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On national television, Biden administration spokesperson John Kirby mounted a feeble attempt to explain the presidents COVID-19 vaccine mandate for the military.Kirby, a retired Navy admiral, had no acceptable answers when pressed about the administrations "folly" and the perilous impact the mandate is already having on our national security.
Remarkably, Kirby perpetuated the narrative that the militarys mandate must remain in place while admitting with a straight face that he was quarantined for 10 days due to his current bout with COVID-19, despite being vaccinated and double boosted.
The unrelenting push to remove thousands of religious service members from the military for their sincerely held objections to taking the COVID-19 vaccine should be classified as a clear dereliction of duty by the Biden administration. The president himself declared "the pandemic is over."
A U.S. Marine receives the Moderna coronavirus vaccine at Camp Foster on April 28, 2021, in Ginowan, Japan. (Carl Court/Getty Images)
As Kirby revealed on national television, COVID-19 vaccines are ineffective in preventing infection or the spread of the virus. According to the Centers for Disease Control, service members who were only vaccinated once last fall are still at risk of severe illness. And boosters are not mandated by the Department of Defense.
HOUSE REPUBLICANS DEMAND ANSWERS ON PENTAGON COVID VACCINE MANDATE AMID PUNISHMENTS FOR UNVAXXED SOLDIERS
At this point, there is no "compelling government interest" in vaccinating this small percentage of religious service members because there is no evidence that the COVID-19 vaccines promote the "health and safety" of our force.
John Kirby holds a news briefing at the Pentagon on March 9, 2022, in Arlington, Virginia. (Kevin Dietsch/Getty Images)
In April 2021, top military leaders admitted that "the U.S. military has successfully continued operations and kept our forces safe during the pandemic by implementing other force health protection guidelines." Despite this statement, on Aug. 9, 2021, Kirby had an unusual message regarding the mandate, "You can consider this memo not just a warning order to the services but to the troops themselves," with the chairman of the House Armed Services Committee commenting that, "Some may try and criticize the Secretarys decision, using anti-vax arguments that are not supported by facts or science to politicize the conversation. These desperate attention seekers must be ignored."
While service members of faith are being denied accommodations and are presently prevented from doing their jobs and maintaining their careers, the Air Force is willingly accommodating service members who are unvaccinated for COVID-19 for medical reasons.
To any reasonable person, the hypocrisy and unlawfulness is clear.
ARMY PENALIZING SOLDIERS SEEKING RELIGIOUS ACCOMMODATIONS TO VAX MANDATE: TECHNIQUE OF COERCION
In a recent decision in a lawsuit brought by United Airlines employees, U.S. Court of Appeals for the Fifth Circuit Judge James C. Ho provided the best explanation of what the real objective is with these mandates.
In his concurrence, Judge Ho stated that United Airlines placed its employees with religious objections to taking the COVID-19 vaccine on indefinite, unpaid leave "to coerce its employees into violating their religious beliefs and whats worse, to do so irrevocably and permanently."
Judge Ho rightly concluded that Uniteds business decision had nothing to do with safety, but rather "the real reason for the vaccine mandate and indefinite unpaid leave policy is virtue signaling and currying political favor."
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Its time for the Biden administration to put its false, damaging narrative to rest. As the Supreme Court urged this past fall, "even in a pandemic, the Constitution cannot be put away and forgotten." The Supreme Court has also held that where it is "only conduct motivated by religious conviction that bears the weight of the governmental restrictions," then there "can be no serious claim that those interests justify the [militarys COVID-19 vaccination mandate.]"
At this point, the Department of Defense should be more concerned with its own 100% compliance with the Constitution rather than 100% vaccination compliance. How will religious liberty ever be preserved if our own executive branch is permitted to overtly dishonor it?
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Danielle Runyan is counsel for First Liberty Institute, a nonprofit law firm exclusively dedicated to defending religious liberty for all Americans, and a plaintiff in the lawsuit, Spence v. Austin. Read more at FirstLiberty.org.
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Although arbitrators in Canada have considered whether an employer in a unionized workplace can place an employee on unpaid leave for failing to comply with its mandatory COVID-19 vaccination policy, the British Columbia Supreme Court in Parmar v. Tribe Management Inc., 2022 BCSC 1675 rendered the first civil court decision examining whether an employer can do so in a non-unionized workplace. The court rejected the employees argument that she had been constructively dismissed when, after she refused to comply with her employers policy, she was placed on an unpaid leave of absence. The court found the employers actions reasonable and that the employees losses were the result of her personal choice not to follow the policy.
Background
On October 5, 2021, the employer, a condominium property manager, announced it was implementing a policy that would require all employees to become fully vaccinated by November 24, 2021. The policy permitted medical and religious exemptions, and extra time for employees who were unable to meet the deadline.
The employee, an accounting professional, advised the employer that she would not comply with the policy but made no request for a medical or religious exemption. Among other things, she expressed concern about the vaccines hasty preparation, and fear of possible side effects and health issues. The employee asked if she could work exclusively from home, or on a hybrid basis with strict compliance to safety protocols and rapid testing on her days in the office. She argued the policy was unreasonable as it made no exceptions for employees who could work entirely or almost entirely from home. The employer responded that there would be no exceptions to the policy.
On November 25, 2021, the employer advised the employee that, due to her non-compliance with the policy, she would be put on an unpaid leave of absence from December 1, 2021, to February 28, 2022, but subsequently the employer made the leave indefinite. The employee alleged that by placing her on leave, the employer constructively dismissed her.
Decision
The court began its analysis by noting that the employees employment contract expressly provided that she would comply with the employers policies, as amended from time to time at the employers discretion. Accordingly, subject to the implied qualification that its policies would be reasonable and lawful, the employer was allowed to implement and amend workplace policies and the employee was obliged to comply with them.
The court determined that the reasonableness of the employers policy must be assessed based on the state of knowledge about COVID-19 at the time it was implemented and the extraordinary circumstances of the pandemic in the winter of 2021 and January 2022, as well as in the context of the employers obligation to protect the health and safety of its employees, clients, and residents in the buildings it managed. It noted that private-sector employers were strongly encouraged to implement policies that aligned with government vaccine mandates and directives. In addition, the court took judicial notice of COVID-19s easy transmissibility and potential to cause death, and the ability of vaccines to reduce the severity of symptoms and bad outcomes.
The court stressed that in implementing the policy, the employer was required to balance the employees personal beliefs against the employers interest in ensuring that it protected the health and safety of its other employees, and ultimately the former had to yield to the latter. The court found the policy was a reasonable and lawful response to the uncertainty of the pandemic based on the information that was available to the employer; it reflected the prevailing approach at the time; it was not arbitrarily or selectively applied; it allowed employees to take a position against vaccination without losing their employment because they would be put on leave; the employee placed on leave could return to their employment if they became vaccinated; the policy reflected the employers statutory obligation under s. 21 of the provinces Workers Compensation Act to, among other things, ensure the health and safety of its workers; and, finally, the employer intended to review the policy as more became known about COVID-19, and if the pandemic subsided, the employee could return to work without discipline.
While the court acknowledged the employees right to hold her beliefs about the COVID-19 vaccination and to protect her bodily integrity, it did not believe this entitled her to impact other employees or, potentially, the thousands of residents in buildings for whom the employer provided property management services. The court stressed also that the employees beliefs did not entitle her to be excepted from the policy given her senior management position and the fact that she was the only employee who refused to comply with it. The court concluded that the employers policy was reasonable.
In its reasoning, the court emphasized that the employee chose to remain unvaccinated; it was her voluntary decision to resign; in refusing to comply with the policy she repudiated her employment contract; rather than accepting that repudiation the employer acted reasonably in putting the employee on an unpaid leave; and any losses suffered by the employee from being put on unpaid leave were the result of her personal choice not to follow the employers reasonable policy.
Although the court acknowledged that it is extraordinary for an employer to enact a workplace policy that impacts an employees bodily integrity, it concluded that to do so was reasonable in the context of the extraordinary health challenges posed by the global COVID-19 pandemic. Such policies do not force an employee to be vaccinated; rather they force an employee to choose between getting vaccinated, and continuing to earn an income, or remaining unvaccinated, and losing their income, and the employee made her choice.
Upon determining that the employee had failed to meet the test for constructive dismissal and that her claim would be dismissed, the court said:
A reasonable employee in [the employees] shoes would not have felt in all the circumstances than an unpaid leave as a consequence of failing to comply with the [policy] was a substantial alteration of an essential term of the employment contract. This is confirmed by the fact that all but one of her fellow employees complied with the [policy] and that most adult Canadians have since been vaccinatedmany as a condition of continued employment.
Bottom Line for Employers
The question whether a policy is reasonable may turn on the policys language and the facts of the case. With that in mind, non-unionized employers that implemented a policy may derive encouragement from the courts findings in Tribe Management that the employers policy was reasonable, the employer had the right to place a non-compliant employee on unpaid leave, and, in doing so, the employer did not constructively dismiss the employee.
The court in Tribe Management adopted an attitude we have seen arbitrators express repeatedly; first, that an employees right to their personal beliefs is outweighed by an employers obligation to protect the health and safety of its other employees; and second, that a mandatory COVID-19 vaccination policy does not force an employee to become vaccinated, rather it forces them to choose between becoming vaccinated and continuing to receive their income, and refusing to become vaccinated and losing their income.
