Despite the widespread availability of COVID-19 vaccines to health care workers in the United States, there still appears to be a stubborn resistance to getting them among nursing home staff. And unfortunately, that resistance has proved to be fatal: According to a recent study by the CDC, a nursing home in Kentucky experienced a COVID outbreak when an unvaccinated worker triggered a string of infections among residents and staff. And though most residents had been inoculated, the virus still managed to spread its way through the home — disproportionately infecting unvaccinated people — and three residents wound up dead.
What’s alarming is that health care professionals are not the only workers in high-risk conditions who have been reluctant to get the vaccine. Correctional officers have also been slow to get the vaccine despite being eligible since the start of the year. As of February, for example, more than half of workers in Massachusetts’ Department of Correction had refused the vaccine, even though prisons have been vectors for the disease. Other state employees who regularly interact with the public have also shown signs of hesitancy: As of last month, 30 percent of State Police had not been vaccinated at department-run sites, indicating that many of them have yet to be vaccinated.
Numbers like these are a serious public health risk. While the United States now has ample supply of COVID-19 vaccines, the next hurdle in reaching herd immunity — which Dr. Anthony Fauci has estimated might require up to 90 percent of the population to be immune to the virus — is convincing enough people to actually get the shot. That target is still far away: even though Massachusetts has one of the highest vaccination rates in the country, still only about 35 percent of its residents are fully vaccinated. That’s why some employers, both public and private, must start mandating the COVID-19 vaccine. Not doing so could prolong the pandemic indefinitely, and make the return to normalcy seem more like a mirage than a soon-to-be reality.
The first employers that should jump in to help reach herd immunity are those whose work focuses on serving the public. According to Ezekiel J. Emanuel, a professor of medical ethics and health policy at the University of Pennsylvania, that means starting with health care workers. “Health care workers, and anyone in the health care industry, take a pledge of, ‘My patient first. I am here to promote the health of patients,’” Emanuel said. Allowing workers to remain unvaccinated would only undermine that pledge.
Employers have the authority to mandate vaccines for their workers, except in cases where an employee has a medical exemption or if a vaccine might conflict with their religious beliefs. And though there’s a question of whether or not federal law allows employers to mandate vaccines that are under Emergency Use Authorization, the Centers for Disease Control and Prevention has issued guidance that such mandates are a matter of state law. “Many health care facilities have required their workers to get a flu vaccine before. Why is the flu vaccine in that context different from COVID?” Emanuel said. “If anything, we ought to be mandating COVID [vaccines] because it’s a much more deadly disease.”
Massachusetts Attorney General Maura Healey has argued that the state should also start requiring some of its workers, particularly correctional officers and State Police, to get the vaccine — a step that Governor Baker has so far been reluctant to take. “While existing law allows for businesses and institutions to have their own vaccine requirements, the Biden-Harris Administration has made clear there will be no federal requirement for a vaccine credential and the Commonwealth will remain focused on administering vaccines as quickly as possible,” the governor’s office said in a statement to the Globe Editorial Board. But mandating vaccines for state employees who not only interact with the public but also work in high-risk conditions, such as prisons, is a matter of public safety. And the more states that follow, the sooner Americans reach herd immunity.
For their part, many colleges and universities across the country are moving to require that all of their students receive their shots before the fall semester. The move could significantly boost vaccination rates among young people, who have been getting infected and hospitalized at higher rates than before. And though many schools in Massachusetts — including every school that is part of the state university system — have mandated vaccinations for students, they could go one step further and require that their staff, who will be regularly interacting with people, get vaccinated too.
Requiring anyone to undergo a medical procedure, even one as low-risk as a vaccination shot, is rare — and appropriately so. In general, the presumption should always be that people have autonomy over their own bodies. But requiring people to take vaccines that have been shown to be overwhelmingly safe is responsible and certainly ethical public health policy if they have the potential to save the lives of not just those who take them but the people around them as well. And given the extreme circumstances of the pandemic, and the deadly consequences if too few Americans get the vaccine, such a step would be justified.
With the coronavirus receding in much of the United States, it’s easy to start thinking about COVID in the past. But the country is still very much in the midst of a pandemic, and over 700 infected Americans are still dying every day. The COVID vaccines, which are extremely safe and effective, are Americans’ way out of this nightmare, and employers — including the state — owe it to their workers and the public to create safe working conditions. And they should act quickly. As the case in the Kentucky nursing home showed, vaccine mandates are a matter of life and death.
Editorials represent the views of the Boston Globe Editorial Board. Follow us on Twitter at @GlobeOpinion.