Biden is pushing a new push for vaccinations, but experts say more is needed


Washington – Facing a sharp drop in Vaccination ratesPresident Biden said Tuesday that his administration will be sending people door to door, setting up workplace clinics and urging employers to offer paid time off as part of a renewed drive to reach tens of millions of unvaccinated Americans.

But top health experts say that simply isn’t enough, and that the president needs to take the potentially unpopular step of encouraging states, employers, colleges and universities to Vaccinations required In order to slow the spread of the coronavirus.

Instead, in a speech on Tuesday, Biden doubled down on the idea of ​​persuading people to get vaccinated — a voluntary approach that appears to have maxed out the large number of Americans who say they don’t intend to take the shot.

Please vaccinate now. It works. Mr. Biden said in brief remarks at the White House. “It has never been easier, and it has never been more important. Do it now for yourself and the people you care about, for your region, and for your country. It sounds cliched, but it is a patriotic act.”

Case numbers have risen in parts of the country Where vaccination rates remain low, which are fed by a highly contagious delta variable. This has alarmed some public health officials that the administration is not aggressive enough in launching what the president calls a “war effort” to ensure the protection of the US population.

“I try to restrain myself, but I kind of struggled with it,” said Kathleen Sebelius, who served as health secretary for five years under President Barack Obama. She said schools and businesses should be encouraged to order the vaccine. “You know, we’re going to be playing on our toes about mandates,” she said. “It’s like, ‘Come on. I’m kind of over it. I want to make sure the people I’m with don’t have it, so I’m not passing it on to my granddaughter.'”

But Biden’s options to be more aggressive are limited.

As president, he can commission members of the military to receive the vaccine – a move his administration has made refused to takeThis is partly because the drugs are still considered experimental under emergency permits granted by the Food and Drug Administration last year.

The Biden administration considered and rejected calls for federalism Vaccine passport, a move that some experts said would help contain the spread of the virus by allowing people to prove they have been vaccinated. And last month, management issued directive Federal agencies say they should not require employees to be vaccinated.

For the most part, the Power lies in the hands of statesAnd the The bosses or private institutions.

Dr. Ezekiel J. Emmanuel, professor of bioethics and health policy at the University of Pennsylvania, said it is unlikely the United States would be able to make major strides in the vaccination campaign without mandates.

“I would say the mandate is legal, ethical and effective,” he said. “Ultimately, workplaces will probably have to.”

In his speech, Mr. Biden said his administration has not given up on convincing people that vaccination is in their best interest and that of the country. But he did not mention the need for states, private companies, schools and other institutions to start asking people who are reluctant to get the vaccine.

Jen Psaki, the White House press secretary, admitted in remarks to reporters on Tuesday that some companies, schools, and other institutions have begun ordering vaccines. But she said the administration had no intention of encouraging them to do so.

“We’ll leave it to them to make those decisions,” Ms. Psaki said.

But others say the administration could be more aggressive.

Lawrence O’Justin, professor of global health law at Georgetown University, said that although the federal government’s power to enact states was limited, the Biden administration still had significant authority to recommend them. He said it could provide more funding for proof of vaccination systems and create incentives for colleges, universities and organizations to request that a vaccine be offered.

“Vaccine mandates have been very successful in the United States and globally, even in politically difficult situations, because they make vaccination the default option,” Mr. Justin said. “We have to make not vaccinating the hard choice, not the easy one.”

The debate comes as Biden and the United States face an uneasy moment days later Hard to miss 70 percent of adults are at least partially Vaccinated by July 4. By the end of the week, nearly 160 million Americans – not half the population – will be fully vaccinated. However, vaccination rates decreased from where they were in the spring, and some parts of the south And the Midwest continues to struggle to vaccinate their population.

Alabama He vaccinated only about 50 percent of the adult population; Mississippi It gave shots to only 46 percent of adults. At their current rates, it would take months to reach both countries Biden’s goal on July 4th. Louisiana and the Virgin Islands each vaccinated less than half of their population.