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Attorneys for a group of former Maine health care workers who sued the state over its vaccine requirements last summer are asking a panel of judges in Boston to revive their case.
Last month, U.S. District Judge Jon Levy dismissed the groups lawsuit, which argued they have a religious right to refuse the vaccine overtheir belief that fetal stem cells from abortions were used to develop it. They also argued that the state mandate was discriminatory by allowing for medical exemptions, but not religious ones.
Levy ultimately disagreed.
Exempting individuals whose health will be threatened if they receive a COVID-19 vaccine is an essential, constituent part of a reasoned public health response to the COVID-19 pandemic. It does not express or suggest a discriminatory bias against religion, Levy wrote in his order on Aug. 18.
Attorneys have a month to file a brief to the 1st Circuit Court of Appeals in Boston, outlining their reasons for an appeal.
The plaintiffs worked for MaineHealth, Genesis Healthcare, Northern Light Eastern Maine Medical Center and MaineGeneral Health. All are named as defendants in the complaint, along with Gov. Janet Mills, Maine CDC Director Nirav Shah and Commissioner Jeanne Lambrew of the Maine Department of Health and Human Services.
Nine plaintiffs originally sued in August 2021, all anonymously.
The Portland Press Herald, Kennebec Journal, Morning Sentinel and Sun Journal filed a motion last November challenging the groups right to anonymity. The newspapers argued that the plaintiffs alleged fear of harm no longer outweighs the publics interest in open legal proceedings.
Both Levy and the 1st Circuit Court of Appeals agreed, ordering the group to file a new complaint that included their names in July.
Plaintiffs named in the dismissal document are Alicia Lowe, formerly an employee of MaineHealth; Debra Chalmers and Garth Berenyi, formerly of Genesis Health; Jennifer Barbalias, Natalie Salavarria and Adam Jones, formerly of Northern Light Eastern Maine Medical Center; and Nicole Giroux, formerly of MaineGeneral Health.
They are represented by Maine attorney Steve Whiting, and lawyers from Liberty Counsel, a conservative, religious law firm based in Florida that has participated in several lawsuits against Maine and other states over COVID-19 vaccine mandates and restrictions. Theyve also opposed safe and legal access to abortions and same-sex marriage, leading the Southern Poverty Law Center to identify the firm as a hate group.
Federal judges at every level the U.S. District Court,the 1st U.S. Circuit Court of Appeals in Boston andthe U.S. Supreme Court refused to block Maines COVID-19 vaccine mandate from taking effect while the courts considered the merits of the lawsuit.
The mandate took effect in October, and major health care providers reported that most workers decided to get their shots.
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People wait to receive a dose of Covishield at a hospital in Noida, August 30, 2021. Photo: Reuters/Adnan Abidi
Since 2021, mandatory proof-of-vaccination policies have been implemented and justified by governments and the scientific community to control COVID-19. These policies, initiated across the political spectrum, including in most liberal democracies, have spread globally and have involved:
(See table.)
The publicly communicated rationale for implementing such policies has shifted over time. Early messaging around COVID-19 vaccination as a public health response measure focused on protecting the most vulnerable. This quickly shifted to vaccination thresholds to reach herd immunity and end the pandemic and get back to normal once sufficient vaccine supply was available.1 2 In late summer of 2021, this pivoted again to a universal vaccination recommendation to reduce hospital/intensive care unit (ICU) burden in Europe and North America, to address the pandemic of the unvaccinated.
COVID-19 vaccines have represented a critical intervention during the pandemic given consistent data of vaccine effectiveness averting COVID-19-related morbidity and mortality.36 However, the scientific rationale for blanket mandatory vaccine policies has been increasingly challenged due to waning sterilising immunity and emerging variants of concern.7 A growing body of evidence shows significant waning effectiveness against infection (and transmission) at 1216 weeks, with both delta and omicron variants,813 including with third-dose shots.14 15
Since early reports of post-vaccination transmission in mid-2021, it has become clear that vaccinated and unvaccinated individuals, once infected, transmit to others at similar rates.16 Vaccine effectiveness may also be lower in younger age groups.17 While higher rates of hospitalisation and COVID-19-associated morbidity and mortality can indeed be observed among the unvaccinated across all age groups,36 broad-stroke passport and mandate policies do not seem to recognise the extreme risk differential across populations (benefits are greatest in older adults), are often justified on the basis of reducing transmission and, in many countries, ignore the protective role of prior infection.18 19
Mandate and passport policies have provoked community and political resistance including energetic mass street protests.20 21 Much of the media and civil debates in liberal democracies have framed this as a consequence of anti-science and right-wing forces, repeating simplistic narratives about complex public perceptions and responses. While vaccine mandates for other diseases exist in some settings (e.g., schools, travel (e.g., yellow fever) and, in some instances, for healthcare workers (HCWs)),22 population-wide adult mandates, passports, and segregated restrictions are unprecedented and have never before been implemented on this scale.
These vaccine policies have largely been framed as offering benefits (freedoms) for those with a full COVID-19 vaccination series,23 24 but a sizeable proportion of people view conditioning access to health, work, travel and social activities on COVID-19 vaccination status as inherently punitive, discriminatory and coercive.20 21 2528 There are also worrying signs that current vaccine policies, rather than being science-based, are being driven by sociopolitical attitudes that reinforce segregation, stigmatisation and polarisation, further eroding the social contract in many countries.
Evaluating the potential societal harms of COVID-19 pandemic restrictions is essential to ensuring that public health and pandemic policy is effective, proportionate, equitable and legally justified.29 30 The complexity of public responses to these new vaccine policies, implemented within the unique sociopolitical context of the pandemic, demands assessment.
In this paper, we reflect on current COVID-19 vaccine policies and outline a comprehensive set of hypotheses for why they may have far-reaching unintended consequences that prove to be both counterproductive and damaging to public health, especially within some sociodemographic groups. Our framework considers four domains: (1) behavioural psychology, (2) politics and law, (3) socioeconomics, and (4) the integrity of science and public health (see figure 1).
Our aim is not to provide a comprehensive overview or to fully recapitulate the broad ethical and legal arguments against (or for) COVID-19 vaccine mandates and passports. These have been comprehensively discussed by others.3133 A full review of the contribution of mandates and passports to COVID-19 morbidity and mortality reductions is not yet possible, although some existing studies on vaccine uptake are cited below.
Rather, our aim is to add to these existing arguments by outlining an interdisciplinary social science framework for how researchers, policymakers, civil society groups and public health authorities can approach the issue of unintended social harm from these policies, including on public trust, vaccine confidence, political polarisation, human rights, inequities and social well-being. We believe this perspective is urgently needed to inform current and future pandemic policies. Mandatory population-wide vaccine policies have become a normative part of pandemic governance and biosecurity response in many countries.
We question whether this has come at the expense of local community and risk group adaptations based on deliberative democratic engagement and non-discriminatory, trust-based public health approaches.
What can we learn from the behavioural sciences?
Reactance, entrenchment and vaccine uptake
Apart from mandatory vaccination of the elderly (planned in Czech Republic, Greece, Malaysia and Russia), most policies do not specify individuals at higher risk of severe COVID-19 outcomes among whom COVID-19 vaccine uptake rates, and vaccine confidence, are very high.34 35
Although studies suggest that current policies are likely to increase population-level vaccination rates to some degree,3639 gains were largest in those under 30 years old (a very low-risk group) and in countries with below average uptake.36 Moreover, insights from behavioural psychology suggest that these policies are likely to entrench distrust and provoke reactance a motivation to counter an unreasonable threat to ones freedom.
Literature reviewed by Drury et al,40 including a survey by Porat et al41 in the UK and Israel, found that compulsory COVID-19 vaccination would likely increase levels of anger, especially in those who are already mistrustful of authorities, and do little to persuade the already reluctant. Two experiments in Germany and the USA found that a new COVID-19 vaccine mandate would likely energise anti-vaccination activism, reduce compliance with other public health measures, and decrease acceptance to future voluntary influenza or varicella (chickenpox) vaccines.42 43
A third experiment found that selective mandates increased reactance when herd immunity targets were not clearly explained44 which most governments failed to communicate adequately and convincingly as they shifted their rationale from herd immunity to hospital/ICU admission metrics. De Figueiredo et al45 found that vaccine passports in the UK would induce a net decrease in inclination to get vaccinated among those who had not received a full vaccination dose, while Bell et al46 found that UK HCWs who felt pressured to get vaccinated were more likely to have declined the COVID-19 vaccine.
