COVID-19 vaccination mandates in the United States

Main article: COVID-19 vaccination in the United States

File:USA. Percent of people receiving at least one COVID-19 dose reported to the CDC by state or territory for the total population.png

United States. Percentage with at least one vaccination dose. See Commons source for date of last upload. US territories: GU = Guam. AS = American Samoa. RP = Republic of Palau. FM = Federated States of Micronesia. MP = Northern Mariana Islands. MH = Marshall Islands. VI = Virgin Islands.

COVID-19 vaccine mandates have been enacted by numerous states and municipalities in the United States, and also by private entities. In September 2021, President Joe Biden announced that the federal government would take steps to mandate COVID-19 vaccination for certain entities under the authority of the federal government or federal agencies.

When acting as president-elect in December 2020, Biden said he did not intend to mandate that all citizens receive a COVID-19 vaccine, arguing that "I will do everything in my power as president to encourage people to do the right thing and when they do it, demonstrate that it matters." BBC News writer Anthony Zurcher felt that Biden avoided a general mandate due to the "stubbornly pervasive" anti-vaccine movement in the country, which "could create a groundswell of opposition that would prove counterproductive to public health." Furthermore, in April 2021, the Biden administration ruled out plans for a federal database, "credential", or "passport" to verify COVID-19 vaccination status, citing data privacy and discrimination concerns.

To protect co-workers and the general public, mandates have largely been enforced by means of employers (including private businesses and governmental divisions) requiring that their staff be vaccinated for COVID-19, while some private businesses (such as restaurants and event promoters) may also decline to serve customers if they do not present proof of vaccination. In August 2021, several cities announced plans to require proof of vaccination for patrons of certain types of non-essential indoor venues.

In some cases, provisions that are described as a vaccine mandate are officially termed as a constraint requiring those who are not fully-vaccinated for COVID-19 to undergo regular testing—thus allowing for medical or religious exemptions to be fulfilled when needed.

The initial EUA status of the vaccines led to questions over whether such mandates were legal, as FDA regulations state that a person must be informed "of the option to accept or refuse administration of the product, of the consequences, if any, of refusing administration of the product, and of the alternatives to the product that are available and of their benefits and risks." As these regulations refer to an "option to accept or refuse", some legal experts initially questioned whether a vaccine issued under EUA can be mandated. However, courts addressing the issue uniformly held that such mandates were permissible, with the court in Klaassen v. Indiana University in particular addressing this subject at length.

On May 28, 2021, the Equal Employment Opportunity Commission (EEOC) issued guidance stating that employers can require their employees to be vaccinated, unless covered by an exemption under the Americans with Disabilities Act (medical exemptions) or Title VII of the Civil Rights Act (religious exemptions). By contrast, a presidential waiver would have been required for the U.S. military to mandate vaccination while still under EUA status. With the Pfizer vaccine formally receiving FDA approval on August 23, it was anticipated that more organizations and employers would become willing to introduce vaccine mandates.

Despite months of vaccine availability and incentives, many Americans continued to resist vaccination amid rising cases in several states. On September 9, 2021, Biden announced a six-point plan of new measures to help control the pandemic, which included new executive orders and regulatory actions to effectively mandate vaccination for COVID-19 among a large swath of the American workforce. Executive orders were announced directing all federal agencies to mandate the vaccination of their employees (with exceptions as required by law, and no option for regular testing in lieu of vaccination) per guidance to be developed by the Safer Federal Workforce Task Force, and all future government contracts to include a clause requiring compliance with guidance to be developed by the Safer Federal Workforce Task Force (likely to include a similar mandate). It was also announced that the employees of all federally-funded Medicaid and Medicare-certified health care facilities, and Head Start program facilities, must also be vaccinated. The administration later set a November 22, 2021, deadline for most federal employees to be fully vaccinated, and a December 8, 2021, deadline for federal contractors to be vaccinated.

Furthermore, it was announced that the Occupational Safety and Health Administration (OSHA) was developing an Emergency Temporary Standard to require all companies with more than 100 employees to, at a minimum, conduct weekly testing of employees who are not yet fully-vaccinated for COVID-19, and provide paid time off to employees for vaccination appointments. In total, these policies were estimated to apply to at least 100 million Americans. Biden explained that corporate vaccine mandates had already been implemented by "some of the biggest companies" in the country, including Disney, Fox News, Tyson Foods, and United Airlines, and that "We’ve been patient. But our patience is wearing thin, and your refusal has cost all of us."

Many Republicans asserted Biden's order was an unconstitutional overreach of federal authority, and some Republican governors said they would sue to block it. Despite the network being specifically cited by Biden during his speech as a major employer with vaccine requirements, Fox News pundits criticized the move; Sean Hannity described Biden as having "cancelled all medical freedom". The next day, Biden responded to the threats, stating "Have at it. Look, I am so disappointed that, particularly some of the Republican governors have been so cavalier with the health of these kids, so cavalier with the health of their communities. We're playing for real here, this isn't a game, and I don't know of any scientist out there in this field that doesn't think it makes considerable sense to do the six things I've suggested."

State and territorial vaccine mandates for workers

Several states have enacted vaccine mandates for certain employees.

