survey, which reported results in both March and June, found that faith-based approaches to vaccine hesitancy, such as encouragement from religious leaders or religious groups giving out information, had a significant influence on increasing vaccine acceptance.
As more mandates come out, so do the questions of legality, specifically on violating religious freedom.
If any cases are brought to state or federal court, determining the legality of mandates and exemption responses will be based on numerous factors, said Shaakirrah Sanders, a University of Idaho law professor.
Religious freedom comes from two places in the First Amendment: the establishment clause, which says the government cannot establish a religion or programs that exclude religions, and the exercise clause, which says the government cant do anything to prevent free exercise of religion.
Exemptions to certain laws because of religion have been established both by statute and by case law from the U.S. Supreme Court.
But you dont get an exemption in every case, Sanders said.
On vaccine mandates, the government may argue theyre not forcing anyone to change their religious beliefs, only forcing them to change their behavior, Sanders said.
For any lawsuits that come out of these mandates, the court will likely take into account what alternatives to vaccine the mandate offers, such as testing, an individuals consistency on vaccines; whether their specific job can be accommodated in any way and the state of emergency brought on by the COVID-19 pandemic.
If a state or federal mandate offers a testing option instead of receiving the vaccine, for example, a court may decide that it does not violate a persons religious freedom because there are options, Sanders said.
The vaccine mandates in Washington state do not offer a testing option instead of vaccination. That could be a factor that turns a particular case, Sanders said.
The court may then have to look for which industries are subject to the mandate and if there are other options for a worker to stay employed, such as working from home.
Its hard to know definitively how a court will rule, she said.
Then, it may come down to the individuals own beliefs.
Under current law, individuals looking to get religious exemptions dont need to be a part of organized religion, Sanders said, and they dont have to believe in all tenets of that religion.
So, despite numerous religious leaders calling on their members to get vaccinated, those who refuse due to religious reasons can still do so as long as it is sincerely held.
However, anyone who brings a case to court will likely have to prove that they are opposed to all vaccines and not just the COVID-19 vaccine, Sanders said. If they only object to one, that could present problems for them.
Another factor could be the COVID-19 pandemic itself.
In the context of the First Amendment, there is no emergency exemption, Sanders said. However, the scope of those freedoms could be hindered, such as by not limiting the number of people allowed in a church at one time due to social distancing.
The state of the economy might play a role in these decisions as well, especially if there are industries still struggling to get workers, Sanders said.
Weve seen their inability to have any predictability on how a case will turn, Sanders said. Thats risky for people bringing a claim, and its also risky for the government making a regulation.
One thing that is predictable, however, is the timing of these cases.
Federal and state courts are still backed up, Sanders said, and no one knows how long the pandemic will continue. If the pandemic eases by the end of next spring, courts may find the cases on mandates moot.
COVID-19 boosters shots could become more widely available right as doctors recommend that people get their flu shots.
Thats because the U.S. Food and Drug Administration and the Centers for Disease Control and Prevention are reviewing and considering authorizing COVID boosters just when the flu season typically starts.
An FDA advisory panel recently voted to recommend an emergency use authorization for third doses of Pfizers COVID vaccine for people 65 and older, and those at high risk for severe illness. A CDC advisory panel meets this week and is expected to further define whos in the high-risk group.
Health experts say that there shouldnt be any concern about getting both the COVID vaccine and a flu shot at the same time.
In general, there isnt any evidence that getting a flu vaccine and a COVID-19 vaccine at the same time poses any added risk, said Dr. Ed Belongia an infectious disease epidemiologist and vaccine researcher at the Marshfield Clinic Research Institute in Wisconsin.
The immune system is pretty good at handling multiple things at once, said Deepta Bhattacharya, a professor of immunobiology at the University of Arizona College of Medicine. He noted how children often receive multiple vaccines at visits to their pediatrician.
Belongia suggested that, while theres no safety issue, older people who typically get a high-dose flu shot may want to space out the flu and COVID vaccines if they are concerned about side effects like fatigue, achiness and sore arms.
Health experts warn that this years flu season could be especially harsh -- and its return is not a question of if, but when. We do not know when [the flu] will come back in the United States, but we know it will come back, Sonja Olsen, a CDC epidemiologist, told The New York Times.
Heading into the fall, experts are concerned about a twin-demic, which could occur if surges in COVID cases coincide with the seasonal resurgence of the flu. As more and more people return to relatively normal lives -- socializing, going to school, dining out, traveling -- that could result in more flu circulating this year.
