Immunization mandates work, but only if they are executed well


The point is, formal FDA approval was not required for a warrant, but it turns out to be sufficient. Businesses, schools and local governments that wanted to avoid a backlash over the requirement for “experimental” vaccines now feel they have an even greener light. (Maybe it was just a sham anyway; Texas Gov. Greg Abbott, anti-mandate policy used to quote EUA, and after approval changed to specify any Covid-19 vaccine.) “They worried about litigation, they worried about employee perception, they worried about public perception “says Lawrence Gostin, a public health policy official. expert at Georgetown University. “We are going to see, I think, an avalanche of companies and universities follow suit in the coming weeks.”

The most important thing about vaccination warrants, however? “They work,” says Saad Omer, director of the Yale Institute for Global Health and vaccine acceptance expert. “Much of the evidence comes from childhood vaccinations. For adults, these are influenza vaccinations for health workers. This shows that having mandates is effective. It takes you from 70 or 80 percent to 90 or 95 percent.

Public schools across the United States require children to show proof of vaccination against various diseases; different states have different levels of withdrawal options allowed. A analysis of these requirements have shown that they have increased overall immunization rates by 18 percent. Reverse: in 2006, Omer and his colleagues show which indicates where it was easier to get exemptions for children also had higher rates of pertussis, one of the childhood illnesses with a widely available vaccine. (It could be worse; Australia is fining parents for missing children’s vaccinations, and Uganda is putting parents in jail.)

There’s a catch: you have to do it right. On the one hand, mandate policies seen as extraordinarily harsh can trigger an anti-vaccine reaction. But the real problem is that one size cannot fit all. People are not vaccinated for many different reasons. Of course, some of them have political or philosophical disagreements. Some people don’t believe in the (very good, very solid) science behind vaccines, or subscribe to conspiracy theories about their creation. According to a Civiqs survey, 91% of people who identify as Democrats have been vaccinated, as have 64% of independents; only 53 percent of Republicans have it. And according to another survey of the Kaiser Foundation, 5 percent of those Republicans say the only way they already getting vaccinated is if it was necessary. Then Hi! It is now. Welcome!

But some people are not vaccinated due to forces beyond their control. Covid-19 has hit certain groups particularly hard – people of lower socio-economic backgrounds and people of color, in particular. They are at the center of many of Venn’s overlaps: more likely to have health issues that can make Covid infection fatal, less likely to have easy access to health care, more likely to have jobs in high risk with high exposure, less likely to have good internet access, more likely to have hourly jobs and not allow sick leave. If you have all of this going on, it can be hard to imagine getting an appointment for the vaccination, let alone taking time off work if you have side effects that send you to bed. If the vaccination warrants deny access to certain spaces and the unvaccinated are, say, blacks, that would make the effect of the warrants racist.

The answer? Do not do that. “You shouldn’t demand vaccination from someone who doesn’t have access to it,” says Gostin. “Bring the vaccination to the workplace or to the campus, or give paid time off to get the vaccine, including paying for carpools to get there.” You need to focus on access and fairness.



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