Courts block two Biden administration Covid vaccine mandates
reuters.com> Doughty said the CMS lacked the authority to issue a vaccine mandate that would require more than 2 million unvaccinated healthcare workers to get a coronavirus shot.
> "There is no question that mandating a vaccine to 10.3 million healthcare workers is something that should be done by Congress, not a government agency," wrote Doughty.
That's a good point. You can agree that its within the federal authority to mandate vaccines, but it really should be a decision made and explicitly endorsed by elected representatives rather than some agency (Centers for Medicare & Medicaid Services) that I have never heard of until now and whose head is appointed by one person.
[EDIT]
Too often we look at the end results (e.g. will this increase vaccination rates) rather than the means of getting there. You see it on the left and right. If their guy is in power, they want to expand the scope and reach of their office. Everything is a crisis and someone can solve it if they're just given the right permissions.
And this eventually leads to dishonesty and loss of trust. Even news is reported through a utilitarian lens. Many journalists today think they're doing advocacy rather than reporting. They're not assigned topics but talking points. Someone could be the 'tech bad' guy and his stories are nominally about tech but about how big tech is subverting democracy, bad for the environment, you name it.
Could you imagine a news report about how the much touted vaccine efficacy of 95% didn't really pan out? It's true. Everyone was around 6 months ago and remembered the efficacy levels being thrown around. Now people are being gaslit to thinking they didn't hear what they heard and its about hospitalization. All because being honest could hurt the cause. And yes, vaccine efficacy was 95% and yes it does mean what you think it means [0]
/rant
https://www.thelancet.com/journals/laninf/article/PIIS1473-3...
Except that the role of the CMS, as established by congress, is to set the guidelines of care and standards of participation for providers who opt to accept Medicare and Medicaid patients.
They set rules for everything from how many hospitals can be owned by a single entity, to what sorts of qualifications are required for hospital administrators, to what types of medical orders are allowed to be given to patients. Their explicit charter is to ensure Medicare and medicaid patients are cared for and their health is looked after. From that lens, requiring a vaccination that reduces the likelihood that one of those patients is infected with a potentially deadly disease (particularly deadly for those on Medicare, given the demo), is eminently reasonable.
And the administrator is confirmed by congress. If this regulation was about almost anything else, this would be a nothingburger
> to what types of medical orders are allowed to be given to patients
Suppose an anti-abortion president gets elected and he elects someone as head and tells them that health care providers that accept medicare or medicaid cannot provide abortions. Not making it illegal per-se, but just for the providers that accept medicare or medicaid for any of their services.
You okay with this as well?
The problem I see with this kind of argument is that whether a health care provider provides abortion services has very little (nothing) to do with the care given to a medicaid or medicare patients. Where-as them being vaccinated for COVID does have a very clear impact on medicaid/medicare patients, especially since medicare patients are more likely to be in a high risk group (IE: old).
It seems to me like you just don't think medicare or medicaid should be a thing to begin with. I think it's basic sense that if we're paying for medicare and medicaid we should require the healthcare providers receiving our tax dollars to meet some standard level of care, or else we're just wasting our money. We can argue over what that level of care should be, but I don't think it's all that debatable that requiring things like vaccines could fall into that level of care if not having them is particularly risky for patients.
> The problem I see with this kind of argument is that whether a health care provider provides abortion services has very little (nothing) to do with the care given to a medicaid or medicare patients.
There's no mechanism to enforce this reasoning. It's whether the agency has the power to do it or not. For instance it could be argued that natural immunity is far superior to vaccines, so excluding healthcare workers with natural immunity from working is not about protecting patients.
> It seems to me like you just don't think medicare or medicaid should be a thing to begin with.
???
> There's no mechanism to enforce this reasoning. It's whether the agency has the power to do it or not. For instance it could be argued that natural immunity is far superior to vaccines, so excluding healthcare workers with natural immunity from working is not about protecting patients.
