Biden makes new push for Covid-19 vaccinations, but experts say more is needed
WASHINGTON (NYTIMES) – Faced with a steep decline in vaccination rates, President Joe Biden said on Tuesday (July 6) that his administration would send people door to door, set up clinics at workplaces and urge employers to offer paid time off as part of a renewed push to reach tens of millions of unvaccinated Americans.
But top health experts say that it is simply not enough, and that the president needs to take the potentially unpopular step of encouraging states, employers and colleges and universities to require vaccinations in order to slow the spread of the coronavirus.
Instead, in a speech on Tuesday, Mr Biden doubled down on the idea of coaxing people to get vaccinated – a voluntary approach that appears to have hit its limit for a large number of Americans who say they have no intention of taking the shot.
“Please get vaccinated now. It works. It’s free,” Mr Biden said in brief remarks at the White House. “It’s never been easier, and it’s never been more important. Do it now for yourself and the people you care about, for your neighbourhood, for your country. It sounds corny, but it’s a patriotic thing to do.”
Case numbers have gone up in parts of the country where vaccination rates remain low, fuelled by the highly contagious Delta variant. That has some public health officials worried that the administration is not being aggressive enough in waging what the president calls a “wartime effort” to ensure that the population of the United States is protected.
“I’m trying to restrain myself, but I’ve kind of had it,” said Ms Kathleen Sebelius, who was the health secretary for five years under president Barack Obama.
Schools and businesses should be encouraged to require the vaccine, she said. “You know, we’re going to tiptoe around mandates,” she said. “It’s like, come on. I’m kind of over that. I want to make sure that people I deal with don’t have it so I don’t transmit it to my granddaughter.”
But Mr Biden’s options to be more aggressive are limited.
As president, he can mandate that members of the military get the vaccine – a step that his administration has declined to take, in part because the drugs are still considered experimental under the emergency authorisations that the Food and Drug Administration granted last year.
The Biden administration considered and rejected calls to require a federal vaccine passport, a move that some experts said would help contain the spread of the virus by allowing people to prove that they have been inoculated. And last month, the administration issued guidance to federal agencies saying they should not require employees to be vaccinated.
For the most part, the power lies in the hands of states, employers or private institutions.
Dr Ezekiel Emanuel, a professor of bioethics and health policy at the University of Pennsylvania, said it was unlikely that the US could make significant strides in its vaccination campaign without mandates.
“I like to say a mandate is legal, ethical and efficacious,” he said. “Ultimately, workplaces are probably going to have to.”
In his speech, Mr Biden said his administration was not giving up on persuading people that vaccination was in their best interests, and in the interest of the country. But he made no mention of the need for states, private companies, schools and other institutions to begin requiring people who were reluctant to get vaccinated.
Ms Jen Psaki, the White House press secretary, acknowledged in comments to reporters on Tuesday that some companies, schools and other institutions were beginning to require vaccines. But she said the administration had no intention of encouraging them to do so.
“We’re going to leave it up to them to make these decisions,” Ms Psaki said.
The debate comes as Mr Biden and the US face a precarious moment days after narrowly missing his goal of having 70 per cent of adults at least partly vaccinated by July 4.
By the end of the week, nearly 160 million Americans – not quite half the population – will be fully vaccinated. But vaccination rates have plunged from where they were in the spring, and some parts of the South and the Midwest continue to struggle to inoculate their populations.
Alabama has vaccinated only about 50 per cent of its adult population; Mississippi has delivered shots to only 46 per cent of its adults. At their current rates, it would take months for both states to reach Mr Biden’s July 4 goal. Louisiana and the Virgin Islands have each vaccinated fewer than half of their populations.
Numbers were down across the US: As of Tuesday, providers were administering about 870,000 doses per day on average, a 74 per cent decrease from the peak of 3.38 million doses reported on April 13.
That reality prompted Mr Biden to announce what he called a renewed push to increase the number of vaccinated Americans.
States have broad authority to require vaccinations, including among health care workers, though they generally have not mandated vaccines for adults or for Covid-19 shots.
All 50 states require certain vaccines for children who attend school, but those mandates apply only to vaccines that have been fully approved by the FDA, a status the coronavirus shots have not yet reached. Any state mandates for Covid-19 vaccines would almost certainly allow students to opt out for medical, religious and sometimes philosophical reasons, as they do for other childhood shots.
“There is so much toxic politics around Covid that it’s constraining sensible action,” Dr Tom Frieden, a former CDC director, said in an interview last week. “Obviously it makes sense to require proof of vaccination in various settings, but that has become a political lightning rod.”
Studies have shown that many Americans are anxious about taking a new vaccine under so-called emergency use authorisation, seeing the review system as rushed. They are waiting for the FDA to fully approve a vaccine before taking it. A recent Kaiser Family Foundation survey found that three in 10 unvaccinated adults said they would be more likely to accept a vaccine if one were to be approved.
But approvals are considered unlikely until at least September, according to people familiar with the FDA review process. Regulators are already working to conduct a review that typically takes at least 10 months in half the time or less.
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