Jrgensen et al47 found that the reintroduction of vaccine passports in late 2021 in Denmark increased distrust among the unvaccinated. Finally, recent evidence from France suggests that the passe sanitaire was associated with increased vaccination but that it did so to a lower extent among the most vulnerable, may have contributed to increased nocebo effects and did not reduce vaccine hesitancy itself; the authors concluded: Mandatory vaccination for COVID-19 runs the risk of politicising vaccination further and reinforcing distrust of vaccines.48
Cognitive dissonance
The public interpretation of these policies has occurred within the context of the rapidly changing pandemic. Oftentimes, public announcements and media coverage have oversimplified, struggled to communicate potential adverse events (including a potentially higher risk in the convalescent)49 and overstated vaccine efficacy on transmission. Significant public concerns about safety signals and pharmacovigilance have been furthered by the lack of full transparency in COVID-19 clinical trial data50 51 as well as shifting data on adverse effects, such as blood-clotting events,52 myocarditis53 and altered menstrual periods.54
These changes have been associated with changes to vaccination guidelines in terms of eligibility for different vaccines in some countries. Mandates, passports and segregated restrictions create an environment where reactance effects are enhanced because people with low vaccine confidence see contradictory information as validating their suspicions and concerns. The pressure to vaccinate and the consequences of refusal heighten peoples scrutiny of information and demand for clarity and transparency. Current policies have likely facilitated various layers of cognitive dissonance a psychological stress precipitated by the perception of contradictory information.
Citing the potential for backlash and resistance, in December 2020, the director of the WHOs immunisation department stated: I dont think we envision any countries creating a mandate for [COVID-19] vaccination.55 Many governments originally followed with similar public statements, only to shift positions, often suddenly, in mid- or late-2021 during the delta or omicron surge, including in Austria (the first country to announce a full population-wide mandate).56 57
Cognitive dissonance may have been compounded by the changing rationale provided for vaccine mandate policies, which originally focused on achieving herd immunity to stop viral transmission and included public messaging that vaccinated people could not get or spread COVID-19. Policies often lacked clear communication, justification and transparency, contributing to persistent ambiguities and public concerns about their rationale and proportionality.58 In late 2021, however, the re-introduction of onerous non-pharmaceutical interventions in countries with mandates and passports perpetuated cognitive dissonance, since governments had made promises that vaccination would ensure a return to normal and many people (especially younger people) had vaccinated based on these announcements.36 48
When mandate rules are perceived to lack a strong scientific basis, the likelihood for public scrutiny and long-term damage to trust in scientific institutions and regulatory bodies is much higher. A good example is the lack of recognition of infection-derived immunity in employer-based vaccine mandates and passports in North America, including most universities and colleges.59 Despite clear evidence that infection-derived immunity provides significant protection from severe disease on par with vaccination,18 31 prior infection status has consistently been underplayed.
Many individuals with post-infection immunity have been suspended or fired from their jobs (or pushed to leave) or been unable to travel or participate in society31 5659 while transmission continued among vaccinated individuals in the workplace. This inconsistency was widely covered in American conservative and libertarian-leaning media in ways that reinforced distrust not only about the scientific basis of vaccine policies but also the entire public health establishment, including the US Centers for Disease Control and Prevention (CDC).
Stigma as a public health strategy
Since 2021, public and political discourse has normalised stigma against people who remain unvaccinated, often woven into the tone and framing of media articles.60 Political leaders singled out the unvaccinated, blaming them for: the continuation of the pandemic; stress on hospital capacity; the emergence of new variants; driving transmission to vaccinated individuals; and the necessity of ongoing lockdowns, masks, school closures and other restrictive measures (see table 2).
Political rhetoric descended into moralising, scapegoating, and blaming using pejorative terms and actively promoting stigma and discrimination as tools to increase vaccination. This became socially acceptable among pro-vaccine groups, the media and the public at large, who viewed full vaccination as a moral obligation and part of the social contract.61 The effect, however, has been to further polarise society physically and psychologically with limited discussion of specific strategies to increase uptake especially in communities where there would be disproportionately larger individual and societal benefits.
There is rarely a discussion of who and why people remain unvaccinated. Vaccine policy appears to have driven social attitudes towards an us/them dynamic rather than adaptive strategies for different communities and risk groups.
Leveraging stigma as a public health strategy, regardless of whether or not individuals are opposed to vaccines, is likely to be ineffective at promoting vaccine uptake.62 Unvaccinated or partially vaccinated individuals often have concerns that are based in some form of evidence (e.g., prior COVID-19 infection, data on age-based risk, historical/current trust issues with public health and governments, including structural racism), personal experiences (e.g., direct or indirect experience of adverse drug reactions or iatrogenic injuries, unrelated trauma, issues with access to care to address adverse events, etc) and concerns about the democratic process (e.g., belief that governments have abused their power by invoking a constant state of emergency, eschewing public consultation and over-relying on pharmaceutical company-produced data) that may prevent or delay vaccination.45 46 6366
Inflammatory rhetoric runs against the pre-pandemic societal consensus that health behaviours (including those linked to known risk factors for severe COVID-19, for example, smoking and obesity) do not impact the way medical, cultural or legal institutions treat individuals seeking care. Some governments discussed or imposed medical insurance fines or premiums on the unvaccinated, while hospital administrators considered using vaccination status as a triage protocol criterion. The American Medical Association released a statement decrying the refusal to treat unvaccinated patients67 but this has not prevented the ongoing narrative of shaming and scapegoating people choosing not to get vaccinated.
Trust, power and conspiracy theories
Trust is one of the most important predictors of vaccine acceptance globally68 69 including confidence in COVID-19 vaccines.63 70 71 Data show that being transparent about negative vaccine information increases trust and Petersen et al72 found that when health authorities are not transparent, it can increase receptivity to alternate explanations.
COVID-19 vaccine policies have the potential to erode vaccine confidence, trust and the social contract in the particular context of the pandemic, which has exacerbated social anxieties, frustrations, anger and uncertainty. By the time COVID-19 vaccine mandates were introduced, many communities had struggled under lockdowns and other severe public health restrictions, undergone a succession of pandemic waves with changing rules that stretched public confidence in government, had their economic security and livelihoods negatively impacted and been exposed to a media-induced culture of fear perpetuated by an abundance of conflicting and confusing information. All of this occurred within the broader global trend of increasing inequities between North and South, rich and poor, as well as the erosion of trust in institutions and experts.
It is likely that many of the alternative explanations of the pandemic, often called conspiracy theories, were further entrenched when vaccine policies were forcefully implemented in 2021, creating a strong confirmation bias that governments and corporate powers were acting in an authoritarian manner. Those who resist vaccine mandates and passports are more likely to have low trust in government and scientific institutions,2528 63 64 and these beliefs and distrust have likely grown due to the propensity of policies to justify social segregation, creating new forms of activism.
Furthermore, multiple social perceptions and logics about science, technology and corporate and government power have been grafted onto the public discussion about COVID-19 vaccines, specifically related to authoritarian biosurveillance capabilities.73
These include concerns about the adoption of implantable tracking devices (including microchips), digital IDs, the rise of social credit systems and the censorship of online information by technology companies and state security agencies. The COVID-19 pandemic happens to coincide with far-reaching technological advances that do provide the capability for new forms of mass state surveillance.74 75
For example, emerging biocompatible intradermal devices can be used to hold vaccine records,76 while multifunction implantable microchips (that can regulate building access and financial payments, much like cellphones) are now available on the market.77 Aspects of vaccine passport policies (dependent on QR codes) combined with these innovations as well as censorship by social media companies of vaccine clinical trial and safety issues from reputable sources like the BMJ78 have likely reinforced and exacerbated suspicion and distrust about the impartiality of public health guidance and vaccines.79
It is highly likely that reactance effects generated by current vaccine policies have increased the view that public health is influenced by powerful sociopolitical forces acting in the private interest, which may damage future social trust in pandemic response.
The political and legal effects of vaccine mandates, passports and restrictions
The erosion of civil liberties
The COVID-19 vaccine policies that we have outlined represent a broad interference with the rights of unvaccinated people. While some governments introduced mandates and passports through the democratic process (e.g., Switzerland, Austria, France), many policies were imposed as regulations, decrees, orders or directions under states of emergency and implemented in ways that allowed ad hoc juridical decisions and irregular and overpermissive private sector rules, with limited accountability or legal recourse to address rights violations.58
Vaccine passports risk enshrining discrimination based on perceived health status into law, undermining many rights of healthy individuals: indeed, unvaccinated but previously infected people may generally be at less risk of infection (and severe outcomes) than doubly vaccinated but infection-nave individuals.80 A weekly negative SARS-CoV-2 test is often seen as a compromise in lieu of full vaccination status, but this places additional burdens (including financial) on the unvaccinated while also risking reputational damage.
Employer-imposed mandates that do not provide reasonable accommodation (e.g., testing, relocation or reassignment of duties) or that require people to be vaccinated following prior infection even where employees can work remotely, arguably constitute a disproportionate imposition of a health intervention without workplace-related justification.81 Many countries have also tightened the ability to seek religious, medical or philosophical exemptions, open to unclear decision-making and political interference.82
Perhaps the most high-profile case to date involves the deportation of the top-ranked mens tennis player, Novak Djokovic, at the Australian Open 2022, despite having been granted a medical exemption on the basis of documented prior infection.83 While media outlets were quick at hinting about problems in his official submission, the Minister of Immigration accepted that he had a valid test result and that he posed only a very low risk to the health of Australians.84 Yet, the court ruled that it was reasonable for the Minister to conclude that Mr Djokovics presence could foster anti-vaccination sentiment and thus have a negative impact on vaccination and boosters.84 It endorsed Mr Djokovic characterisation as a threat to Australian civil order and public health.83 84
The case underlines concerns of vaccine mandates and passports as a tool for disproportionate policy that circumvents normative civil liberties and process.