State	State government workers	Health care workers	Educational workers	Hospitality workers	Testing alternative
California	Yes	Yes	Yes		Yes (except for healthcare workers)
Maine		Yes			No
Washington	Yes	Yes	Yes
Hawaii	Yes				Yes
Delaware	Yes
Minnesota	Yes
Pennsylvania	Yes (if involved in healthcare settings)				Yes
Oregon	Yes (in October, for executive branch employees)	Yes	Yes
New York	Yes (by September 6)	Yes
Virginia	Yes (by September 1)
Illinois	Partial (for workers in high-contact settings)		Yes
New Mexico	Yes
Vermont	Partial (for workers in high-contact settings)
Maryland	Partial (for workers in corrections, veterans and healthcare settings)	Yes
District of Columbia	Yes	Yes (by September 30)
Guam	Partial (for executive branch workers)
Puerto Rico	Yes	Yes		Yes	Yes
Connecticut	Yes	Partial (for nursing home workers)	Yes		Yes
Rhode Island		Yes
Massachusetts	Yes	Partial (for nursing home workers)
Colorado		Yes
New Jersey	Yes	Partial (State-owned health care agencies, correctional facilities)	Yes		Yes

County and municipal vaccine mandates for workers

City or county	State	City/county government workers	Health care workers	Educational workers	Hospitality workers	Testing alternative
Tucson	Arizona	Yes				Yes
Boston	Massachusetts	Yes				Yes
Los Angeles	California	Yes				Yes
New York City	New York	Yes		Yes		Yes
San Diego	California	Yes				Yes
Jackson	Mississippi	Yes				Yes
Newark	New Jersey	Yes				Yes
Hoboken	New Jersey	Yes				Yes
Richmond, Virginia	Virginia	Yes				Yes
Denver	Colorado	Yes				Yes
Pasadena	California	Yes				Yes
New Bedford	Massachusetts	Yes				Yes
San Jose	California	Yes				Yes
New Orleans	Louisiana	Yes				Yes
San Francisco	California	Yes				Yes
Aquinnah	Massachusetts	Yes				Yes
Philadelphia	Pennsylvania	Yes
Portland, Oregon	Oregon	Yes (by September 10)
Seattle	Washington	Yes
King County	Washington	Yes
Providence	Rhode Island	Yes
St. Louis	Missouri	Yes
Sacramento	California	Yes
Chicago	Illinois	Yes

Private organizations requiring proof of vaccination

File:CDC COVID-19 Vaccination Record Card.jpg

A COVID-19 vaccination record card issued by the CDC.

In order to protect their employees and patrons, some businesses and entities may mandate that their on-site employees be vaccinated. Some employers were initially hesitant to impose vaccine requirements, citing concerns over their validity due to the present EUAs among other factors. A June 2021 survey of companies found that only 3% planned to implement a vaccine mandate.

However, by late-July 2021 due to the threat of Delta variant, a number of major private employers across many industries announced vaccination requirements for employees. Similar mandates were announced for California state employees, and federal employees and contractors.

In an effort to protect their employees and other customers, some businesses may voluntarily require that their customers or patrons present proof of vaccination or a recent negative test in order to receive service or access.

Many U.S. colleges and universities, both public and privately owned, have started requiring students to be vaccinated before attending in-person classes in fall 2021. This has led to a black market in counterfeit CDC vaccination cards for students who want to violate this requirement instead of attending a different school.

The National Football League made rule changes intended to place liabilities on players who are not vaccinated, including monetary fines for each individual violation of COVID-19 protocol, and making teams liable for games canceled due to COVID-19 outbreaks involving unvaccinated players if they cannot be made up during the regular season (which will count as a loss by forfeit, and require the team to pay financial compensation to the opposing team).

In mid-August 2021, Anschutz Entertainment Group (AEG) and Live Nation Entertainment both announced that they will mandate vaccination at their venues (where legally possible) in October 2021, with AEG requiring all attendees, staff and performers to be vaccinated with no exceptions effective October 1, and Live Nation requiring attendees to be vaccinated or have recently tested negative for COVID-19 effective October 4.

Government-required proof of vaccination for entry to private facilities

Vaccination incentives were used in California and New York as part of their easing of restrictions in mid-2021; New York allowed seating sections of outdoor venues to operate at full capacity if they were exclusive to vaccinated attendees, and California allowed venues to operate at a higher capacity than normally allowed under its Blueprint for a Safer Economy framework if all patrons present proof of vaccination or a recent negative test.