The numbers are down across the US: As of Tuesday, providers were administering about 0.87 million doses per day on average, down 74 percent from the peak of 3.38 million doses reported on April 13.

This reality prompted Mr. Biden to announce what he called a new push to increase the number of Americans being vaccinated.

All the steps he outlined in his address are methods his government has already taken: Door-to-door communication to vaccinate Americans; payment to provide vaccinations to primary care physicians; Strengthening efforts to provide vaccines to pediatricians and other providers who serve youth so that adolescents ages 12-18 can get vaccinated; Expanding mobile clinic efforts and workplace changes.

“Please get vaccinated,” Mr. Biden said on Tuesday. “It makes a huge difference.”

The question of whether pleading is sufficient is at the heart of what the government and private companies do next to try to slow the spread of the virus.

States have broad power over Vaccinations required, including among health care workers, although they generally do not have compulsory adult vaccinations or Covid vaccines.

All 50 states Requires certain vaccinations for children who attend school, but these authorizations only apply to vaccines that have been fully approved by the Food and Drug Administration, a state that coronavirus shots have yet to reach. Any government mandates for Covid vaccines will almost certainly allow students to opt out on medical, religious and sometimes philosophical reasons, Like they do in other childhood shots.

Several states were mandated to vaccinate schoolchildren for the first time in the 1960s, at the urging of the Centers for Disease Control and Prevention after the measles outbreak.

Dr. Emanuel said the idea of ​​requiring vaccinations as a condition of employment or status as a student could be a politically volatile idea, which could backfire on Mr Biden if he embraces it too forcefully.

He said that just wearing a mask has become highly politicized and has not included a new vaccine.

“You just have to be realistic about what’s possible,” said Dr. Emmanuel. “If the federal government did that, there would be a lot of backlash. It would be a political event. If the private industry did it, it would be like, ‘Okay, this is a private industry, that’s what we’re founded on.’

The Health Innovation Alliance, an alliance that supports the use of data and technology to improve outcomes, asked the White House this spring to set digital standards “Vaccine passports” – Apps that can check if a person has been vaccinated – but this batch has gained a bit of traction.

“The government is not now and we will not support a system that requires Americans to hold credentials,” Ms. Psaki said at the time. “There will be no federal database for immunizations and there will be no federal mandate requiring everyone to have a single certification document for immunization.

And when the White House hosted 1,000 military personnel and essential workers in Fourth of July Bash In the south garden on Sunday, No proof of vaccination was requiredTo the dismay of public health experts.

“There are so many toxic policies around Covid that they limit reasonable measures,” Dr. Tom Frieden, former director of the Centers for Disease Control and Prevention (CDC), said in an interview last week. “Obviously it makes sense to demand proof of vaccination in various places, but this has become a political concern.”

Studies have shown that many Americans are concerned about taking a new vaccine under a so-called emergency use authorization, considering the review system to be urgent. They are waiting for full FDA approval for the vaccine before taking it. newly Kaiser Family Foundation Survey It found that three out of 10 unvaccinated adults said they would be more likely to accept the vaccine if one was approved.

But approvals are considered unlikely until at least September, according to people familiar with the FDA’s review process. Regulators are already working on a review that typically takes at least 10 months in half the time or less.

Full approval will have a significant impact on how the public perceives the safety of vaccines, said Dr. Stephen Joffe, a bioethicist at the University of Pennsylvania, and will likely increase vaccination rates. In addition to making vaccinations more convenient, he said, Biden should use the platform to support more employer vaccine requirements.

“It would be a very good thing for the federal government to encourage that, and to set standards,” Dr. Joffe said. “The danger is when they start pushing things too hard, it’s entering a politically charged territory, regardless of its legality.”

Sheryl Jay Stolberg And the Sharon LaFranier Contribute to the preparation of reports.

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