Mandate Minute Week 6

Members | December 23, 2021 | by Dee Pekruhn, Jill Schumann

LeadingAge Coronavirus Update Calls feature brief segments called “Mandate Minute” to promote the successful implementation of federal and state vaccination mandates for employees. We will cover developments in the news, research, and innovative practices that support our members in attaining high vaccination rates.

This Week’s Highlights:

Volume Ten: Air Date 12.20.21. “Regional Vaccine Mandates”

Boston and Philadelphia have joined New York City in setting new, restrictive vaccine mandates on employees and patrons of restaurants, gyms, and other entertainment venues.

Today, Boston’s Mayor Michelle Wu announced a sweeping vaccine mandate for all indoor entertainment venues, including restaurants, museums, and gyms. By January 15, all patrons and employees of such venues will have to present proof of vaccination to enter. City workers, who previously had the option of weekly testing if not vaccinated, will no longer have that option unless they have a medical or religious exemption. Right now, about one third of Bostonians are unvaccinated, so the hope is this new mandate will prompt people to get the shot.

Philadelphia instated a similar mandate last Monday; this applies to any establishment that sells food or drink for consumption onsite. (Notably, congregate care settings are exempted.) Philly’s mandate includes a two week ‘grace period’ between January 3 -17 when patrons or employees may still show proof of a negative test result. After that, however, all patrons and workers must show proof. Young children have until February 3rd to be fully vaccinated to be permitted in these venues. Mayor Jim Kenney said it was a compliment to the masking mandate that was established in the fall and cited rising infection and hospitalization rates as a reason for this new mandate. Children under 5, and people with documented religious or medical exemptions are the only people who may present a negative test result after January 17.

And New York City, which issued a vaccine mandate for entertainment venues on December 6, added to their requirements that all non-public school staff as well as private sector employees show proof of vaccination. And, Mayor DeBlasio hinted that the City is considering mandating booster shots in the future.

As with many other cities around the country, Boston, Philly and New York are all bracing for the predicted Omicron surge, tracking sharp rises in new infections, and hoping these mandates will ultimately save lives.

Volume Eleven: Air Date 12.15.21. “Mandate Perceptions”

What effect does the Omicron variant have on how vaccine mandates are being viewed?

While we are early in understanding the full story on Omicron, several patterns are emerging:

  1. It is highly transmissible and has gone from constituting about 13% of US cases on December 11 to 73% of new cases just 10 days later. Dr. James Lawler, co-executive director of the Global Center for Health Security at the University of Nebraska Medical Center says, “Based on the math, if you have to choose between a virus that is twice as transmissible and twice as lethal, you should always choose the virus that is twice as lethal. With each new generation of cases, the growth of the more transmissible virus is exponential, and the math catches up with you very quickly, with more severe outcomes.
  2. Preliminary research shows that most of the monoclonal antibody treatments will not be effective against the omicron variant - https://www.nature.com/articles/d41586-021-03829-0. When virologists saw that Omicron has a multitude of mutations concentrated on its spike protein, they feared what it would mean for these treatments. The outcome was even worse than they anticipated, says Olivier Schwartz, a co-author of one of the studies. “We didn’t expect to see such a shift in the antibodies’ effectiveness,” he says. There is one that appears to work, but it is in short supply.
  3. While two-dose Pfizer and Moderna vaccines seem to be only 30% effective in preventing cases, hospitalizations and death with the omicron variant, those who have received boosters are about 70% protected from severe illness and death. A recent study from the Africa Health Research Institute showed a 41-fold reduction in neutralization against Omicron compared to the Beta variant. The study may bolster the push by some medical experts to change the definition of fully vaccinated from 2 doses to California has just mandated booster shots for healthcare workers.
  4. With the current surge and the spread of the omicron variant, it is ever more likely that people will be required to show proof of vaccination to enter many businesses, entertainment venues, and countries. Because the CDC vaccine cards are so readily faked, three in five states have now thrown their weight behind the SMART Health Card, which has emerged as the vaccine verification standard in the United States.
  5. The first confirmed omicron variant death has occurred in Texas. The man who died was in his 50s, unvaccinated and had previously been infected with COVID-19, per a press release.

So what does all this mean for vaccine mandates? That is certainly far from clear at this point. A Kaiser Family Foundation poll published yesterday showed that About 87 percent of unvaccinated adults in the U.S. said news about the omicron coronavirus variant does not make them more likely to get the shots. But, increased transmissibility; reduced opportunity for monoclonal antibody treatments; increased likelihood of vaccine mandates by individual businesses and cities, along with improved verifiability; seem to point toward the benefit of having more people vaccinated and boosted.