Is It Time to Mandate COVID-19 Vaccination?

As COVID vaccination rates stall, and the Delta variant spreads across the U.S., the Biden administration announced in early July that it will implement several strategies to encourage more people to get vaccinated.

By providing more vaccine doses to family doctors and healthcare providers, the administration hopes to improve accessibility to unvaccinated individuals and increase uptake among adolescents ages 12 to 18.

The administration will also dispatch more mobile clinics and team up with employers to make COVID vaccines more easily available by meeting people where they are.

"Any and all efforts to promote vaccination and continue to combat the pandemic are essential," Arjun Venkatesh, MD, MBA, chief of administration in the department of emergency medicine at Yale Medicine, tells Verywell.

However, localized efforts may not be enough. Many experts say that vaccine mandates should come into play to convince unvaccinated individuals to get the shots.

Are Vaccine Mandates New?

Even before the COVID pandemic, states and institutions have required people to get certain vaccinations to minimize the spread of vaccine-preventable diseases.

For example, the idea of mandating vaccination before allowing a student to enroll or an employee to return to work is far from uncommon.

“While vaccine mandates are receiving substantial attention recently, they are neither uncommon nor new to most of us,” Venkatesh says. “Many people have attended schools requiring vaccination, worked in a variety of industries requiring vaccinations or even traveled abroad to countries that require vaccination.”

The chickenpox (varicella), hepatitis A and B, polio (IPV), and measles, mumps, rubella (MMR) vaccines are recommended for school-age children in the United States. However, the exact vaccination requirements and allowable exemptions for a child's entry to daycare and schools vary by state.

“Without any federal or state intervention, many universities and companies have already begun to set vaccine mandate deadlines alongside exceptions for individuals with specific medical conditions or spiritual concerns,” Venkatesh says.

However, some states have banned educational institutions from requiring students to show proof of COVID-19 vaccination before they are allowed to attend in-person classes.

Can Employers Establish Vaccine Mandates?

Currently, none of the COVID-19 vaccines have full approval from the Food and Drug Administration (FDA). Mandating vaccines that operate under an Emergency Use Authorization (EUA) comes with some challenges. However, if there is a need for employees to be vaccinated, employers do have the authority to mandate vaccines.

“Employers could mandate vaccines on their own, particularly if those employers work directly with and/or provide crucial services to the public,” Melva Thompson-Robinson, DrPH, executive director of the Center for Health Disparities Research at the University of Nevada, Las Vegas, tells Verywell. “For example, some hospitals are mandating the vaccine for their staff.”

Employers can reduce their risk of running into legal problems by incentivizing employees to get vaccinated instead of mandating it. However, an incentive cannot be so big that it could be seen as coercive.

“If all other channels of communication and incentivizing have failed or enough of the entire population gets vaccinated, then mandates may have to come into play if COVID-19 and its variants continue to spread at such an alarming pace,” Thompson-Robinson says.

Many institutions have already started mandating COVID-19 vaccinations for their employees and staff. Experts say that the practice is likely to become increasingly common as more employers try to ensure their employees’ safety, as well as once the vaccines gain full FDA approval.

“As more universities, schools, and employers mandate vaccination other organizations are more likely to follow their lead,” Venkatesh says. “Ultimately, mandates may be so commonplace that debates and controversies that are around today become background issues just as other COVID topics such as employer testing requirements and travel requirements.”

Vaccination Barriers Won't Be Fixed by Mandates 

Mandates and existing community outreach efforts may help increase vaccination rates, but experts say that these strategies alone will not adequately address the barriers to vaccination many people are still facing.

“We know that gaps in vaccination are complicated and not solely due to hesitancy or reluctance, but also often due to poor access or other real and perceived barriers,” Venkatesh says. “While vaccine mandates may encourage many individuals to get vaccinated, they will not serve as a panacea capable of broadly expanding vaccination rates around the country.”

The lack of vaccine accessibility and availability are major factors that hinder vaccination uptake, but it’s not the only reason preventing some Americans from getting their shot. In addition, vaccine mandates at educational institutions or workplaces may not be effective in reaching vulnerable populations who aren’t studying or working.

“Vaccination mandates cannot solve ubiquitous challenges in vaccine access including transportation difficulties, language barriers, perceived financial costs of vaccination, and misconceptions regarding vaccine safety,” Venkatesh says. "Furthermore, among select populations, vaccine mandates could hinder vaccination by stigmatizing or targeting groups in whom vaccine reluctance is grounded in historical mistrust of the healthcare system, vaccines or even the government.”

A lack of understanding about how vaccines work also contributes to vaccine hesitancy, which mandates won’t necessarily tackle. Thompson-Robinson says that not having full FDA approval for the COVID-19 vaccines can affect the public’s understanding of how important they are.

“As vaccine mandates become more prevalent, existing and new efforts to engage individuals with personally tailored information and messages as well as improving access to vaccinations will continue to remain a cornerstone to both national and local efforts," Venkatesh says.

The information in this article is current as of the date listed, which means newer information may be available when you read this. For the most recent updates on COVID-19, visit our coronavirus news page.