With the increased spread of Delta variant in the United States and to overcome vaccine hesitancy, several major U.S. cities announced in August 2021 that individuals 12 and older would be required to present proof of vaccination in order to enter certain non-essential indoor businesses, such as gyms, dine-in restaurants, bars, and entertainment venues;

• On August 3, 2021, Mayor of New York City Bill de Blasio announced that a vaccine mandate known as Key to NYC Pass would take effect August 16, with enforcement beginning September 13. Anyone 12 and older must present proof that they have received at least one vaccine dose (using either a physical record, the state Excelsior Pass app, or the city's NYC COVID Safe app) in order to enter indoor gyms, bars, restaurants, and entertainment venues. Ahead of the announcement, The Broadway League, Carnegie Hall, and the Metropolitan Opera had announced similar policies, with the latter two also prohibiting attendees younger than 12 from attending shows.
• On August 11, 2021, Los Angeles City Council unanimously approved a motion proposing an ordinance requiring patrons 12 and older of indoor public spaces to have received at least one vaccine dose.
• San Francisco announced a vaccine mandate on August 12, 2021, requiring the patrons of indoor bars, restaurants, and any entertainment venue that serves food or drink, to be fully-vaccinated.
• New Orleans also announced a vaccine mandate on August 12, 2021, effective August 23, mandating that patrons of indoor venues such as gyms, restaurants, casinos, arenas, and stadiums, as well as any outdoor gathering of more than 500 people that exceeds half of the venue's total capacity, present proof of vaccination or recent negative test.
• On September 10, 2021, West Hollywood, California announced that by October 11, patrons 18 and older of the indoor portions of health and fitness facilities, personal care facilities, and any venue that serves food and drink indoors, must be fully-vaccinated.
• On September 14, 2021, Contra Costa County, California announced that a health order requiring patrons 12 and older of indoor gyms, bars, restaurants, and entertainment venues to be fully-vaccinated, effective September 22. The employees of such venues must also be fully-vaccinated by November 1, 2021, or they must be tested weekly for COVID-19.
• On September 15, 2021, the Los Angeles County Department of Public Health (LAC DPH) announced that effective October 7, proof of at least one vaccine dose will be required to enter indoor bars and nightclubs, and outdoor events with more than 10,000 people. Beginning November 4, full vaccination will be required.

Political views

As with mask mandates before, support and opposition towards vaccine mandates and immunity passports has fallen along party lines, with Democrats largely supporting such measures, and Republicans considering them to be an infringement of personal freedoms and choice.

As of August 12, 20 states—all controlled by Republicans—had passed legislation or issued executive orders prohibiting state agencies from issuing vaccine passports or otherwise requiring proof of vaccination as a condition of service. Alabama, Florida, Iowa, Montana, and Texas also prohibit private businesses from requiring proof of vaccination as a condition of service, with the Florida order threatening fines of $5,000 per-instance, the Montana order terming it as a prohibition of "discrimination" on the basis of vaccination status (with exceptions for long-term care facilities and public schools), and the Texas order enforceable by state licensing agencies (such as the Texas Alcoholic Beverage Commission, which has threatened to revoke the liquor licenses of establishments that request proof of vaccination in violation of state law). The Iowa ban prohibits businesses requiring proof of vaccination from receiving state grants and contracts. There have also been bills enacted or introduced to prohibit employers from enforcing vaccine mandates, and prohibiting vaccine mandates that apply to students.

Some politicians, such as Marjorie Taylor Greene, have claimed that under the Privacy Rule of the Health Insurance Portability and Accountability Act (HIPAA, also sometimes referred to as HIPPA), individuals may not be asked to provide their vaccination status. The Privacy Rule only applies to specific "protected health information" being stored by a "covered entity" (such as a health plan, health insurer, health care clearinghouse, or medical service provider), and does not generally prohibit private businesses or employers from requesting information on vaccination status directly from individuals.

Legal challenges

On May 29, 2021, a lawsuit was filed by 117 employees of Houston Methodist Hospital, who were fired refusing to comply with the hospital's vaccine mandate. The lawsuit was dismissed by district judge Lynn Hughes roughly a couple weeks later. An appeal was filed following the ruling.

In July 2021, Norwegian Cruise Line sued the Surgeon General of Florida over the state's prohibition of vaccine mandates by private businesses. On August 8, district judge Kathleen M. Williams issued a preliminary injunction in favor of Norwegian, stating that the Florida state government failed to "provide a valid evidentiary, factual, or legal predicate", and that "documentary proof of vaccination will expedite passengers' entry into virtually every single country and port where Plaintiffs intend to sail."

A vaccine mandate being enforced by the Indiana University (requiring those who are not vaccinated for COVID-19 to submit to weekly testing if they attend in-person classes) was challenged by a group of eight students, who argued in Klaassen v. Indiana University that risks of the vaccines outweighed the benefits, and that it was a violation of the 14th Amendment. District judge Damon R. Leichty rejected a motion for a preliminary injunction, ruling that the university had a right to "a reasonable and due process of vaccination in the legitimate interest of public health for its students, faculty, and staff", that the students had alternatives (such as agreeing to testing or applying for an exemption, remote learning, or going to a different university) if they did not want to be vaccinated, and that "the situation here is a far cry from past blunders in medical ethics like the Tuskegee Study." The 7th Circuit Court of Appeals, in an opinion by judge Frank Easterbrook, upheld the ruling, citing case law dating back to smallpox in 1905.

On August 12, Supreme Court Justice Amy Coney Barrett, who is assigned to the Seventh Circuit, denied a request for emergency relief in the Indiana University matter; she acted with no comment, and did not refer the case to the full Supreme Court. Media outlets believed that Barrett's decision to uphold the mandate may have implications in future legal challenges.