As President Biden promised that 90% of American adults would be vaccine-eligible by April 19 and be within five miles of a vaccination site, a return to normalcy appears on the horizon. With vaccine availability increasing, some have asked legal and ethical questions about mandatory vaccinations for people to return to work, travel, school, etc. These questions are likely to stir public interest as Americans itch for reopening and find optimism in reports that the Moderna and the Pfizer-BioNTech COVID-19 vaccine were reported to have an efficacy rate of over 90%. Suppose a large percentage of Americans were to refuse the vaccine, the government may look for ways to push the population toward herd immunity.
One idea that has emerged recently is “vaccine passports,” which would allow those inoculated from COVID-19 to move more freely by carrying around vaccination documentation. Republican legislators such as Jim Jordan (R-OH) criticized the vaccine passport and brought attention to the Biden administration’s handling of the southern border. Rep. Lauren Boebert (R-CO) called vaccine passports “unconstitutional. Period.” White House Press Secretary Jen Psaki said the Biden administration is working on making guidelines for the private sector to follow rather than supporting vaccine passports. Psaki also promised that “there will be no centralized, universal federal vaccinations database and no federal mandate requiring everyone to obtain a single vaccination credential.”
While the uproar over potential mandatory COVID-19 vaccinations is new, the concept of compulsory vaccines is not. For many years, every state has mandated that parents vaccinate their kids against diseases like polio and measles to attend public school. Mandatory vaccines to participate in public schools are an efficient way to get to herd immunity due to large enrollment numbers. This method not only creates herd immunity but also reduces medical costs by preventing potential outbreaks. For example, the 1989-1991 measles outbreak cost $100 million. Nevertheless, some mandates have exceptions, such as religious and philosophical exemptions. If these exemptions are used extensively, herd immunity can be compromised, creating outbreaks of previously eradicated diseases like measles.
Religious exemptions to mandatory vaccinations have been challenged in court. The U.S. Supreme Court ruled that a state’s prerogative to promote public health can outweigh a person’s right to exercise their religion freely. That is to say, a person’s right to exercise their faith does not overrule a child’s right to live free from infectious disease. Eighteen states allow philosophical exemption from vaccines, allowing people to check a box on a form to obtain an exemption from vaccination. Disease “hot spots” sometimes arise in communities in which vaccine exemptions are common. This is especially problematic in religious communities in which few, if any, of the community members are vaccinated. However, not all people who claim religious or philosophical exemptions hold the convictions necessary to obtain an exemption. Because herd immunity is a collective effort, some parents decide to coast off the group’s herd immunity while not bearing any individual burden by vaccinating their children.
A return to in-person learning at schools has been met with demands from teacher unions that doses be set aside for teachers first. For example, in Massachusetts, teachers' unions pushed for a delay for in-person learning so more teachers could get vaccinated before returning to in-person work. Massachusetts Governor Charlie Baker's administration expressed frustrations with teachers' unions, claiming that diverting the vaccine supply to educators was a selfish move on the unions and would deny the shots to vulnerable people.
The debate over the ethics and legality of mandatory vaccines will continue to rage over the coming months. This vaccine tug-of-war takes place as governments try to balance public health with unions' demands and special interests. Past court rulings have shown the legality of mandating vaccines at places such as public schools. There is no reason to believe private businesses cannot make their own decisions regarding mandatory vaccines before returning to work. The ethics of the situation are more debatable as civil liberties concerns about the state's power to enforce a shot are balanced against the state's prerogative to promote public health through mandatory vaccinations.