I'm not sure what you're getting at, Congress gave the agency the power to set guidelines for requirements for caring for medicaid/medicare patients, that's what they do. If a guideline would not actually impact medicaid/medicare patients, then they can't do it and it would rightfully get struck down in court when it is challenged for not falling within their powers. That's quite literally the same mechanism currently being used to challenge their power to require vaccines.
Your point about natural immunity seems reasonable, it doesn't mean requiring vaccines for those without natural immunity wouldn't still make sense though so I don't think it really fits your point. Claiming that the particular way they went about this requirement is bad is different from saying they can't require a vaccine at all. I think your point makes some sense, but it could still be paired with a vaccine requirement making it effectively the same thing.
> ???
I thought what I said was pretty self explanatory. If Medicare and Medicaid are going to be worth it then we have to have some standard level of care that we're paying for - we shouldn't be paying tons of money just for medicare/medicaid patients to receive bad care. Why should my tax dollars to go a healthcare provider who doesn't want to get the vaccine when that money can go to one who will? The medicare/medicaid patients that we're paying for will get better treatment from those healthcare providers who require vaccination, and if better care is not the goal than what is?
>> It seems to me like you just don't think medicare or medicaid should be a thing to begin with.
Please don't ascribe beliefs or intentions to me that I didn't explicitly state.
> Why should my tax dollars to go a healthcare provider who doesn't want to get the vaccine when that money can go to one who will?
Medicare and Medicaid should be fee for treatment. Why shouldn't I be allowed to choose what provider I want to visit for the same treatment? They can have different covid policies, much like schools do. I don't think it should be a federal issue.
> The medicare/medicaid patients that we're paying for will get better treatment from those healthcare providers who require vaccination, and if better care is not the goal than what is?
You're mistaking treatment for safety protocols. A health care provider can have a certain doctor to nurse ratio or a million other things and they may not all be "optimal" as defined by the powers that be. We should allow people to choose what health care provider is right for them based on their constraints and not restrict options.
> We should allow people to choose what health care provider is right for them based on their constraints and not restrict options.
Disagree. If I'm footing the bill for that care (as a taxpayer) I expect to have a say in what constitutes minimum quality of care.
And allowing unvaccinated healthcare workers to treat patients is reckless, and falls well below that minimum quality bar.
(I would also accept healthcare workers with natural immunity, assuming we can establish some sort of testable minimum antibody level that confers a similar level of protection as a vaccine.)
> Why shouldn't I be allowed to choose what provider I want to visit for the same treatment? They can have different covid policies, much like schools do. I don't think it should be a federal issue.
You can, by paying for it yourself :P
> You're mistaking treatment for safety protocols. A health care provider can have a certain doctor to nurse ratio or a million other things and they may not all be "optimal" as defined by the powers that be. We should allow people to choose what health care provider is right for them based on their constraints and not restrict options.
I see what you're saying but I think it's an odd distinction, treatment outcomes and safety protocols are clearly linked, why should tax dollars go to treatment provided with substandard safety protocols when the same can be spent for better treatment elsewhere? Functionally it would just end up costing us and the program more over time and lead to worse outcomes. The other issue here is that most patients aren't even going to know enough about the various things you listed to make an informed opinion about them.
> There's no mechanism to enforce this reasoning.
The mechanism would be the judicial system, and in the case of restricting abortion services, the regulation would probably be subject to strict scrutiny.
> For instance it could be argued that natural immunity is far superior to vaccines
Lots of things could be argued; some things shouldn't be argued without evidence.
During a pandemic, statements that will be interpreted as suggesting that catching the disease beats vaccination fall squarely in that category.
"it could be argued" is not a substitute for the judgement of the regulatory body. The regulatory body hears arguments and makes a determination, I'm pretty sure that's the mechanism. (And it sounds like the court has decided to overrule it on shaky grounds.)
The person you're replying to has a slightly incorrect statement. At least to my knowledge.