There are also significant privacy issues with passports, which involve sharing medical information with strangers. Having set these population-wide passport precedents, it is conceivable that they could be expanded in the near future to include other personal health data including genetic tests and mental health records, which would create additional rights violations and discrimination based on biological status for employers, law enforcement, insurance companies, governments and tech companies.
COVID-19 vaccine passports have normalised the use of QR codes as a regulated entry requirement into social life; in France and Israel, double-vaccinated citizens lost their status when passports required a booster dose in 2021/2022.85 86 Technology companies interested in biosurveillance using artificial intelligence and facial recognition technology have obtained large contracts to implement vaccine passports and now have a financial interest in maintaining and expanding them.87
Political polarisation
COVID-19 vaccine policies have generated intense political debate, mass street protests and energised new populist movements with varied political views.20 21 2528 56 Studies show that while many support these policies, others view them as inherently coercive, discriminatory, disproportionate and counter to liberal values of bodily autonomy, freedom of choice and informed consent.2528 It is clear that current policies are divisive and unpopular with many, even vaccinated people, and that they have become a source for collective rage and anger, notably for those who have been fired from their jobs or isolated and barred from social life.
COVID-19 vaccine policies may influence upcoming elections. For instance, right-wing and populist parties in Germany (the Alternative for Germany), Canada (Peoples Party) and Austria (Freedom Party) have come out strongly against medical segregation. After implementing the worlds first population-wide mandatory vaccine policy in February 2022, Austria suspended it sixdays before police would impose fines (max. 3600), partially due to legal concerns, mass street protests and the fact that the rate of vaccination had not significantly improved (20% of adults remain unvaccinated).56 88
In 2022, the US Supreme Court struck down the Biden administrations federal vaccine mandate as unconstitutional,89 just as it came into effect for 80million workers (although upholding the mandate for HCWs); republicans had long criticised the mandates.90 91 In Martinique and Guadalupe, vaccine passports have led to months of political unrest and violent protests that threaten the stability of the French government.48 Pottinger92 argued that mandates and passports could trigger insurrection and civil war in South Africa.
Just as the smallpox vaccination mandates in 1850s Britain created the first anti-vax movement,93 the backlash against COVID-19 policies is energising a global network connected by modern communication technology against these measures. These backlashes may contribute to increased distrust of other vaccines and foster new forms of radicalisation and protest.
While mainstream news outlets have voiced concern about the rising anti-vaccination fervour among the far-right, and potential for violence,94 centre and left politicians have also used this rhetoric for their own agenda. In Canada, Prime Minister Trudeau used majority support for mandatory vaccination and passports to divide the conservative opposition in the 2021 federal election. The end to exemptions for unvaccinated truckers crossing the US-Canadian border precipitated the trucker freedom convoy protests in early 2022 in Canada, which led to weeks of protesters occupying streets outside parliament. The protest ended with the unprecedented invoking of the Emergencies Act, equivalent to martial law, which was heavily criticised by civil liberty organisations and included the freezing of protester bank accounts.95 96
In the USA, California and New York (Democrat-controlled states) have implemented COVID-19 vaccine passports for children while Florida, Georgia and Texas (Republican-controlled) are introducing legislation to remove childhood school vaccine mandates in general. Some medical freedom and anti-vaccination groups have made increasingly false and inflammatory claims, and business owners and employees requiring QR codes for entry have been targeted for abuse, in some cases.
In turn, pro-vaccine advocates have equated anti-mandate social groups as anti-vaxxers and even domestic terrorists, calling for government agencies and social media companies to strengthen censorship laws. Echo chambers have skewed the reasonableness of risk assessment of some pro-mandate individuals, who now fear that unvaccinated people are unsafe physically but also culturally despite the scientific evidence. Political polarisation and radicalisation both anti-mandate and pro-mandate will increase if punitive vaccine policies continue.
Disunity in global health governance
Current vaccine policies risk furthering disunity in global health governance. Despite the WHO stating in early 2022 that boosters would prolong the pandemic by contributing to vaccine hoarding and low supply,97 universities (including some global health departments) in wealthy countries have mandated boosters for low-risk healthy students and faculty,59 when vaccination rates remained low in many low/middle-income countries (LMICs).98
Efforts to pressure pharmaceutical companies (who developed vaccines with the support of publicly funded research money) to remove patent protections have proven unsuccessful.99 100 Pharmaceutical companies have ensured that the costs of adverse effects are borne by governments101 ; in turn, the worlds tens of millions of migrants and asylum-seekers may be denied COVID-19 vaccines because of legal liability issues.102
Simultaneously, some scientists are calling the unvaccinated (as a homogeneous group) the source of future variants (variant factories) fuelling inflammatory rhetoric103 that may have contributed to the heavily criticised reaction to close international borders to southern Africa during the spread of Omicron in late 2021. International travellers, especially from the global south, have been barred from travelling to high-income countries based on the type of received vaccine.
The rollout of vaccine passports and mandates is financially costly and diverts resources and focus away from other interventions. In Canada, $1 billion was pledged by the Trudeau government for vaccine passports104 and in New York State, the Excelsior Pass App-system developed by IBM will cost more than $27million.87
Importantly, focus on the unvaccinated as the cause of health system collapse diverts public attention away from global equity failures and deep structural challenges facing public health capacity in many countries. It absolves governments of attending to other strategies for opening schools and keeping public spaces safe, including improved ventilation and paid sick leave. The indiscriminate global adoption of current COVID-19 vaccine policies may also compromise national sovereignty by skewing health priorities in LMICs, taking budgets away from other important health priorities and disregarding public opinion a new form of vaccine colonialism.
Perhaps more significantly, it is possible that vaccination metrics become tied to international financial agreements and development loans and that pharmaceutical and technology companies influence the global adoption of passport systems and mandate policies for the current but also future pandemics.
Socioeconomic impacts
Increasing disparity and inequality
Historically, marginalised groups those facing economic challenges and racial and minority groups tend to have less confidence in vaccination programmes and are more likely to be distrustful.6366 6871 This raises the possibility that current vaccine policies may fuel existing inequity.105 A rapid policy briefing by the Nuffield Council on Bioethics106 emphasised that immunity passports could create coercive and stigmatising work environments and are more likely to compound than redress structural disadvantages and social stigmatisation.106
It is highly likely that mandates and passports have been implemented in ways that discriminate against disadvantaged groups including immigrants, the homeless, isolated elderly people, those with mental illness, specific cultural and religious groups, those in precarious living circumstances, and people with certain political views and values.
Moreover, communities who have historically been subject to state surveillance, segregation, structural racism, trauma or violence may be more likely to resist medical mandates. In Israel, reports suggest that Bedouin and Palestinian communities in the Occupied Palestinian Territory have faced major barriers to vaccine access, with more distrust of vaccination and bureaucratic barriers to accessing and using green passes even when vaccinated.58
Similar challenges have been raised among Europes Roma and in black communities in the UK and the USA.45 66 107 Altogether, rather than enhancing human agency and strengthening communities and social cohesion, many current vaccine policies including monthly fines for non-compliance (e.g., Greece and Austria) may work to disempower individuals and contribute to long-term psychosocial stress and disharmony.
Reduced health system capacity
The pandemic has created immense strain on health systems, contributing to disruptions in global immunisation programmes108 and burnout in healthcare and social care workers that risk worsening clinical outcomes for all patients. These trends may be exaggerated by the current policy push towards mandatory COVID-19 vaccination of healthcare/social care workers and firing of unvaccinated staff. The ethical arguments against these policies have been outlined by others.31 33 109
Despite these considerations, many countries may lose frontline staff due to mandates. By December 2021, despite the forthcoming imposition of a (later rescinded) vaccine mandate for patient-facing National Health Service (NHS) workers, 8% of medical practitioners in the UK (73000 people) remained unvaccinated.110 In late 2021, Quebec (Canada) dropped its proposed mandate for HCWs, citing the devastating labour shortage it would cause in hospital systems (3% of staff, or 14 000, were unvaccinated).111 Both cases created immense stress on already overburdened health staff and administrators, and were decried for their lack of clarity and clumpy policy process.112
Exclusion from work and social life
COVID-19 vaccination policies that disproportionately restrict peoples access to work, education, public transport and social life can be considered a violation of constitutional and human rights.113 The economic effects of restricting access to work may also have indirect implications for dependents of the unvaccinated. A survey in October 2021 in the USA found that 37% of unvaccinated participants (5% of participants overall) would leave their job if their employer required them to get a vaccine or get tested weekly; this rose to 70% of unvaccinated participants (9% of all participants) if weekly testing was not an option.114
Economic deprivation and parental stress resulting from restricted access to work and exclusion from social life may have long-term psychological and livelihood consequences on individuals, families and especially children.30 Commentators have also highlighted the potential impact of mandates in creating supply chain bottlenecks in certain commodities and with cross-border trade and argued that changing vaccine rules and regulations threaten to negatively impact overall economic recovery in some sectors of the economy including tourism.115
The integrity of science and public health
Erosion of key principles of public health ethics and law
Current vaccine policies may erode core principles of public health ethics. As some of those supporting mandates recognise,113 116 and contrary to the media portrayal that the unvaccinated are entirely free to decline, many COVID-19 vaccine policies clearly limit choice and the normal operation of informed consent. This has placed medical professionals in an awkward position, blurring the lines between voluntary and involuntary vaccination.
