Why federal research strengthens the case for a coronavirus vaccine mandate
Just a day after President Biden issued a sweeping mandate aimed at encouraging American workers to get vaccinated against the coronavirus, federal health officials released new data showing that unvaccinated Americans are more likely to die from COVID-19 than people who are unvaccinated. 11 times more likely.
Three large studies published Friday by the Centers for Disease Control and Prevention also shed light on the shots’ effectiveness in preventing infection and hospitalization with the virus.
The research underscores a deep belief among scientists that vaccine hesitancy and denial have prolonged the pandemic. Several experts interviewed said the administration’s new plan should stop the flood of infections and bring the country back to normal in the long run.
“This is going to fundamentally change the arc of the current boom,” said Dr. Ashish Jha, dean of the Brown University School of Public Health. “This is what is needed at the moment.”
The new data could also help boost confidence in the country’s vaccines, which has been eroded amid unexpected reports of breakthrough infections.
One of the studies looked at more than 600,000 virus infections in 13 states, representing nearly a quarter of the US population, between April and July. The researchers concluded that Americans who were not fully vaccinated were more vulnerable to infection, disease, and death from the virus.
Even after the delta version went into effect in the United States over the summer, the vaccine’s protection remained strong: Compared to vaccinated adults, who were not fully vaccinated, they were 4.5 times more likely to be infected, hospitalized, was 10 times more likely to occur. 11 times as likely to die from covid.
Researchers said the cumulative data made it clear that the country cannot expect to end the pandemic with some 37 percent of Americans not receiving a single dose of the COVID vaccine. Cases and hospitalizations are expected to rise only as Americans move indoors to homes, schools and offices in the fall.
That’s why scientists generally welcomed the Biden administration’s vigorous vaccination campaign. Biostatistician Natalie Dean of Emory University in Atlanta said mandatory vaccination will be critical to keeping endemic viruses under control in the United States: “It’s part of a shift from short-term responses to long-term solutions.”
Still, some experts cautioned that the results of the administration’s plan would take several weeks to come out. It’s unclear when the new requirements will be finalized or how the legal challenges promised to Republicans will play out in the courts. Furthermore, while the administration said the mandate would cover 100 million American workers, no one knows how many of them have already been vaccinated.
In any event, vaccination is not a quick process—at least six weeks for a two-dose vaccine. The administration did not emphasize measures that work more quickly to contain the virus: masking and widespread rapid testing, for example.
The nation will need every tool at its disposal to stop the Delta version, a far more formidable foe than the original version of the virus. The variant became the dominant version of the virus in the United States only in mid-July, and its consequences have been beyond experts’ predictions.
The number of reassuringly low cases and hospitalizations in June has risen to nearly 10 times their previous levels for weeks. About 1,500 Americans, most of whom have not been vaccinated, are dying every day.
New research from the CDC found that many sufferings are preventable. An analysis of 32,867 patient visits across nine states found that even though the delta variant was dominant, the vaccines had an overall effectiveness rate of 86 percent in preventing hospitalization, although they were less protective for adults aged 75 and older. Were.
Moderna vaccines had the highest efficacy rate of 95 percent, compared to 80 percent for Pfizer-BioNtech and 60 percent for the Johnson & Johnson vaccine.
The shots’ effectiveness in preventing infection decreased somewhat, from 91 percent to 78 percent, as the variant spread. The Moderna vaccine had an effectiveness rate of 92 percent against infection, compared to 77 percent for the Pfizer-BioNtech shot and 65 percent for Johnson & Johnson.
“There are more breakthrough infections happening than ever before — it’s a real phenomenon,” said Heather Scobie, an epidemiologist at the CDC and lead author of the largest study. “But for the most part, people are not going to hospitals if they have been vaccinated.”
New data shows the vaccine mandate will protect millions more people, especially from severe disease, and relieve pressure on the health care system, Dr Dean said. “It sets a precedent for other organizations to make similar decisions,” he said.
The administration’s new mandate covers health care workers, which requires that any provider receiving Medicaid or Medicare funding enforce the vaccination requirement on staff members. The measure, experts said, is likely to have an immediate effect mostly, as health care facilities are high-risk settings for transmission.
There is substantial historical precedent for the decision to hold hospitals to certain standards—specifically, the historical directive to segregate patients by race, Dr. Jha said.
“We have a real lack of leadership from health care systems that isn’t mandated within their own organizations, and it’s imperative that the president needs to protect patients,” he said.
The need for some health care and nursing home workers, especially many who are nearing retirement age, to leave the profession, can exacerbate staffing shortages. Yet, there is much more to be lost than a mandate, said Dr. Nahid Bhadelia, founding director of the Center for Emerging Infectious Diseases Policy and Research at Boston University.
“This is an important step in getting us out of the pandemic,” she said. “People caring for vulnerable people who come to the hospital need to be our first line of defense.”