CMS only controls this for patients covered by Medicaid/Medicare. It can set the tone for the entire industry, but does not solely control the industry. Typically, they create influence by setting/rejecting Medicaid/Medicare reimbursement standards. Since enough patients are covered by CMS, it tends to be easier for hospitals to broadly adopt the policies.
It might be a difference without a distinction, but technically the provider is participating, non-participating, or opt-out. In the first two cases, the provider has to meet those standards, and while I'm sure that there might be deltas between how medicare/medicaid patients and non- are covered (e.g. minimum post-procedure length of stays), all of the requirements around the provider apply to everyone at the provider. That is, you can't have one hospital administrator with a degree for the medicaid people and one without for not - the hospital administrators, full stop, have to have the appropriate degrees and certifications.
No- they say play by our rules for everyone or the majority of your revenue disappears.
> Suppose an anti-abortion president gets elected and he elects someone as head and tells them that health care providers that accept medicare or medicaid cannot provide abortions
Not comparable. Based on current law, abortion is a Constitutionally-protected right. Based on precedent from the Spanish-flu era, the government has broad public health powers.
All that said, as someone who isn’t a fan of how much power Congress has ceded to the executive through administrative powers (which delegate legislative powers to the executive through rulemaking), I wouldn’t mind seeing those curtailed.
You should probably read the Jacobson decision more carefully [1], since you believe that it grants the government the right to mandate vaccines.
The decision is much more narrow that you've been led to believe.
It specifically addresses state police powers, not federal powers.
It also doesn't mandate vaccination, it allows a small fine to be paid instead.
Also, according to a well known attorney I consulted (who has argued several cases before the Supreme Court) the Jacobson decision has been overturned countless times and is considered an awful ruling, the Healthcare equivalent of Dred Scott.
[1] https://en.m.wikipedia.org/wiki/Jacobson_v._Massachusetts
> since you believe that it grants the government the right to mandate vaccines
Specifically avoided saying that. Stated simply, my point is there is positive precedent to the precursors to vaccine mandates, and reasonable ambiguity to the question per se. There is clear negative precedent for abortion. As such, comparing them is misleading. (Better analogy may be found in gun rights.)
I'm not ok with it, but would be forced to accept that it is within the authority granted to the agency to make that call.
Assuming it is: I think policy measures like that should be subject to medical needs. I think there's a clear medical need to require COVID vaccinations for healthcare workers, but banning abortions doesn't pass that test.
And hell, didn't the Trump administration actually do this, though maybe through different means? Withholding federal funding from providers who offer abortions?
No, of course not, but that's not what I was referring to - I was referring to, are doctors allowed to leave standing orders for patients? Can they give them over the phone? What kind of procedures can nurses and NPs order? Those sorts of things.
Your example is a covered procedure, some of which is defined by the CMS, but much of it is defined by federal statute that dictates what classes of procedure are covered by medicaid/medicare. To go to your example specifically, federal statute ALREADY limits medicaid abortion coverage to abortions arising from rape, incest, or that put the health of the mother at risk. 16 states go beyond that and cover abortion in more cases, but they pay for that with their own money (which is also allowed statutorily). So in your case, what the new CMS head was declaring is unlawful on its face, as this is something that congress has specifically addressed.
Banning health care providers from abortion would be unconstitutional. It would be the same as a president banning health care providers from serving muslims. Women have a constitutional right to get an abortion. People don't have a constitutional right to not vaccinate. Government can and has jailed and/or fined people for not getting a vaccine. These SCOTUS approved mandates helped rid America of smallpox.
Ehh constructional right is a bit strong.
The supreme court ruled that the 14th amendment[0], has somewhere hidden within it a right to privacy. This right to privacy appearently applies exclusively to abortion, as warrentless wiretapping of every US citizen has been determined not to be a constitutional violation.
I find it funny that they can find a right to privacy in the 14th, but give the thumbs up to civil asset forfeiture that directly contradicts the text and is a obvious violation. They seem to make things up as they go along depending on what is politically expedient.
