Last week the Supreme Court of the United States (SCOTUS) in a 6 to 3 decision set aside the November 4th 2021 OSHA mandate requiring companies with more than one hundred employees to enforce vaccination against COVID. As has been stated previously, EGG-NEWS is not in favor of mandates since they are basically ineffective and generate antagonism towards the most effective method of suppressing COVID.
The decision by SCOTUS was based on the legal reality that Congress did not extend authority to OSHA to issue a mandate to enforce vaccination for a disease that is not strictly acquired in the workplace. The decision in no way reflects adversely on the public health benefits of COVID vaccination. The mandate would have extended vaccination to 80 million workers, many of whom have in fact been vaccinated. Submissions by the Solicitor General to the Court projected that the mandate would have saved 6,500 lives and prevented 250,000 hospitalizations over six months. Whether these figures based on models are in fact valid is now moot.
Again considering the strict legal aspects of mandates, SCOTUS ruled 5 to 4 to allow a vaccine mandate for 10.4 million healthcare workers in medical facilities receiving either Medicare or Medicaid funding. This decision would apply to 10.4 million workers in 76,000 facilities. It is a matter of record that large hospitals have attained 99 percent compliance among workers with minimal resistance to receiving a COVID vaccine.
The SCOTUS ruling does not bar individual companies from imposing mandates on their employees. Numerous private and public companies including Starbucks, GE, Google, Tyson Foods, Southwest and United Airlines, American Express and City Bank have required employees to be fully vaccinated or submit justification for an exemption based on medical or religious grounds or due to sincere beliefs.
Predictably, organizations including the FMI, National Grocers Association and the National Retail Federation lauded the SCOTUS decision. The concerns of these organizations focused on the prospect that their members would lose workers who resisting vaccination, further complicating a difficult labor situation. There is, however, little evidence that a vaccine mandate imposed by a company results in appreciable resignations as noted by the reports from companies previously requiring vaccination. Anecdotal evidence suggests that most workers in large companies especially in situations where work requires close contact, feel more confident knowing that fellow workers are immunized or alternatively tested and masked.
The Kaiser Family Foundation determined the average cost of a single hospitalization for an unvaccinated adult to attain $20,000 per case. Over the period June to November 2021 the total cost for 700,000 hospitalizations for the unvaccinated over the six-month period was $13.8 billion. In the report, the foundation noted, "the monetary cost of treating unvaccinated people for COVID is borne not only by patients but also by society more broadly including taxpayer-funded public programs and private insurance premiums paid by workers, businesses and individual purchasers".
The decision to defer or reject vaccination against COVID should not be considered only as a freedom and personal rights issue alone as rejecting vaccination has implications for the economy. In recognition of the financial burden associated with failure to be immunized, Delta Airlines imposes a fee on workers for regular testing. The Province of Quebec has imposed a tax on those who are not vaccinated.
We have been living with COVID caused by variants of SARS-CoV-2 for twenty-three months and face the future prospect of viruses emerging that may express altered infectivity and pathogenicity. The level of incidence rates, hospitalizations and deaths in counties and communities in the U.S. is indirectly correlated with the proportion of immunized individuals in the population. This should confirm the value of vaccination, irrespective of political persuasion or response to misleading internet posts or talk-radio rhetoric.
The decision by the Administration to mandate vaccination was a ham-handed but sincere attempt to reduce the burden of the disease on our Nation. The end-run by OSHA was ill-advised and now determined to be illegal by SCOTUS. Notwithstanding the decision, epidemiologic evidence confirms the value of vaccination that is overwhelmingly beneficial in terms of public health and the economy. By mid-January 2020, 527 million doses of COVID vaccine have been administered, and 207 million or 63 percent of the population have received two doses. About 34 percent have received a ‘booster’ dose now regarded as “fully vaccinated”. On a state basis U.S. COVID vaccination rates range from 48 percent in Wyoming to 78 percent in Vermont. Of concern is that the three major egg-producing states range from 52 percent in Indiana to 60 percent in Iowa. Proportions of those vaccinated in rural counties where egg complexes are located are even lower than state averages, a situation that should concern producers.
It is hoped that vaccination rates will increase, contributing to a reduction in hospitalization and mortality. The U.S. has demonstrated considerable restraint in imposing restrictions on the unvaccinated compared to the EU. Newly elected Chancellor of Germany, Olaf Scholz stated, "we will not allow a tiny minority of unhinged extremists to impose its will on our entire society”. Germany has banned unvaccinated people from most areas of public life but has stopped short of a mandate. President Emmanuel Macron of France stated, "we really want to piss off the unvaccinated, we are going to keep doing it until the end, this is our strategy". Proof of vaccination is obligatory for most public and social activities in France. Austria has imposed a lockdown for the unvaccinated and is scheduled to introduce a vaccine mandate from February 1st. The non-vaccinated, devoid of certificates are progressively excluded from participating in society with the general approval of the majority of citizens in E.U. nations.
In the U.S. our strategy should be to encourage vaccination by demonstrating the health benefits supported by reliable statistics and coupled with reasonable, rational, practical and enforceable incentives and disincentives. The encouragement of family physicians, ministers, employers, educators at the local and county levels and endorsement by entertainment and sports personalities will do more to encourage the vaccine hesitant to be protected than federal mandates.