In the White House’s most aggressive move yet to bring the coronavirus pandemic under control, U.S. President Joe Biden recently announced a new “action plan.” Under it, federal workers and contractors must all be vaccinated, and the employees of private companies with at least 100 workers must likewise or else get tested weekly for the virus. Speaking to the minority of the U.S. population that remains unvaccinated, Biden said, “We’ve been patient, but our patience is wearing thin, and your refusal has cost all of us.” Still, many Americans continue to refuse. Right-wing media is replete with anger and indignation about the new mandates, while 24 Republican state attorneys general are threatening legal action, claiming that they represent not just an undue restriction on individual liberty but a “public health disaster that will displace vulnerable workers and exacerbate a nationwide hospital staffing crisis, with severe consequences for all Americans.” What are the actual public-health outcomes likely to be here?

Timothy Caulfield is the Canada Research Chair in Health Law and Policy at the University of Alberta. According to Caulfield, the mandates will certainly increase the number of fully vaccinated Americans, possibly even by 5 to 10 percent. But this impact will vary across the U.S., including between Democratic- and Republican-leaning states, given how politically polarized the issue of vaccination is. Caulfield acknowledges that some businesses—even businesses that support vaccination—are worrying about losing employees who object to the mandates; and he anticipates a major backlash, grounded in the belief that the mandates violate Americans’ individual rights, despite the extent to which the unvaccinated are prolonging the pandemic and restricting their fellow citizens’ ability to return to the normal freedoms of everyday life.

Graham Vyse: To start with the basics, how will these new mandates affect the overall vaccination rate in the U.S.?

Timothy Caulfield: If you just look at vaccines in people’s arms, I think they’re going to work. I think you’re going to see an uptick. The big questions are where they’re going to work and to what degree. We’re likely going to see jurisdictional variation. The U.S. is such a diverse country politically, you’re likely to see that reflected in how the population responds to these mandates. But if we look at evidence from other countries—or even historical evidence—we know mandates work. They work best on people who are complacent or moderately hesitant about getting vaccinated. There’s an open question about the degree to which they’re going to work on hardcore deniers and those who are politically and ideologically motivated against vaccination.

Vyse: What kind of jurisdictional variation are you anticipating?

Caulfield: A big factor is going to be predominantly Republican states versus predominantly Democratic states. For example, the moderately hesitant in Democratic states seem more likely to respond to the vaccine mandate than the hardcore deniers in Republican states.

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