It is clear that many who are vaccinated did so because of the serious consequences of refusal, such as loss of employment and livelihood or access to social events and travel. We should pause to consider the extent to which current policies, and how they are implemented in clinical settings, sets a precedent for the erosion of informed consent into the future and impact the attitude of the medical profession to those who are reticent to undergo a specific medical procedure.
According to public health ethics, the principle of proportionality requires that the benefits of a public health intervention must be expected to outweigh the liberty restrictions and associated burdens.32 It would violate the proportionality principle to impose significant liberty restrictions (and/or harms) in exchange for trivial public health benefits, particularly when other options are available. Evidence shows that the efficacy of current COVID-19 vaccines on reducing transmission is limited and temporary,716 likely lower in younger age groups targeted for vaccine mandates and passports36 and that prior infection provides, roughly speaking, comparable benefit.18 31 80
The effectiveness of vaccine mandates in reducing transmission is likely to be smaller than many might have expected or have hoped for, and decrease over time. These issues have been widely discussed in the public arena, raising the idea that many current vaccine policies are no longer being guided by the best science but are rather being used to punish individuals who remain unvaccinated and to shape public opinion and compliance. Some governments have publicly admitted this much; in the words of French President Emmanuel Macron, the aim is to piss off [the unvaccinated] to the end. This is the strategy.117
Mandating a third dose for young boys to attend college or university in America has been widely discussed in the US media despite the lack of evidence for substantial clinical benefit,59 118 and with evidence of small but still significant risk of myocarditis that compounds with each dose.119121 Scandinavian countries have taken a precautionary and voluntary approach in their recommendations to the vaccination of children, with Swedish authorities stating that [because of] a low risk for serious disease for kids, we dont see any clear benefit with vaccinating them.122 This furthers the perception that current COVID-19 school vaccine mandates (e.g., in California) are disproportionate, especially as safety studies in young children remain relatively sparse.123
Proportionality is also a key condition from a constitutional and human rights perspective.113 124 125 The formal requirements of legal proportionality tests, which differ slightly depending on jurisdiction and context, generally reflect a balancing similar to the one in public health ethics. In part because of legally required restraint when it comes to assessing the reasonableness of complex policy interventions, several courts, human rights tribunals and committees, and labour arbitrators have upheld mandates as proportionate or made statements as to their legitimacy.113
This appears to have led to a broad presumption that mandates are legally unproblematic. But a common requirement of legal proportionality is that no other, less rights-restricting measures are available that can reasonably achieve the key public health goal. Accommodation of the workplace, or alternatives to vaccination such as testing, should be and have often been identified by courts, tribunals and arbitrators, as being a core element of the legality of mandates.81 113 124 126 Mandates imposing unconditional vaccination, those ignoring the role of prior infection, and those ignoring a shifting risk/benefit balance depending on specific populations, should be considered suspect from a legal proportionality perspective.
When members of the public perceive mandates to be ethically and legally problematic and in violation of established norms of informed consent and proportionality, this will erode trust in public health and scientific institutions and even courts that endorsed or actively promoted such policies. This presents a challenging paradox for experts and authorities: will pro-mandate scientists and organisations come to acknowledge that mandates and passports were disproportionate policy responses?
One key aspect of building trust in science and public health involves the open acknowledgement of when experts are wrong and when policies were misguided; however, it appears that many officials have doubled down in their narratives. This may undermine key ethical and legal criteria for policy and have damaging effects on the integrity of public health itself.
Erosion of trust in regulatory oversight
COVID-19 vaccines were developed in record time to meet an urgent public health need and have been accepted by billions of people, preventing deaths, severe hospitalisation and long-term sequelae from SARS-CoV-2.36 COVID-19 vaccines have also generated at least $100billion profit for pharmaceutical companies, especially Pfizer.127 Has the acceptance of mandates and passports and the rhetoric around anti-vaxxers contributed to a cultural shift in norms of scientific and corporate transparency and accountability?
Governments have refused to disclose the details of contracts with manufacturers, including for additional doses or next-generation vaccines.99 Vaccines are typically not approved until 2years of follow-up data are gathered,2 but given the urgency of the COVID-19 pandemic and international harmonisation of new agile regulations, the novel mRNA COVID-19 vaccines were placed into emergency use in Europe and North America in late 2020.128
There is concern that, in the fog of crisis, vaccine policy is being driven by vaccine manufacturers rather than independent scientific and regulatory review. For example, in April 2021, Moderna informed their investors that they were expecting a robust variant booster market as a source of profits. Similarly, Pfizer CEO Albert Bourla suggested that a fourth dose of vaccine would be necessary, without any clinical trial data or independent evaluation that the benefits of subsequent doses outweigh any risks, nor consideration of the changing clinical dynamics with the Omicron variant.118 This only adds to distrust over decision-making around vaccine use and ensuing mandates.
The public is aware of the history of corporate pharmaceutical malfeasance and criminal and civil settlements in the billions of dollars, including with Pfizer, in part resulting from marketing practices and misrepresentation of safety and efficacy of medicines.50 51 129
The nature of mandates, passports and restrictions has increased public demands for scientific accountability and transparency shown to be fundamental to building long-term confidence in vaccination.130 This has increased the need to diligently track all safety signals for adverse effects in specific demographics131 and explore trends in overall population mortality and potential non-specific effects.132 However, the original clinical trial data remain unavailable for independent scientific scrutiny50 51; a whistleblower raised important concerns about data integrity and regulatory oversight practices at a contract company helping with Pfizers clinical trials in the USA.133
After a Freedom of Information Act (FOIA) request by a civil society group, the US Food and Drug Administration (FDA) requested (ultimately denied by a federal judge) 75 years to fully release internal documents and communications related to the regulatory process between FDA and Pfizer. In September 2021, an FDA advisory committee voted 16-2 against boosting healthy young adults in the USA but was over-ridden by the White House and CDC, leading to the resignation of two top FDA vaccine experts.118
Such efforts have only increased the perception that regulatory agencies are captured by industry and would conveniently ignore a higher than usual adverse effect ratio to control the pandemic. Concerns have been raised about the lack of due process in vaccine injury compensation claims for the COVID-19 vaccines,100 which are to be borne by governments and not pharmaceutical companies. A video of a US congressional roundtable on COVID-19 vaccine adverse events with medically confirmed vaccine-injured individuals from the original clinical trials, a US military clinician and Peter Doshi (senior editor of the BMJ) was permanently removed by YouTube.134
These practices do not reinforce confidence that authorities are being transparent or applying optimal standards for regulatory safety, efficacy and quality for these novel vaccines standards which should arguably be more stringent given the legal precedent for mandates and passports.
Conclusion
The adoption of new vaccination policies has provoked backlash, resistance and polarisation. It is important to emphasise that these policies are not viewed as incentives or nudges by substantial proportions of populations2528 41 45 especially in marginalised, underserved or low COVID-19-risk groups. Denying individuals education, livelihoods, medical care or social life unless they get vaccinated especially in light of the limitations with the current vaccines is arguably in tension with constitutional and bioethical principles, especially in liberal democracies.3033
While public support consolidated behind these policies in many countries, we should acknowledge that ethical frameworks were designed to ensure that rights and liberties are respected even during public health emergencies.
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The Unintended Consequences of COVID-19 Vaccine Policy The Wire Science - The Wire Science
"The Law of COVID-19: Courts, Education, and Civil Rights," the theme of the Elon Law Review's 2022 online symposium, takes place virtually on September 23 with legal scholars and advocates discussing the way the pandemic has affected the judicial system and the balance of public health with protecting individual freedoms.
The 2022 Elon Law Review Symposium takes place virtually on September 23 with legal leaders, scholars, and advocates poised to explore and discuss the impact of the COVID-19 pandemic on the administration of justice
There is no cost to attend and the Elon Law Review has applied to the North Carolina State Bar for the program to count toward 4.0 general CLE credits. You do not need to be a lawyer to participate.
The September 23 program runs from 10 a.m. 3:30 p.m. with a break for lunch. Register here to attend.
The symposium includes Elon Laws annual Jennings Family Lecture in Memoriam to Associate Professor Mike Rich. The Hon. Sam Ervin IV of the Supreme Court of North Carolina will deliver the 2022 address shortly after introductions by the Elon Law Reviews symposium editors.
Questions may be sent to lawreview@elon.edu. Links and additional information will be emailed to registrants prior to the event.
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Symposium to explore impact of COVID-19 on courts & justice - Today at Elon
For the third summer in a row, school leaders are facing the question of what if anything theyre going to do to stop the spread of Covid-19 when students return to classrooms.
One thing is clear: Almost none of them will be requiring vaccines.
Just 31 percent of children between 5 and 11 in the US have been fully vaccinated, and 61 percent of 12- to 17-year-olds have been. (Only about 3 percent of children under 5 had received a first dose by July 20.)