There is certainly a sense of concern that if the flu does come back, it could be more severe, Belongia said. If kids are back in school and theyre engaged in more normal activities that spread respiratory viruses, that could lead us to a robust flu season.
Last year, some scientists expressed similar concerns at a conference of the Infectious Diseases Society of America, according to reporting from Science News.
But with mask mandates in many states and many schools offering virtual learning options, there basically wasnt a flu season last winter.
Last year, the CDC estimated that 2,136 people tested positive for the influenza virus, and 748 deaths were attributable to the flu. These figures are much lower than in previous years. In the 2019-2020 flu season, for example, the CDC estimated there were 38 million illnesses and 22,000 deaths from the flu.
The decrease in flu cases last winter was good in terms of not having to deal with flu but that actually makes us more concerned now, because peoples immunity over time to flu has waned, Belongia said.
He said that although many people want to compare COVID and the flu, the two diseases present different scenarios for the immune system. While COVID is a new disease, most people already have had multiple encounters with influenza.
All that prior history of infections and vaccinations will shape your immune response to a subsequent exposure, he said.
With so little influenza circulating, he said that scientists had a challenge trying to identify which strains of the virus might circulate this year.
With all the uncertainty about what this years flu season might look like, the important thing to remember is to get a flu shot in September or October, he said.
The Australian state of New South Wales will begin a two-week trial of a COVID-19 vaccine passport app on 6 October.
This comes ahead of the possible reopening of hospitality venues on 11 October on the condition that the state fully vaccinates 70% of its population.
WHY IT MATTERS
Sydney Morning Herald reported that the vaccine passport app is being developed by Service NSW to simplify the check-in process at pubs, restaurants and other venues, so people do not need to move through separate apps for QR codes and proof of vaccination.
The app will integrate the check-in features in the Service NSW app with the proof of COVID-19 vaccination stored in the Medicare Express app of the federal government.
According to the news report, the trial will involve around 500 volunteers, including those from aged care facilities and community clubs.
The state government is currently obtaining vaccination information via the federal government's Australian Immunisation Register; prior consent from residents will be secured to store their vaccination status in the app.
Based on a news report by the Australian Financial Review, the NSW government opted to pilot the app across the state's regions instead of its capital Sydney to minimise the risk of infections spreading in hospitality venues.
THE LARGER CONTEXT
Fully vaccinated Australians can get their digital proof of vaccination via the Medicare Express app. Their COVID-19 digital vaccine certificate can also be added to their mobile wallets.
Last month, a software engineer found a bug in the Medicare app that could potentially lead to the creation of fake digital COVID-19 vaccine certificates. The federal agency has since acknowledged the report by Richard Nelson, who has taken part in research that previously unearthed flaws in the government's contact tracing app COVIDSafe.
Meanwhile, the federal government is also developing a smartphone app that can store digital vaccine certificates and test results. A tender for the digital health app was recently issued by the Australian Digital Health Agency. It is targeted to be introduced on iOS and Android devices by December.
Today, the City of St. Louis Department of Health announced the full rollout of its gift card incentive program at Department of Health and Federally Qualified Health Centers (FQHC) to further encourage COVID-19 vaccinations. Individuals will receive their gift cards on-site once they receive their vaccination. With community spread impacting every area of the region, the city is encouraging individuals to get vaccinated to protect young adults and schoolchildren, especially those under 12 who at this time cannot get vaccinated.
"Offering incentives is one way to encourage individuals to get vaccinated, especially those who are still undecided, and the health department's highest priority is to ensure people have accurate information so they can make informed decisions about their health," says Dr. Fredrick Echols, Acting Director and Health Commissioner for the City of St. Louis. Vaccination remains the best way to avoid severe complications from COVID-19 and stay out of the hospital. An incentive may be the extra push some need to get vaccinated.
Initially proposed by Alderwoman Shameem Clark-Hubbard (26), this $1.25 million gift card vaccination incentive program is one portion of the $135 million initial allocation of federal American Rescue Plan dollars passed by the St. Louis Board of Aldermen. This initial allocation includes $11.5 million in public health infrastructure, including mobile vaccine clinics, community canvasses and education, vaccine marketing, and more.
Upcoming Department of Health COVID-19 Vaccination Clinics:
Free, No Appointment Required, COVID-19 Testing Sites in the City St. Louis
Visit the Department of Health website at stlouis-mo.gov/health or call 314-657-1499 for updates on dates, times and locations free COVID-19 vaccination clinic and testing sites.
For FQHC testing events, contact the FQHC directly.
