By Marie Rosenthal, MS
President Joe Biden took sweeping action on Sept. 9 to get the 80 million American holdouts vaccinated against COVID-19.
He signed an executive order mandating that all executive branch federal employees be vaccinated, as well as mandating that all federal contractors and subcontractors make sure their employees are vaccinated against COVID-19.
In addition, he expanded his requirement that all nursing home employees who treat Medicare and Medicaid patients be vaccinated to include all health care workers who work in hospitals, home health care or other medical facilities that accept Medicare and Medicaid patients. “If you are seeking care at a health facility, you should be able to know that the people treating you are vaccinated. Simple. Straightforward. Period,” he said.
The Society for Healthcare Epidemiology of America, which recently published a consensus statement in support of requiring health care workers to be vaccinated against COVID-19, supported this expanded requirement for COVID-19 vaccination "to protect them and their patients from the COVID-19 virus and the even more contagious Delta variant.“Vaccines continue to be the most effective and scientifically proven way to protect patients, staff, and visitors in the healthcare setting,” said Mary Hayden, MD, the president of the SHEA Board of Trustees.
“Vaccination reduces the risk of transmission among healthcare personnel, patients, and communities. When we developed the multi-society statement, we knew that now was the time to act collectively and make a difference,” added David Weber, MD, member of the SHEA Board of Trustees and lead author of the SHEA vaccination as a condition of employment statement.
But the president is not stopping with health care workers or federal employees, he ordered the Department of Labor to develop an emergency rule requiring all employers with 100 or more employees to ensure their workforces are fully vaccinated or provide a negative COVID-19 test at least once a week. In addition, employers will be required to provide paid time off for employees to get vaccinated or to take a family member to be vaccinated. He named several companies that are already requiring vaccination for its employees, including United Airlines, Disney, Tyson Foods and Fox News.
“We are going to protect vaccinated workers from unvaccinated coworkers. We are going to reduce the spread of COVID-19 by increasing the share of the workforce that is vaccinated in businesses all across America,” he said.
“This is not about freedom or personal choice,” he said. “It’s about protecting yourself and those around you, the people you work with, the people you care about, the people you love. My job as president is to protect all Americans.”
Although 75% of eligible Americans have had at least one vaccination against COVID-19, the remaining 25% are causing “a lot of damage,” he said.
“The vast majority of Americans are doing the right thing. Three-quarters of the eligible have gotten at least one shot, but one-quarter has not gotten any [vaccine]—that's nearly 80 million Americans that are not vaccinated,” President Biden said.
As hospital ICUs are again running above capacity, he reminded the country that these hospitalized patients are mostly unvaccinated: “Only one out of every 160,000 fully vaccinated Americans are hospitalized for COVID-19,” he said.
Progress has been made, he noted. In January, more than 25,000 Americans were dying of COVID-19 every week. That figure is down 70%, even with the latest surge; only about 2 million Americans were fully vaccinated, now more than 175 million Americans are protected; and America has gone back to work, he said. So, it is important to protect this workforce.
Although this is real progress, “we’re in a tough stretch, and it could last for a while because of the highly contagious delta variant.”
The Infectious Diseases Society of America issued a statement supporting the multipronged approach to boosting vaccination rates. "Vaccination is our way out of this pandemic," said IDSA President Barbara D. Alexander, MD, MHS, FIDSA, reiterating that most hospitalizations are among unvaccinated individuals.
“With COVID-19 cases on the rise and health systems stretched to capacity, it is imperative to public health and safety that eligible people get vaccinated. Strategies like employer vaccination mandates, especially for health care personnel, and paid time off will help increase vaccination rates by increasing urgency and making vaccines more accessible."
The president said it is imperative that steps be taken to assure that children returning to in-person learning will be safe in the classroom, and he urged parents to make sure they and their children who are ages 12 and older are vaccinated to protect younger children. “Almost all the serious COVID-19 cases we’re seeing among adolescents are in unvaccinated 12- to 17-year-olds,” he said, adding that studies are still being conducted concerning the safety of vaccinating younger children.
“We know that if schools follow the science and implement the safety measures, like testing, masking, adequate ventilation assistance, if you provided the money for social distancing and vaccinations, then children can be safe from COVID-19 in schools today. About 90% of school staff and teachers are vaccinated. We should get that to 100%,” he said.
President Biden said all of the nearly 300,000 educators in federal programs, such as Head Start, will be required to be vaccinated and called on “all governors to require vaccination for all teachers and staff.”
Local officials who are undermining school district efforts to protect children, by overruling masking and other requirements, will face a showdown with the Department of Education, which is taking legal action against states that are threatening teachers’ and school officials’ salaries if they mandate masking, social distancing and other protective measures. “We will have that pay restored by the federal government—100%. I promise you I will have your back.”
He took steps to make testing “more available, more affordable and more convenient” by increasing the number of rapid free tests and by arranging for at-home tests to be sold at cost in certain stores, such as Wal-Mart, Amazon and Kroger’s. In addition, he increased the amount that small businesses impacted by COVID-19 can borrow, and increased the number of people working in surge response teams. These are teams comprised of experts from the federal government who are responding to areas that are overwhelmed by the surge.
The president also purchased more vaccine doses in case the CDC and FDA decide that boosters will be needed for vaccinated individuals. He said his scientific advisors “believe the booster is likely to provide the highest level of protection. The decision of which booster shots to give, when to start them and who will give them will be left completely to the scientists at the FDA and the Centers for Disease Control [and Prevention].
“While we wait, we’ve done our part; we bought enough booster shots, and the distribution system is ready to administer them,” he said.
In the meantime, he urged those 80 million eligible Americans to get vaccinated. “My message to unvaccinated Americans is this: What more is there to wait for? What more do you need to see? We’ve made vaccinations free, safe and convenient. The vaccine [Comirnaty, Pfizer-BioNTech] has FDA approval. Over 200 million Americans have gotten at least one shot. We’ve been patient, but our patience is wearing thin and your refusal has cost all of us,” he said.
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