President Joe Biden delivers remarks on his plan to stop the spread of the Delta variant and boost Covid-19 vaccinations through a broad mandate on Sept. 9, 2021.

Despite Precedent, Covid-19 Vaccine Mandates Spark Backlash

Writing for Undark in April 2020, science journalist Katharine Gammon reported that some experts were optimistic that the Covid-19 pandemic would bring renewed public attention to the benefits of vaccination. Many of her sources, Gammon wrote, thought “the current crisis could usher in an era of increased interest in vaccines — or at least in taking responsibility for the health of others.” One preventative medicine specialist predicted that anti-vaccination advocates would grow quiet in the face of an effective Covid-19 vaccine backed by the nation’s leaders.

Seventeen months later, regulators have authorized three safe, effective Covid-19 vaccines for public use, and vaccines are indeed the focus of national attention — although not, perhaps, in the way public health leaders once hoped. Instead, the United States’ Covid-19 vaccination campaign has slowed, and new vaccine mandates are inspiring extensive backlash. In the process, the politicization of mass vaccination and other interventions has raised concerns about broader attacks on U.S. public health practice.

According to federal data, 63.5 percent of people in the U.S. have received at least one dose of a Covid-19 vaccine — and around 80 million eligible Americans, for a range of reasons, have not received the shot. In response, President Biden announced a broad vaccine mandate late last week. The new policy applies to some 100 million people; it makes vaccination mandatory for health care workers, and also requires large businesses to ensure workers receive a vaccine or undergo weekly Covid-19 tests.

Vaccine mandates are common in the U.S., and in a recent Axios-Ipsos poll a sizeable majority of respondents said they support Covid-19 vaccination requirements. Still, the new White House mandate has inspired plenty of pushback. Business leaders have expressed concern about how to implement the policy. Some Republican lawmakers have described it as “authoritarian,” and compared Biden to a dictator. The legal challenges have already begun, including a lawsuit filed Tuesday by Arizona attorney general Mark Brnovich. In a statement, Brnovich’s office described Biden’s mandate as “one of the greatest infringements upon individual liberties, principles of federalism, and separation of powers ever attempted by an American President.”

Those legal challenges may not get far: U.S. courts have a long history of supporting vaccine requirements. “Biden’s vaccine mandates are on rock solid legal grounds,” Georgetown public health law expert Lawrence Gostin wrote on Twitter this week. But some analysts are concerned that the swift politicization of vaccine policy signals future trouble for other policies — such as vaccine mandates in public schools — that have previously enjoyed broad bipartisan support.

Indeed, the opposition to mandates comes as part of a broader Republican-led campaign to rewrite public health powers in the U.S., with consequences that could last long beyond the Covid-19 pandemic. In some cases, as Undark reported earlier this year, the legislation addresses widely acknowledged gaps in emergency public health law. But, many public health leaders argue, many of the new policies go too far, curtailing the ability of health officials to respond to many public health crises — and to keep up with the ongoing challenges of Covid-19. “It’s kind of like having your hands tied in the middle of a boxing match,” Kelley Vollmar, who leads the Jefferson County Health Department in Missouri, told Kaiser Health News this week.

Also in the News:

• The largest hospital in Alaska announced this week that it would begin rationing medical treatment due to an overwhelming surge of Covid-19 patients. With that announcement, the Providence Alaska Medical Center in Anchorage joined a growing list of hospital systems around the country forced to turn away patients and delay surgeries and other procedures due to the overwhelming rise in desperately ill patients, most of whom are unvaccinated. Idaho activated crisis care standards for 10 hospitals last week; hospitals in Nevada reported turning patients away as rooms filled this month; and Oregon hospitals declared some cancer treatments would need to be delayed due to the Covid surge there. The federal government reported that Alabama was at 100 percent ICU capacity, while Texas, Georgia, Mississippi were above 90 percent. Reports have begun surfacing of resulting harm to patients — for instance, a Texas Army veteran who died of a treatable gallstone ailment because it took so long to find a hospital bed; a Florida boy whose appendix ruptured after he waited hours to see a doctor; an Alabama man who died of cardiac arrest after his local hospital, which could not treat him, tried and failed to find him a bed at 43 hospitals across three states. “The U.S. health care system wasn’t built to withstand a pandemic,” concluded Vox. (Multiple sources)