Still, no state in the country is planning to require student vaccinations, a marked turnaround from where things seemed to be headed last winter, when multiple states and school districts suggested vaccine mandates were coming soon. Only Washington, DC, has announced a mandatory school vaccine policy this fall, for students 12 and older.
Other mitigation measures from masks to ventilation may also be on their way out. The Centers for Disease Control and Prevention will likely soon recommend easing school testing, quarantine, and social distancing requirements, CNN reported last week. (Many schools often disregarded CDC guidelines, but the update is a sign of how expectations have shifted.)
Burbio, a company that specializes in aggregating school calendars, reported that so far, the vast majority of school districts it tracks nationwide will not be requiring masks this fall. And a June CDC study found just under 40 percent of American public schools had replaced or upgraded their HVAC systems to provide improved ventilation.
For the last three years, school requirements closed or open? masks on or off? have been a battleground in the culture war over Covid-19. Fear of wading back into the polarized fights over vaccination is one reason school leaders have backed away from requiring the shots. So is the fact that vaccines for children under 12 are not yet fully approved by the FDA.
But an even bigger factor might be mass indifference: American adults are more hesitant to vaccinate their kids, especially younger kids, than they were to get shots themselves. And no influential health group or federal agency is pushing states to require them to do so.
In October 2021, Californias Democratic Gov. Gavin Newsom was the first in the nation to announce a planned Covid-19 vaccine mandate for K-12 students once the FDA had fully approved the shots. He said at the time that it could take effect as early as January.
Some school districts in the state tried to impose vaccine mandates that would take effect even earlier. Los Angeles Unified School District, the second largest in the nation, announced in September 2021 that students 12 and older must be fully vaccinated by December 19, or switch to online schooling. In Oakland, California, the school board passed a similar vaccine requirement in late September for eligible students, with a deadline of January 1. The Pfizer vaccine for 16- and 17-year-olds had been fully approved in August, while the shots for 12- to 15-year-olds were still under FDAs emergency use authorization.
By December 2021, facing both political and legal pressure, school leaders pushed back the vaccine mandates to the start of the 2022-23 school year. LAUSD board president Kelly Gonez has said their decision was not about conceding to a vocal minority of anti-vaxxers, although those who oppose mandatory Covid vaccines hailed the delay as a victory.
But as 2022 continued, pressure for youth Covid-19 vaccines declined. A state lawmaker in California who had introduced a bill to require Covid-19 vaccines for K-12 students withdrew it in April, saying that focus needed to be on ensuring access to the vaccine. The same week, the California Department of Public Health announced it would no longer add the Covid-19 vaccine to its list of mandated childhood vaccines for public schools because they had not all yet received full FDA approval. The earliest the requirement would take effect, they said, was July 2023. Individual school districts like Los Angeles followed suit.
A California health department spokesperson told Vox that the state was waiting to ensure sufficient time for successful implementation of new vaccine requirements. As of last month, the vaccines are now fully approved for ages 12 and up, but not yet for younger children. The California health agency also said even after all the shots receive full approval, officials would still take into consideration other health group recommendations before issuing a new mandate.
Louisiana, likewise, retreated on a student vaccine mandate Democratic Gov. John Bel Edwards announced last November. New Orleans Public Schools is the only district in the state to require students to be vaccinated against Covid-19, though policy enforcement has been mixed. New York City Mayor Eric Adams, who said in January he was considering a student vaccine mandate for the fall, quietly dropped the idea, scaling it back to a requirement for students participating in certain sports and other high-risk extracurriculars like choir.
The California situation illustrates the several factors at play in schools reluctance to require vaccines.
One issue is the lack of full FDA approval for vaccines for younger children. The US Supreme Court has endorsed states authority to require student vaccines, but many policymakers were wary of testing that legal authority for Covid-19 shots that had only received emergency use authorization. (The Justice Department issued a memo last summer saying schools could legally do this, but the threat of defending those decisions in court was both real and unappealing.)
As a result, even once youth vaccines became available, leaders hesitated to require them without full FDA approval. But now the FDA has fully approved vaccines for teens and adolescents, and that still hasnt led states or districts to require the shots for older kids.
Policymakers are also wrestling with the fact that the virus is much less deadly for children compared to adults. (Approximately 1,180 of the more than 1 million Americans who have died of the virus were 17 or younger, though health experts stress vaccination can still help protect against these rare outcomes.) Kids can also catch the virus in school and spread it back at home to their more vulnerable parents and grandparents, but that risk became easier to tolerate once adult vaccines were approved.
Most school districts were wary of igniting another public school culture war battle at a time when students were still struggling to regain academic and social skills lost during the pandemic. On the eve of the anniversary of the January 6 riot, former President Donald Trump blasted President Joe Biden for supposed talk that his administration might enforce a vaccine mandate for school children and urged MAGA nation to rise up against any such requirements. (The Biden administration has not publicly discussed any student vaccine mandate.)
Conservative law firms were also helping to mount legal challenges against proposed Covid-19 vaccine requirements, and groups fighting mask and vaccine mandates have insisted there is no reason to vaccinate kids to protect more vulnerable populations.
Polling also indicated that many parents were not eager to have their kids get the shots, and administrators felt hesitant to impose any rules that could keep vulnerable students particularly Black and Latino students out of in-person learning for even longer than they already endured.
The Covid-19 Vaccine Monitor, run by the Kaiser Family Foundation, reported recently that parents intentions to vaccinate their older children have remained relatively steady since the start of the year: About six in 10 parents of those aged 12-17 say their child has been vaccinated (57 percent); about 30 percent say they will definitely not get their teen vaccinated. Eight percent said they will only vaccinate their child if required.
Covid vaccination uptake is even lower among children ages 5-11, and nearly half of parents of that age group either say they will only get them vaccinated if required to do so (10 percent) or say they definitely wont (37 percent).
While all demographic groups in the KFF study expressed concerns about long-term effects and side effects, Black and Hispanic parents also voiced more concerns over the logistics of getting their kids vaccinated.
Jeremy Singer, an education policy researcher who has been studying Covid-19 school reopenings, said its notable that resistance to youth Covid-19 vaccine requirements is present in nearly all school districts. One reason why, he said, may be what school districts are hearing from parents and community members.
District leaders may still be feeling risk-averse, but at this point the riskier thing for them could be to impose an unpopular mandate, he said.
In January 2022, Singer and his colleagues surveyed Detroit parents on whether they supported or opposed various health measures. Parents expressed overwhelming support for almost every measure ... except vaccine mandates for staff and especially students, for which there was a lot more ambivalence, he said of their findings, which are not yet published.
Back in February, Education Secretary Miguel Cardona wrote in a letter to schools, The #1 tool we have available right now to make sure our schools remain safe and open for all students is vaccination, and encouraged schools to provide information and host clinics. But the department has stopped short of encouraging schools to require the shots. Elaine Quesinberry, a spokesperson for the Education Department, referred Voxs questions about student Covid-19 vaccines to the CDC, and the CDC did not return a request for comment.
The CDCs last updated schools guidance, posted in late May, does not recommend schools require the shot, though encourages schools doing targeted outreach to promote it. A White House spokesperson declined earlier this year to say if Biden would support schools requiring Covid-19 vaccines for students if the vaccines had received full FDA approval.
Susan Martin, a spokesperson for the American Academy of Pediatrics, referred Vox to their policy statement recommending Covid-19 vaccines for all eligible children, and their interim guidance on safe schools, which says Covid vaccination and boosters should be encouraged.
Even teacher unions which were influential in shaping school reopening decisions in the 2020-21 school year have not staked out youth vaccination as a dealbreaker for safe in-person learning. An NEA spokesperson said, Our position on vaccines have not been changed or updated at this point and referred Vox to a position statement published in December 2020, which said parents should follow vaccine guidelines from the CDC and the American Academy of Pediatrics.
Back in October 2021, the last time the American Federation of Teachers released a formal statement on youth vaccines, president Randi Weingarten said vaccine approval will be critical to keeping our kids safe and healthy, and making sure our schools stay open and remain safe and welcoming for all. In a statement to Vox, Weingarten said the group is awaiting full authorization by the FDA to inform requirements for kids but in the meantime we must ensure the other guardrails, including revamped ventilation, are in place.
The big exception is in the nations capital. In late December, Washington, DC, councilmembers voted overwhelmingly in favor of legislation requiring all eligible students to get vaccinated against Covid-19.
The bill set a vaccination deadline for March 1, 2022, though enforcement was delayed until the start of the 2022-23 school year, a concession to help keep students in school. At the time, just over 60 percent of DC young people ages 12-17 had received their two shots.
Last month the city announced it would move forward with its back-to-school vaccination policy, requiring Covid-19 vaccines for all students ages 12 and older within the first 20 school days. DC is also ramping up outreach and enforcement for its other required youth vaccinations like measles and mumps which the city didnt enforce strictly last year, and students fell behind on.
I think one thing that is important to know in terms of how DC is moving forward is were not just talking about the Covid vaccination, we are having a conversation about routine child immunization, and the Covid vaccine just happens to be a part of the series where kids need to get caught up, said Christina Henderson, a DC councilmember and the lead sponsor of the bill requiring Covid-19 vaccines for students.
