Who can require you to get a Covid vaccination?

Analysis by Zachary B. Wolf, CNN

Most Americans can and will get vaccinated. Full stop.

The stragglers will be key to stopping Covid, however, and what exactly the government can do to encourage and cajole anti-vax Americans is coming soon.

The overall numbers aren’t perfect, but they are very good. While the US will miss President Joe Biden’s goal of 70% of eligible Americans being vaccinated by July 4, most of the country has bought into the vaccine.

• More than 87% of Americans over 65 have started the process and 77% are fully vaccinated.
• More than 65% of the Americans over 18 have started the process and 56% are fully vaccinated.
• More than 62% of the population over 12 have started the process.
• More than half the total population (53.7%) has started the process and 45.6% is fully vaccinated.

There are anomalies among states (states with lower vaccination rates tend to be more Republican) and within states. But other countries couldn’t dream of those numbers.

The question is when will enough get vaccinated to protect the country.

And that will take some pushing and prodding, particularly with younger Americans.

I read one CNN report that quoted Lori Tremmel Freeman, the CEO of the National Association of County and City Health Officials, about the difficulty of getting young people in particular to get the shot.

“The trouble is they feel like they are invincible and that makes them a tough group to reach,” she said. The next line of the story is that she hasn’t been able to get her own children vaccinated.

“I’m still working on them and I shame them every day,” she jokes.

If you isolate to just Americans under 30 and assume recent vaccination rates, only 57.5% of people under the age of 30 will have received at least one dose of Covid-19 vaccine by the end of August, according to one projection.

Carrots to get vaccines. We’re all familiar with the freebies, the raffles, the lotteries and the other come-ons the government and companies have hatched to get the disinterested and the disaffected to roll up their sleeves.

Things are starting to get more direct. As in, if you don’t get the vaccine, you can’t study or work here.

Sticks for the unvaccinated. As one CNN report suggests, “What ultimately may speed efforts with this age group is college. More than 500 universities and colleges are requiring students to get the Covid-19 vaccine before they come back to class, according to a tally kept by The Chronicle of Higher Education.”

But not all students are having it. In one much-watched case, eight students at Indiana University have gone to federal court to challenging the school’s requirement that students get vaccinated before starting the fall term.

The school eased around state law by requiring vaccination, but not documentation of the vaccination. The students argue that’s beside the point.

“They’re suing because they’re being stripped of their constitutional rights to make medical treatment decisions for themselves and to protect their own bodily integrity. After all, they are adults and they would like to weigh the risks and consequences of taking the vaccination or getting Covid,” James Bopp Jr., lead attorney for the plaintiffs, told CNN’s Ana Cabrera.

One interesting question courts could answer is whether state universities — congregation points for that young, unvaccinated cohort — are arms of the state.

A federal judge rejected a suit brought by more than 100 employees against Houston Methodist Hospital, which required employees to get vaccinated to keep their jobs. The employees have appealed the decision.

It’s obviously important to track these lawsuits, but it’s also important to recognize the scale of discontent, which actually seems quite small.

It’s a less-than 1% problem. From CNN’s report: Houston Methodist CEO Marc Boom said earlier this month that 24,947 employees were fully vaccinated… On Tuesday, a hospital spokesperson said 153 employees either resigned during a two-week suspension period that began June 8 or were terminated this week.

LaTricia Blank, an ultrasound technologist, is one of the fired employees. She argued to CNN’s Erin Burnett that the three vaccines used in the US have gotten only emergency use approval from the FDA and she worries that they went through a rushed process.

“You’re not going to turn away a patient and give them care if they don’t have a vaccine. Don’t take away my choice,” she said.

There’s no question companies have the ability to employ only vaccinated people after a decision in December by the federal Equal Employment Opportunity Commission, which made clear companies can legally mandate that all employees re-entering the workplace and new hires be vaccinated for Covid-19. Exceptions must be allowed for disabilities and religious reasons. More on that here.

RELATED: Morgan Stanley, Goldman Sachs, require vaccines for return to in-person work.

116 year-old precedent: States can mandate vaccines. It’s not clear how long or even if these questions will make it to the US Supreme Court, but it’s notable the court’s most important vaccine mandate story dates back to 1905, when the city of Cambridge, Massachusetts, levied a $5 fine on people who refused to get smallpox shots.

Pastor Henning Jacobson sued in 1902, arguing “compulsion to introduce disease into a healthy system (the vaccine) is a violation of liberty.”

That sounds exactly like the students in Indiana today.

It took three years before the Supreme Court decided in 1905, in the words of Justice John Marshall Harlan, “upon the principle of self-defense, of paramount necessity, a community has the right to protect itself against an epidemic of disease which threatens the safety of its members.” Read more at the National Constitution Center.

Courts take forever. That key Supreme Court decision was handed down a year before the US Food and Drug Administration, which approves drugs today, was founded in 1906. Things have changed in 116 years!

A US Appeals court in Texas cited that Jacobson case when it ruled earlier in the pandemic that states could temporarily halt abortions.

Life and liberty. The difference today could be the many US states, under Republican governors, passing laws that defer to liberty over public safety when it comes to vaccines.

There will certainly be two tracks for Americans, where the vaccinated have more freedom than the anti-vaxed. As CNN Travel notes, Disney parks in the US are are slowly easing their Covid-19 protocols. Face masks are now optional in most areas for guests of the California and Florida parks who are fully vaccinated.

In the US, it’s the honor system. Traveling to Europe is another story.

Everyone is making a choice about their own vaccination. But those choices have consequences, particularly as the more-contagious Delta variant spreads through the country.

Outbreaks still happen. The concern is that the variants slip between vaccination holes. According to one CNN report: Even if 75% of eligible Americans were vaccinated, a Delta-like variant could result in Covid-19 bouncing back from summer lows to cause more than 3,000 deaths per week in the US at various points during the fall and winter, a recent research model showed.

Proof of this is in recent oubreaks at a Florida government office, where two people died, and in a Wyoming County gearing up for a rodeo.

How outbreaks happen today. We’re learning more about that Florida office outbreak, which is thought to have begun with an IT worker and then “spread to four coworkers in the department, who were unvaccinated and unmasked. But another coworker who had direct contact and exposure to patient zero was not infected, because he was vaccinated.”

One victim’s wife said they had both considered getting the vaccine but were still concerned about things they felt were unknown.

“We were just researching and trying to follow up about the vaccine, we just wasn’t ready yet,” she said.

The guilt tactic: Every new death is preventable. That was the case US Centers for Disease Control and Prevention Director Dr. Rochelle Walensky made Tuesday at a White House briefing. Vaccines, she argued, “are nearly 100% effective against severe disease and death — meaning nearly every death due to Covid-19 is particularly tragic, because nearly every death, especially among adults, due to Covid-19 is at this point entirely preventable.”

We’re going to be talking about these vaccines for a long time. Boosters are likely going to be necessary, for instance, in the coming years. There are new vaccines coming online that may be just as effective and potentially less controversial.

There’s still the very real question of when kids under 12 will be given the vaccine as the medical community considers rare instances of heart inflammation (less than one in a million) among adolescents who have gotten it. The inflammation cases appeared to be mild, and they resolved quickly.

Meantime, the government will try to get as many Americans vaccinated as possible.

The-CNN-Wire
™ & © 2021 Cable News Network, Inc., a WarnerMedia Company. All rights reserved.