• Wednesday evening, a SpaceX rocket launched from NASA’s Kennedy Space Center carrying the first-ever orbital mission crewed entirely by passengers who are not professional astronauts. Physician assistant Hayley Arceneaux, community college professor Sian Proctor, data engineer Christopher Sembroski, and billionaire technology entrepreneur Jared Isaacman — who financed the trip — will orbit Earth for three days in SpaceX’s autopiloted Dragon capsule, at an altitude roughly 100 miles higher than that of the International Space Station. The mission is being described as the beginning of a new era in space travel, one in which private companies routinely carry paying tourists into space with little government involvement. It comes on the heels of two high-profile launches that carried billionaires Richard Branson and Jeff Bezos briefly into the lower reaches of space. But some experts have expressed unease about the prospects of space as a playground for the privileged. Said the National Air and Space Museum’s Matt Shindell to National Geographic, “It’s putting a lot of this into the hands of the billionaires and millionaires of the world, who can afford either to fly on these flights, or to give seats away on flights that they’ve chartered.” (The Atlantic)

• On Wednesday, the Food and Drug Administration released documents revealing skepticism among its scientists over widespread need for a booster shot of Pfizer’s Covid-19 vaccine. While booster shots are already available for some immunocompromised people, the scientists believe that the U.S.-authorized vaccines continue to offer most members of the public strong protection against severe Covid-19 hospitalization and death. But the agency might still authorize a booster shot — a decision that some FDA officials have challenged. (Even if the FDA approves the booster, the decision to distribute it rests with the Centers for Disease Control and Prevention.) Pfizer argues that the efficacy of its Covid-19 vaccine is declining, especially in the face of the more contagious delta variant, and that a third dose will help provide better protection against such variants. The documents also show that the FDA is concerned about potential adverse effects from booster doses, which are yet to be studied. The skepticism is shared by scientists in other parts of the world. In a British study, yet to be peer-reviewed, authors noted that because the vaccines have been so efficient against hospitalization and death, “the additional benefit of a third dose against these more serious outcomes is limited in the current epidemiological situation.” An advisory panel for the agency is considering the boosters at a meeting Friday. (STAT)

• This week in a five-part investigative series, The Wall Street Journal reported on internal documents from Facebook and found that the company is well aware that its social media platforms, which include Facebook and Instagram, can facilitate the spread of violent posts and revenge porn, spread misinformation, erode the mental health of teenagers, and more. For instance, Facebook has conducted in-depth research for three years on how Instagram affects its estimated 22 million daily teen users, using online surveys and diary entries. “Thirty-two percent of teen girls said that when they felt bad about their bodies, Instagram made them feel worse,” read a presentation slide on the research from 2020, according to The Journal. Another slide, the paper said, read: “Teens blame Instagram for increases in the rate of anxiety and depression. This reaction was unprompted and consistent across all groups.” In March 2021, Facebook CEO Mark Zuckerberg told Congress that research indicated the opposite — that social media allows people to connect and can have benefits for mental health. According to The Journal, the internal documents suggested that higher-ups at the company, including Zuckerberg, have seen the internal research and that the company hasn’t done much to address the issues. (The Wall Street Journal)

• And finally: Research into long Covid — in which people report symptoms lasting weeks or months after they’ve recovered from an initial SARS-CoV-2 infection — received major new federal support this week. On Wednesday, the National Institutes of Health announced it had awarded $470 million to New York University Langone Health to build a study on long Covid of tens of thousands of people across the U.S. The research will aim to discover why some people experience lingering symptoms, including shortness of breath, fatigue, and depression. According to the NIH announcement, NYU will serve as a research hub for the study, while also issuing sub-awards to researchers at more than 30 institutions. “Normally it would take two or three or four years to set up something like this, given the scale,” NIH director Francis Collins said in a news conference this week. “But given the urgency, we have moved to put this together considerably faster but without sacrificing rigor.” On Thursday, the CDC published the results of a small survey of residents in Long Beach, California who had been infected with the coronavirus before vaccines became available. One in three reported experiencing at least one lingering symptom two months after receiving a positive test. (The Hill)

“Also in the News” items are compiled and written by Undark staff. Deborah Blum, Brooke Borel, Sudhi Oberoi, Jane Roberts, and Ashley Smart contributed to this roundup.

Michael Schulson is a contributing editor for Undark. His work has also been published by Aeon, NPR, Pacific Standard, Scientific American, Slate, and Wired, among other publications.