Henderson said their effort this year involves more concerted help from pediatricians, school leaders, and public health officials, to stress the importance of vaccination and to relay the evidence that millions of young people by now have safely received the shots.
Henderson pointed to the recent case of an unvaccinated 20-year-old with polio, and stressed that this is not the time to waver on the importance of pediatric vaccination. We also know mandates work, she added, noting that while many teen athletes were initially ambivalent about getting vaccinated, following DC Mayor Muriel Bowsers vaccination requirement to participate in sports last September, even hesitant students got their shots.
The Washington Post reported in late July that about 85 percent of DC students ages 12-15 have been vaccinated against Covid-19, but just 60 percent of Black children in that age range have been.
If one school has a high unvaccinated rate of students, then we will bring a mobile vaccine clinic there, Henderson said. We are not going to assume that parents are purposely saying I dont want to get my child covered. It might just be they were away all summer and didnt know about it, or didnt have time.
Kathryn Lynch-Morin, a spokesperson for DCs Office of the State Superintendent of Education, told Vox that city agencies have been coordinating closely with schools to support them with technical assistance, guidance, and outreach to families.
Our children belong in school with their friends and teachers who care about them, she said. But, we know if an outbreak of one of these serious or deadly diseases were to occur, it could have a harmful impact on our children, families, and staff. We also know that vaccinations save lives.
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Vaccines for Covid-19 arent required in schools this fall - Vox.com
Programs in countries around the world have begun quietly compensating people who have been injured by or died as a result of the COVID-19 vaccines.
Humans are biologically diverse, with respect to both genetic makeup and past environmental exposures. Because of this, explained neurologist Dr. Robert Lowry, people can react very differently to the same medication or vaccination. Whenever a new drug or biologic hits the market, some people will have bad reactions and others may even suffer serious adverse events as a result.
Even under the best testing conditions, rare reactions will be missed. This is especially true for any product which is fast-tracked or authorized for emergency use before all the phases of necessary testing are complete.
COVID-19 vaccines are no exception. Despite the fact that we are constantly and consistently assured that COVID-19 vaccines are safe, and that severe adverse reactions are very rare, the FDA and the CDC with its Advisory Committee on Immunization Practices, as well as the scientists and executives at each of the participating drug companies, know that some people will become permanently disabled or even die as a result of vaccination.
In fact, in 2011 the Supreme Court of the United States (pdf) reiterated the idea that vaccines, like other pharmaceutical products, are unavoidably unsafe.
In many countries around the world, consumers who are injured as a result of vaccines are covered by government compensation programs. In the United States there are two government-funded programs that are designed to compensate consumers for injuries, at the same time shielding vaccine manufacturers from liability for any serious injuries their products cause: The National Vaccine Injury Compensation Program (VICP) and the Countermeasures Injury Compensation Program (CICP).
As of July 1, 2022, not a single claim has been compensated by the CICP. However, 31 COVID-19 countermeasure claims have been denied, because the standard of proof for causation was not met and/or a covered injury was not sustained, according to the CICP website. One COVID-19 countermeasure claim, a COVID-19 vaccine claim due to an anaphylactic reaction, has been determined eligible for compensation and is pending a review of eligible expenses.
At the same time, countries around the world are quietly compensating families whose loved ones have been injured or have died as a result of COVID-19 vaccines.
The Japan Times reported this week that a 91-year-old woman who died after suffering an allergic response and sudden heart attack is the first person in Japan to be compensated for a COVID vaccine injury.
A ministry of health panel ruled that a causal relationship could not be denied in her case. Her family will receive a lump sum worth approximately $325,000.
The panel reviewed another 11 cases ranging in age from 20s to 90s but did not reach any other ruling.
So far in Japan, according to the article, 3,680 people have applied for compensation, 820 have been approved and 62 denied, with decisions on another 16 being postponed.
On June 24, 2022, Taiwans National Vaccine Injury Compensation Program held a meeting to review 65 cases, according to the Taipei Times. The Taiwanese program awarded compensation to 10 claimants. These awards included a lump sum worth $116,877 to the family of someone who died after receiving the AstraZeneca vaccine.
This patient was hospitalized 10 days after receiving the vaccine due to a headache and vomiting. Testing revealed thrombocytopenia, a sometimes-lethal blood disorder that is characterized by low platelets.
However, the patient was discharged the next day, only to return that evening after losing consciousness. The patient died of intracerebral hemorrhage, a common cause of stroke.
When the vaccination program first rolled out in the United States, in December of 2020, an otherwise healthy obstetrician-gynecologist, Dr. Gregory Michael, 56, of Miami Beach, Florida, also died of thrombocytopenia.
Although his death occurred approximately two weeks after he got Pfizers COVID-19 vaccine, and prompted an article exploring this side effect in the New York Times, the coroner deemed that there was no medical certainty that the complications from immune thrombocytopenia was vaccine-induced.
Vicki Spit was the first of a handful of people in the United Kingdom to be awarded compensation for injuries due to COVID vaccines, according to a June 24, 2022 article in the British Medical Journal.
Spits 48-year-old partner, Zion, became ill eight days after receiving the AstraZeneca vaccine and died. The victims were awarded the maximum: $150,000. As of May 2022, 1,681 claims for vaccine injury following COVID-19 vaccinations had been filed.
As quoted in the BMJ, Sarah Moore, a spokeswoman for the law firm representing the victims or their families, pointed out that though the awards will not do much to alleviate the financial hardships caused by the injuries, they constitute the clearest statement yet, by the government, that in some rare instances the COVID-19 vaccines have caused very significant injury or death.
Moore believes most of the compensation awards were for vaccine-induced thrombotic thrombocytopenia (VITT) or cerebral venous sinus thrombosis.
At the same time, Yahoo News has reported that 444 cases of VITT have been recorded in the United Kingdom from 49 million doses of the vaccine, with 81 deaths.
According to Canadas Vaccine Injury Support Program (VISP), from June 1, 2021 to June 1, 2022, 774 claims have been received. Eight of these claims were approved by the Medical Review Board, meaning these claims represent cases where it has been determined by the Medical Review Board that there is a probable link between the injury and the vaccine and that the injury is serious and permanent.
According to the VISP website, eligible individuals may receive income replacement indemnities; injury indemnities; death benefits; coverage for funeral expenses; reimbursement of eligible costs such as otherwise uncovered medical expenses.
Thrombocytopenia can lead to blood clots as well as hemorrhaging. Thrombosis is another word for blood clots. Since it is very unusual for an otherwise healthy younger person to suffer from blood clots, the connection between the vaccines and this injury are difficult to refute.
Scandinavian countries have paid more attention to COVID-19 vaccine injuries than other countries. Norway compensated its first three victims in July of last year, a woman in her 40s who died, as well as a man and a woman in their 30s who both survived their vaccine injuries.
All three were healthcare workers who received the AstraZeneca vaccine, which Norway stopped administering on March 11, 2021, due to reports of serious blood clots, low platelet counts, and abnormal bleeding.
In fact, Norwegian doctors were among the first to point out the connection between the vaccine and these injuries.
Denmark, too, has been quickly and quietly processing vaccine injury claims. The Danish government awarded compensation for their first case of VITT in May of 2021.
At the time, 158 people had filed claims for COVID-19 vaccine injuries. The director of the patient compensation board, Karen Inger-Bast, said, Generally, we often see injuries from vaccination. We also see them from, for example, vaccination against influenza and childrens diseases. Thats also how it will be with COVID-19, with up to 5 million people being vaccinated.
Yet, while other countries are compensating people who have been injured by COVID-19 vaccines, America has yet to financially assist a single claimant. According to the Health Resources and Service Administration, as of July 1, 2022, the CICP had yet to award compensation to anyone for damages due to a COVID-19 vaccine.
Thirty-one claims have been denied compensation because the standard of proof for causation was not met and/or a covered injury was not sustained.
A single claim on behalf of someone who suffered an immediate anaphylactic reaction has been deemed eligible for compensation but is pending a review of eligible expenses. For the majority of claims, the CICP is still waiting for records and documentation to be submitted, the website claims.
The AstraZeneca vaccine associated with so many of the injuries quietly compensated has not been made available in the United States.
At the same time, as of July 22, 2022, 86,604 serious adverse events from COVID-19 vaccines administered in the United States have been reported to the Vaccine Adverse Event Reporting System (VAERS), including 13,805 deaths.
Its difficult to determine exactly how many of those involve blood clots, abnormal bleeding, or low platelets because each of those conditions can be coded in many different ways, but a search by The Epoch Times retrieved 2,609 cases that included some mention of thrombosis or thrombocytopenia, including 420 deaths.
These conditions account for only a small portion of the adverse events that have been reported to the CDC and the FDA. In order for people who have suffered from these adverse events to make a claim, a temporal association between the vaccine and the injury or some kind of causation must be established, as the Norwegian doctors and others did for VITT.
In the United States, we may wait a long time for science that establishes causation with respect to vaccine injuries.
In 2011, the Institute of Medicine conducted a detailed investigation into the science available on 158 suspected links between vaccines and specific adverse outcomes. In this report, the IOM ruled that the science was not sufficient to determine whether a causal link existed or not for 135 of the vaccine injuries patients had sustained.
