If a COVID-19 vaccine is developed, what about so-called “anti-vaxxers” who refuse it for religious or philosophical reasons?
It turns out Colorado, where vaccinations are currently recommended but not required for adults, has the authority to force you to roll up your sleeve and get the shot.
But experts say it’s more likely Colorado would have to deal with vaccine shortages, especially in communities with inferior health-care access, than with people who refuse vaccinations for medical or non-medical reasons.
If people refuse the COVID-19 vaccine, for whatever reason, they could be forced into quarantine if circumstances necessitate.
Colorado Could Mandate a Vaccine
“States are the proper bodies to impose a vaccination mandate,” wrote Michelle Mello, Professor of Law and Medicine at Stanford Law School, in an email to the Colorado Times Recorder. “The federal government could lean on them in various ways to create incentives for them to do so, but the requirement would come from them.”
“There is precedent to extend vaccination mandates beyond schoolchildren–e.g., recently, the NYC health commissioner ordered everyone in certain Brooklyn zip codes who was not up to date with measles vaccinations to get them. A court had little difficulty finding the order reasonable in light of the fact that there was a serious measles outbreak in those neighborhoods.”
Vaccines for Wealthy Zip Codes?
But it’s more likely that in a pandemic, the “issue will be who gets the limited supply,” not who’s required to get a vaccination, wrote Mello.
Public health advocates worry that the COVID-19 vaccinations could flow to the wealthy, extending a disturbing pattern of COVID-19 affecting low-income neighborhoods and people of color in greater numbers than others.
“There will likely be people who decide they don’t want to get vaccinated, but the bigger issue, when the vaccine is available, is that it doesn’t exacerbate the disparities that we’re seeing with the disease, where its disproportionately impacting vulnerable communities, people of color, uninsured, people experiencing homelessness,” Stephanie Wasserman, Director of Immunize Colorado, a health advocacy group, told the Colorado Times Recorder. “I think it’s really important, when the vaccine becomes available, that a plan is in place for disseminating and administering it in a way that makes it available not just to people of means or people who have private insurance.”
“We’ve chronically underfunded our public health system in the United States, and this is showing the cracks in our system,” said Wasserman when asked what could be done now to avoid a scenario where the rich get better access to a COVID-19 vaccine than the poor. “We need to shore up our public health system and make sure our health care providers have access to vaccines so that they can administer them to people regardless of the zip code people live in.”
Vaccine Requirements for Workforce
Short of requiring all residents to be vaccinated, Colorado could mandate that key segments of the workforce get the COVID-19 vaccination. Already, during flu season, healthcare workers are required to be immunized—or find another job.
To limit the spread of COVID-19, a “range of workers” might face vaccination requirements, wrote Jennifer Reich, a professor of Sociology at the University of Colorado at Denver, in response to a question from the Colorado Times Recorder.
Quarantines
More likely than a wide COVID-19 vaccine mandate would be targeted quarantine orders imposed on those who refuse the vaccine, say experts.
During outbreaks of infectious disease, individuals “may not be able to fully participate in communities so long as their lack of immunity presents risks to others,” wrote Reich, who’s the author of Calling the Shots: Why Parents Reject Vaccines.
Federal case law allows the state to separate individuals from the broader society, she said.
“At times of outbreak, community needs take precedent, as we are seeing now with the stay-at-home order,” says Reich. “Some of this is to protect individuals from infection, but much of it is to protect those who are most vulnerable to infection and ensure hospitals will maintain capacity for all critical care without becoming overwhelmed.”
“Colorado has always worked to balance individual rights against community responsibility,” wrote Reich. “Moving forward I believe we will continue to do so.”
Those Who Opt-Out Could Be Quarantined
So it’s possible that Coloradans who reject the COVID-19 vaccine could face the same consequences as Colorado students whose parents opt them out of vaccination requirements for medical, religious, or other reasons.
The student exemption specifically states that if an outbreak occurs, non-vaccinated students may be removed from school and quarantined.
“That’s absolutely a tool that’s available now to public health officials to help contain and control an outbreak of a vaccine-preventable disease,” said Michele Ames, a spokeswoman for Colorado Vaccinates, a coalition of groups aiming to improve Colorado’s vaccination rates. “Not many people realize that even if they’ve had their kids vaccinated, but they haven’t kept the paperwork up with their school, they could have their kid returned to them during an outbreak.”
Republicans Still Voting Against Vaccination Rules
Despite the pandemic, some Republicans in Colorado are continuing to push back against Colorado’s existing vaccination rules, as they’ve done with increasing intensity in recent years at the Colorado Legislature.
Just last week, the Colorado Republican Party updated its platform, stating that “healthcare decisions on topics including immunizations” belong with “individuals, parents, and their doctors rather than government dictates and government healthcare monopolies.”
Decrying “medical tyranny,” Republicans in multiple Colorado counties passed resolutions earlier this month opposing vaccination requirements for schoolchildren—or anyone else.
State Sen. Lori Saine (R-Firestone ), who sponsored legislation this year to loosen vaccination rules, told the Colorado Times Recorder that the COVID-19 pandemic has created a “highly unusual” situation.
“During a crisis time, it is highly likely that certain health care workers could be required to prove their immunity to Covid before interacting with Covid vulnerable populations,” she said. “These are healthcare workers who interact with Covid vulnerable populations, like hospitals and nursing homes. Not all doctors and nurses equally deal with these covid vulnerable populations.
“The state and county might have a role to play in that decision for certain healthcare workers but that decision is best made by the private business. This isn’t a carte blanche for the heavy hand of government to step in in any other circumstances.”
Opposition to Immunization Tracking
Republicans have also stated their opposition to immunization registries, which allow public health officials to track who’s been vaccinated.
The GOP in El Paso County, Colorado, which is home to more Republicans than any other county in Colorado, passed a resolution this month condemning all “government tracking of individuals based on their vaccination status.”
Colorado has had such a tracking program in place since 2007. Residents can choose to opt-out of it.
“The benefits of the [immunization tracking] system are that it consolidates records from multiple healthcare providers, which helps many families who do not have copies of records or who change providers,” wrote Reich. “It also tracks exemptions.”
“In times of outbreaks of vaccine-preventable diseases, it could be helpful to identify which children are most at risk of infection and help to address those pockets,” she wrote.
Scientists say a COVID-19 vaccine will be available at some point, but probably not until next year.
