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The Ever-Changing Vaccine Landscape in the US

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Vaccine mandates are interestingly nothing new for the US. In the 1777 Revolutionary War, George Washington mandated smallpox vaccines for American soldiers. By 1809, mandatory vaccinations started in several states by law, for those over 21. By 1905, the US Supreme Court upheld the authority of states to enforce mandates, and the rest is history.

It’s 2021, and the US Supreme Court is yet again deciding upon such a case. On December 22, the court announced that it will hear arguments in two cases that challenge the current mandates, one regarding The Department of Labor’s Occupational Safety and Health Administration (OSHA) ETS rule for private employers, and other that concerns the vaccine mandates of Centers of Medicare and Medicaid Services (CMS) for certain healthcare facilities. These arguments will be heard on January 07, 2022.

Till then, millions of workers in the US and their livelihoods hang in the balance. The vaccine landscape in the US is in a state of flux, both for businesses and the healthcare sector. All stakeholders (businesses, healthcare facilities, and health systems) need to stay abreast of the current laws about vaccines at their workplace. Especially, since there has been a strong rise in positive cases owing to the Omicron variant in the US. Here’s what is known so far.

The OSHA and CMS guidelines 

Since President Biden took the oath, a strong vaccination policy has been his primary agenda to revive the US economy. In September he announced that all employers with 100 or more workers (covering almost 84 million workers) had to make sure that the employees were vaccinated or had a weekly Covid-19 test. The Department of Labor’s Occupational Safety and Health Administration (OSHA) enforces this law continuously, and in November issued an Emergency Temporary Standard (ETS) to impose this mandate. Over 70% of Americans were vaccinated against Covid by November 04, 2021, up from less than 1% in January when the President took office. 

On November 05, the same day that OSHA declared this law, the CMS also announced a rule that required healthcare providers in various settings, who receive federal Medicare or Medicaid funding to get their first doses within November, and to be fully vaccinated by January 04, 2022. This rule impacts over 17 million workers in healthcare facilities, and home healthcare providers. 

Since then, these laws have been challenged in multiple courts in various states, by state governments and business groups. The result has been contradictory rulings in several circuit courts and federal district courts. For instance, a Sixth US Circuit Court of Appeals in Cincinnati on December 18, 2021, reinstated the OSHA mandate, reversing the decision of a federal judge in a different court.

On December 28, 2021, the CMS reversed its position to begin enforcing the mandate in various states where it is not currently judicially enjoined. These 25 states, including Connecticut, Florida, Maine, Colorado, Massachusetts, and more, are covered under this law, where healthcare service providers must receive at least one dose by January 27, 2022. So, the vaccine mandate is now blocked in some states, and not in others.

Thus the Supreme Court steps in

The Supreme Court is now intervening to give the final word on these rules which have vexed employers and workers for months now. The hearing might not lead to putting a stay on these mandates unless the court takes fast steps to reverse the 6th Circuit ruling and expands the 5th and 8th Circuit’s injunctions to all states.

For those confused about the latter 2 cases, here’s the background. The New Orleans-based 5th US Circuit Court of appeals, applied a preliminary injunction for 14 states, reversing the decision of an earlier federal district judge’s ruling to apply the CMS rule nationwide. Similarly, the St Louis-based 8th US Circuit Court of Appeals had applied this injunction to 10 additional states.

Now, the US Government might be pushed to consider vaccine mandates for travelers on domestic flights, which might again incur opposition from the travel industry.

Vaccines are a contentious topic right now. While vaccines are much necessary to protect lives and spur economic activities, such inconsistencies could put public health in jeopardy. Healthcare compliance software can help institutions to navigate this ever-changing landscape, by staying abreast of current laws and regulations regarding vaccine mandates at workplaces and helping them stay compliant.

Robert Haynes did his degree in psychology at the University of Hertfordshire. He is interested in mental health and well-being.

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