A 2014 Associated Press investigation found that many families with medically documented non-COVID vaccine injuries have been waiting for yearssome over a decadefor the government to help them.
For now, while other countries are quietly making amends, American families who have lost loved ones and Americans who have seen sharp declines in their health following COVID-19 vaccination have nowhere to turn.
Views expressed in this article are the opinions of the author and do not necessarily reflect the views of The Epoch Times. Epoch Health welcomes professional discussion and friendly debate. To submit an opinion piece, please follow these guidelines and submit through our form here.
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OSHA's emergency temporary standard (ETS) requiring healthcare employers to adhere to numerous regulatory requirements addressing COVID-19 was largely withdrawn in December 2021. On June 21, 2022, the U.S. Department of Labor (DOL) published its regulatory agenda forecasting that employers in healthcare settings can anticipate that the Occupational Safety and Health Administration (OSHA) will roll out permanent COVID-19 regulations in September 2022.1 It is expected that many, perhaps most, of the requirements in the ETS will be resurrected in the new final rule. Healthcare employers will be well-served to prepare now to ensure compliance later this year if OSHA, in fact, publishes its new final rule.
One year ago, OSHA issued the 900-page healthcare ETS, which will serve as a starting point for its forthcoming permanent COVID-19 healthcare regulations. The healthcare ETS required employers to develop and implement COVID-19 plans that included paid time off for vaccination, social distancing, personal protective gear, physical barriers, ventilation, patient and employee screening, employee training, recordkeeping and reporting. Although the ETS immediately went into effect, the bulk of the emergency regulation was withdrawn in December 2021 when OSHA was unable to meet the six-month deadline to complete a final standard.2
Nevertheless, OSHA strongly recommended employers continue to adhere to all of the terms of the healthcare ETS and has asserted that doing so will offer protection against citations under the General Duty clause, respiratory standard, and PPE standards as they relate to COVID-19. However, the only healthcare ETS regulations that actually remain in effect are the healthcare ETS's log and reporting requirements, found at 29 CFR 1910.502(q)(2)(ii), (q)(3)(ii)-(iv), and (r).
OSHA opened (and has completed) two comment periods on its proposed final rule and held public hearings on a broad range of topics, including the necessity of permanent standards, compliance with CDC recommendations, and the scope of healthcare workers to be covered. Although it is anticipated that the new permanent regulations will be based upon and have similarities to the healthcare ETS, there are also potential differences. By definition, OSHA can only authorize an ETS in limited circumstances in which workers are in "grave danger." Given that a permanent standard will not have such restrictions, it is possible that the new rule will be applicable (or more clearly applicable) to a broader scope of workers in nonemergency situations, such as home healthcare settings and embedded clinics at non-healthcare workplaces (e.g., a clinic at a manufacturing or processing plant). Additionally, OSHA's requested comments and public hearings suggest that the new, permanent healthcare regulations will not include a mandatory vaccination requirement for employees. OSHA also appears to be contemplating allowing more flexibility in implementing required policies in areas where healthcare employees do not encounter people with COVID-19.
Assuming the new regulations are issued in September, it is likely that legal challenges will ensue targeting specific provisions or the new regulations altogether. DWT will continue to monitor OSHA's progress on these regulations and any potential lawsuits, and provide updates as they occur.
The DOL's regulatory agenda also includes a potential infectious disease regulation for healthcare and other high-risk environments that was initially considered in 2010 and is now scheduled for proposed rulemaking in May 2023. OSHA indicates the prospective rule will address safety standards for COVID-19, among other infectious diseases, in workplace settings that include healthcare, emergency response, correctional facilities, homeless shelters, and drug treatment programs. OSHA would first publish a proposed rule, then allow a period for comments. More will be revealed over the next year.
OSHA's forthcoming healthcare regulations will apply immediately to states in which federal OSHA directly enforces the federal Occupational Safety and Health (OSH) Act and its regulations. But approximately half of U.S. jurisdictions, including California, Washington, Oregon, Alaska, and Virginia have state plans that OSHA has approved and, as such, are administered by local state agencies. Any new OSHA regulations will not immediately be enforceable in these "state plan" states. Subject to OSHA oversight and approval, these state plans must adopt rules within six months of the federal regulation's adoption that are either identical to or more protective of employee safety and health than any new federal regulation. Thus, although any new federal OSHA COVID-19 or infectious disease regulations may not immediately apply to healthcare employers in these state-plan jurisdictions, they or something similar to them (and possibly even more restrictive) may apply in short order.
1 In the ETS, OSHA broadly defined "healthcare setting" to include places where practitioners (e.g., doctors, nurses, and dentists) provided healthcare services and where individuals provided healthcare support services, such as patient intake/admission, patient food services, housekeeping, and medical equipment cleaning. However, the ETS included several exceptions, which limited the application to more traditional healthcare settings (e.g., hospitals). As discussed below, OSHA will have a greater ability to define healthcare setting broadly with a non-emergency regulation than it did with the ETS.2 The OSHA healthcare COVID-19 ETS is not to be confused with OSHA's general industry COVID-19 ETS. The U.S. Supreme Court blocked the enforcement of OSHA's general industry ETS on January 13, 2022, which ruling effectively killed the general industry ETS.
The facts, laws, and regulations regarding COVID-19 are developing rapidly. Since the date of publication, there may be new or additional information not referenced in this advisory. Please consult with your legal counsel for guidance.
DWT will continue to provide up-to-date insights and virtual events regarding COVID-19 concerns. Our most recent insights, as well as information about recorded and upcoming virtual events, are available at http://www.dwt.com/COVID-19.
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Supreme Court Justice Clarence Thomas wrote in a dissenting opinion that genetic materials derived from abortions were used in the development of the COVID-19 vaccines.
Thomas' June 30 opinion came after the U.S. Supreme Court declined to hear a challenge to New York's COVID-19 vaccine mandate for health care workers.
"Petitioners are 16 health care workers who served New York communities throughout the COVID-19 pandemic," Thomas wrote. "They object on religious grounds to all available COVID-19 vaccines because they were developed using cell lines derived from aborted children."
PolitiFact has fact-checked many claims about the COVID-19 vaccines, including one that falsely said that the Oxford-AstraZeneca vaccine contains aborted fetal tissue. Thomas description of the plaintiffs position was more carefully worded and did not claim that fetal tissue is an ingredient in the vaccines.
Instead, he focused on the development of the vaccines and the use of "cell lines."
Thomas did not specify whether the "cell lines" were used in the vaccines testing phase or in final production. However, the complaint denied by the Supreme Court said that all of the COVID-19 vaccines used in the U.S. "employ aborted fetus cell lines in their testing, development, or production." (Were not rating Thomas statement on our Truth-O-Meter because Thomas was describing the plaintiffs legal argument.)
Several media outlets mistakenly misinterpreted the opinion, believing Thomas claimed the vaccines contain fetal cells. The outlets also focused on Thomass use of the words "aborted children," a provocative phrase that doesnt align with how the medical community describes an aborted fetus.
Fetal cell lines have been used to test and develop vaccines since the 1960s. They are made by isolating cells from fetal tissue, in some cases from an aborted fetus. These cell lines can be cloned indefinitely and used for medical research.
Vaccines for chickenpox, rubella and shingles also are developed using fetal cell lines.
The vaccines from Moderna, Pfizer and Johnson & Johnson are currently the only three authorized for use in the U.S. Of the three companies, only Johnson & Johnson uses fetal cell lines to produce its vaccine.
The Johnson & Johnson vaccine uses the companys own proprietary fetal cell line called PER.C6, derived from retinal tissue from an 18-week-old fetus aborted in 1985.
The vaccine uses a modified cold virus known as an adenovirus that can train the body to recognize the coronavirus. The adenovirus is grown and replicated in the PER.C6 cell line, purified of the cells and formulated into the vaccine.
By the time its administered, the vaccine contains only trillionths of a gram of DNA from the cell line.
The use of fetal cell lines in Johnson & Johnsons vaccine has raised moral objections among some Catholics and anti-abortion advocates.
The Vaticans Congregation for the Doctrine of Faith said in 2020 that "it is morally acceptable to receive COVID-19 vaccines that have used cell lines from aborted fetuses in their research and production process."
However, some Catholic bishops considered Johnson & Johnsons vaccine "morally compromised" and encouraged the use of the Moderna and Pfizer vaccines instead.
Those two vaccines were developed with messenger RNA, or mRNA, technology, which uses spike proteins from the coronavirus SARS-CoV-2 rather than a modified cold virus. Fetal cell lines were not used to manufacture Moderna and Pfizer vaccines. But the companies used fetal cell lines as part of their development to test whether their vaccines were safe and effective in humans.
The U.S. Conference of Catholic Bishops issued a statement in 2020 saying the use of fetal cell lines for testing made the Moderna and Pfizer vaccines more palatable.
"In view of the gravity of the current pandemic and the lack of availability of alternative vaccines," the statement said. "The reasons to accept the new COVID-19 vaccines from Pfizer and Moderna are sufficiently serious to justify their use, despite their remote connection to morally compromised cell lines."
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What Clarence Thomas said about fetal cell lines and COVID-19 vaccines - PolitiFact