The Labor Department will order all private sector businesses with more than 100 employees to fully vaccinate their workforce or be tested at least once a week. Employers must give employees paid time off for vaccinations.
The move alone would affect 80 million Americans. But Bill Hannez, an epidemiologist at Harvard University, was skeptical that the mandate would be successful in vaccinating millions more people than had already opted for the vaccine.
Understand the Vaccine and Mask Mandate in America
- Vaccine Rules. On August 23, the Food and Drug Administration granted full approval to Pfizer-BioNtech’s coronavirus vaccine for people 16 and older, paving the way for increased mandates in both the public and private sectors. Private companies are increasingly making vaccines mandatory for employees. Such a mandate is legally permitted and upheld in court challenges.
- mask rule. In July the Centers for Disease Control and Prevention recommended that all Americans, regardless of vaccination status, wear masks in indoor public places within areas experiencing outbreaks, a reversal of guidance given in May. See where CDC guidance will apply, and where states have established their own masking policies. The fight over the masks has become controversial in some states, with some local leaders defying state restrictions.
- Colleges and Universities. More than 400 colleges and universities require students to be vaccinated against COVID-19. Almost all are in states that voted for President Biden.
- schools. Both California and New York City have introduced vaccine mandates for education workers. A survey released in August found that many US parents of school-age children are opposed to mandatory vaccines for students, but were more supportive of the mask mandate for students, teachers and staff members who have had their shots. are not.
- Hospitals and Medical Centers. Many hospitals and major health systems require employees to receive a COVID-19 vaccine, citing the growing caseload fueled by the Delta variant and the stubbornly low vaccination rates in their communities, even as their Even within the task force.
- New York City. Indoor dining, gyms, performances and other indoor situations require proof of vaccination of workers and customers, although enforcement doesn’t begin until September 13. Teachers and other education workers in the city’s vast school system must have at least one vaccine. Dosage until 27 September, without the option of weekly testing. City hospital staff must also get a vaccine or be subject to weekly testing. Similar rules apply for New York state employees.
- at the federal level. The Pentagon announced it wants to make coronavirus vaccinations mandatory for the country’s 1.3 million active-duty soldiers “no later than mid-September”. President Biden announced that all civilian federal employees would have to be vaccinated against the coronavirus or submit to routine testing, social distancing, mask requirements and restrictions on most travel.
He said that some of the people who are in urgent need of protection are older adults who will not be affected by the requirements of the workplace. New CDC research on Friday confirmed that this population was particularly vulnerable.
A study conducted at five Veterans Affairs Medical Centers, where patients bear a burden of chronic diseases that contribute to severe COVID disease, found that the vaccine’s protection against hospitalization decreased with age 65 and older. For people older than that, it went up to 80 percent. From 95 percent for adults aged 18 to 64. A second study found the vaccine’s effectiveness decreased at age 75.
And the mandate is already drawing criticism from conservative Americans. Republican governors in several states have called the mandate unconstitutional and said they plan to sue to stop it.
“My question would be whether it actually gets people vaccinated, or just adds to the political heat around it,” Dr. Heinz said.
More than half of Americans are in favor of a vaccine mandate for workplaces, but in a recent survey, 87 percent said they wouldn’t get shots, even if their employers required them.
Many experts said that by emphasizing that vaccination is the way out of the pandemic, officials in both the Trump and Biden administrations have stressed the importance of masks, testing and ventilation at a time when many people are likely to remain unvaccinated.
“There are many measures that were left on the table, such as an indoor mask mandate linked to community transmission rates, or minimum ventilation standards for schools and workplaces,” said Dr Gavin Yami, a global health expert at Duke University.
Until recently, Dr. Yami was unable to locate a single Binex rapid test within a 100-mile radius of Durham, NC – “which is pathetic,” he said. “I was recently in England, where home antigen tests are free and plentiful.”
Simple and cheap tests are important to monitor the rise and fall of the virus, Dr. Bhadelia said: “If you don’t have eyes on the ground, if you don’t have the ground, you can’t really make any other plans.” .
The Occupational Safety and Health Administration, which regulates workplace safety, will require private businesses to mandate that their employees either be vaccinated or provide weekly proof of a negative test.
But weekly testing is unlikely to be helpful against the delta variant, as the virus replicates quickly in the airways and an infection becomes increasingly contagious. Businesses in remote areas should, at least, consider testing twice a week, Dr. Bhadelia said.
Many public health experts felt “uncomfortable” when Americans urged the administration to prematurely celebrate the heat of liberation from the virus, she said. But with much of the world still vulnerable to the virus, new variants could rise again in the country.
“We need an honest conversation about the goals of what it means to be on the other side of the pandemic phase of this crisis,” she said. “This is a once-in-a-century pandemic, and we definitely have to get it right – and it’s okay to do so.”
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