As 2021 ends, the COVID-19 virus is still infecting thousands of people in the country each day. Although the summer provided a brief respite from the virus—with case counts dropping significantly in the wake of the vaccine rollout—the emergence of the Delta variant saw case counts and deaths spike, leading to increased restrictions and mandates. The Delta variant is easily transmissible, especially through regional pockets of unvaccinated areas, which accounted for the surge in cases in the country over the last few months[1]. However, it seems that the Delta variant is subsiding as well; COVID-19 cases in the United States have decreased by 50% in the last month, and the 7-day average of COVID-19 cases is under 80,000—its lowest point since the summer months[2].
Now that cases are decreasing and vaccination rates are steadily rising, there is reason to think that the worst of the pandemic might be over. On this issue, there are two schools of thought. One says that the upcoming winter, with colder weather driving people to congregate indoors, will increase the spread of the virus. The other says that there is no external factor that impacts the spread of the virus and that its spread is cyclical, meaning that we are currently experiencing the downturn of the current cycle[3]. Only time will tell how the COVID-19 pandemic will develop through this winter, but for now, government leaders are attempting to use all the tools in their possession to mitigate the effects of the virus, including approving vaccine booster shots and implementing vaccine mandates.
COVID-19 Vaccine Booster Shots
Almost immediately after the initial COVID-19 vaccines were approved, discussion began about federal approval for booster shots, which would ensure that the immunity provided by the vaccine would last longer. After a months-long approval process for booster shots, the Food and Drug Administration (FDA) recently concluded that recipients of the Pfizer, Moderna, and Johnson & Johnson vaccines are eligible for booster shots. The Pfizer booster shots were approved in late September, while the Moderna and Johnson & Johnson booster shots were approved last week; however, the exact details of the approved populations varies between vaccines.
The Pfizer and Moderna booster shots are approved for individuals 65 years or older, as well as those younger than 65 who are at high risk of contracting COVID-19. The Johnson & Johnson booster shots are approved for all recipients of the vaccine older than 18. The FDA also approved a “mix and match” approach to boosters, which allows recipients of the Johnson & Johnson vaccine to get Pfizer or Moderna booster shots. A study found that recipients of the Johnson & Johnson vaccine who received a Moderna booster saw their antibody levels increase much more than those who received a Johnson & Johnson vaccine booster shot—though the researchers who undertook this study cautioned that there was no combination of vaccines that was the most optimal, and any vaccine booster shot is sufficient for those who received the Johnson & Johnson vaccine.
The adoption of the “mix and match” booster shot strategy ensures that people do not need to worry about which vaccine they receive for a follow up dose, which might otherwise have been an obstacle for individuals getting their booster shots. Additionally, for Johnson & Johnson vaccine recipients, this strategy allows them the greatest amount of flexibility in bolstering their COVID-19 immunity[4]. Full approval for Moderna and Pfizer vaccine recipients is sure to follow soon, and in communicating this to the public, it will be important for government leaders to avoid confusion about who is eligible for what booster shots and when. As we reported previously, the COVID-19 pandemic has shown the risks of public confusion about population health issues.
Vaccine Mandates
As the threat of COVID-19 variants looms, government officials have employed different methods to incentivize individuals to get vaccinated. At both the state and the federal level, mandates have been implemented to increase vaccination rates among certain populations.
In September, the Biden administration announced that all employers with more than 100 employees will be required to either mandate vaccination for their employees or mandate them to test weekly for COVID-19. Additionally, people who work for Medicare, Medicaid, or the federal government, as well as contractors who do business with the federal government, will be required to be vaccinated[5]. This set of mandates affects millions of people, and as such is a very effective method for the federal government to ensure widespread vaccination rates.
To supplement the federal vaccine mandate, different states have implemented their own vaccine mandates. Certain cities, such as New York City, San Francisco and Los Angeles, have implemented the most restrictive mandates, using digital passes to restrict entry to certain indoor venues without proof of vaccination. There are also less restrictive mandates at a statewide level, such as in New Jersey, Virginia and Michigan, which have created digital vaccine record-storing platforms that certain businesses can utilize if they wish.
However, many states—including Alabama, Florida, and Texas—have gone in the opposite direction, enacting laws that ban any type of vaccine mandate, or digital “vaccine passports” like those that exist in New York or San Francisco. Additionally, many states have enacted laws fining business entities that try to enforce vaccine requirements. These polarized approaches leave the country at a crossroads, and the direction in which the consensus shifts will likely have a major impact on vaccination rates and the overall trajectory of the pandemic in the United States.
For more information about the various federal proposals regarding vaccine mandates, click here.
Footnotes
[1] https://www.cnn.com/2021/10/13/health/us-coronavirus-wednesday/index.html
[2] https://www.nytimes.com/interactive/2021/us/covid-cases.html
[3] https://www.nytimes.com/2021/10/14/health/coronavirus-delta-surge.html
[4] https://www.nytimes.com/2021/10/27/well/live/covid-booster-shot-mix-and-match.html
[5] https://apnews.com/article/joe-biden-business-health-coronavirus-pandemic-executive-branch-18fb12993f05be13bf760946a6fb89be