[0]https://constitution.congress.gov/constitution/amendment-14/
The right to privacy is in the 4th amendment, the 14th amendment is used to "incorporate" constitutional rights to the states. Prior to the 14th amendment the rights in the constitution only prevent abridgement of rights by the federal government but states were free to take them away.
> Banning health care providers from abortion would be unconstitutional.
Forcing care workers to take a medicine against their will is constitutional you say?
All medical procedures should be voluntary, or we go back to the times of lobotomy and forced sterilizations of minorities (and that's not as many decades back as you may think).
> Government can and has jailed and/or fined people for not getting a vaccine.
This means being unvaxed is a something only the rich can afford. Pay fines, and have a good lawyer.
> Forcing care workers to take a medicine against their will is constitutional you say?
They are not forced to take the medicine. They are given an choice to take the vaccine or find another job. If they refused to take the vaccine, that is their choice, period. They cannot claimed they are being forced because they are given an choice in the first place. They are given a free will with their decision. Thousands of Thousands people screeching for being forced when they are given a choice. Society don’t have to conform to those people who want to endanger their people and their livelihood.
This is an incredibly weak argument and the courts have already ruled similar issues.
The government can’t violate your right to free speech. They also can’t “ask” a private company to censor you as it effectively the same thing.
Telling someone “its your choice but if you don’t do it you’ll lose your livelihood” is not a choice at all.
Choices have consequences. I have the choice to stop wearing clothes to my job and the consequence of that choice is that my job would fire me.
The ability of the government to establish vaccination requirements is long established. It's only becoming a hot topic now because anti-science folks have been programmed to fear a safe and effective vaccine.
> I have the choice to stop wearing clothes to my job
The difference is you flipped the switch and decided to turn up to work without clothes. You decided to radically change your behavior and actions in the workplace. This will obviously have consequences due to your unsightly naked body offending co-workers.
When someone doesn't flip any switch, but continues to work exactly as they did before, they have not done anything you can label a "choice with harsh consequences".
Unvaccinated people are not suddenly shedding and dangerous, in the way a naked person is shedding pubic hairs everywhere.
The difference is totally irrelevant.
>Unvaccinated people are not suddenly shedding and dangerous, in the way a naked person is shedding pubic hairs everywhere.
Unvaccinated people are inherently dangerous. The change is that we now have the ability for them to become vaccinated people who aren't nearly as dangerous to their clients.
In June 2020, we had no choice but to have unvaccinated health care workers. Today, we do.
> Unvaccinated people are inherently dangerous.
They are not dangerous. A person who has access to sharp knives but is currently not holding a knife, is no more dangerous than someone who does not have access to knives.
But even that analogy doesn't fit, since vaccinated people can certainly still get sick and transmit the virus.
Besides, I am not restricting my position in this debate to health care workers. I am talking about anyone with a job, who is now required to get vaccinated. That's what happened where I live (Australia). Everyone in my state from barristers, to builders, office workers, truck drivers... literally every professional who isn't working from home, is required to get the vaccine or lose their job.
Many are pissed off with the expanding scope of mandates.
I can understand the requirement for health workers to be vaccinated. But even then, they should have the option to be tested regularly instead.
This is what happens... incremental laws expand and eliminate choice. Suddenly you live in a world where you must get jabbed every 6 months, and repeatedly prove your vaccine status to everyone every day. Tagged, tracked and validated for walking around doing normal things is not a world we should be encouraging, even in pandemic times. If we must disagree on that point, then fine, we disagree.
I think there's really a collision between your conspiracy theory view of the world where getting inoculated is equivalent to being 'tagged, tracked and validated"
Vaccinated people can get sick and transmit the virus, true, but it's much less likely that they will. People with STIs can also transmit the virus, so we wear condoms to make the risk of transmission substantially less. If your sexual partner is unwilling to wear a condom or unwilling to have sex with you if you wear one, you can just choose to not have sex with them and the risk of transmission goes to nothing. That choice doesn't exist with work. If my co-worker chooses to remain a massive public health risk, my chances of catching COVID-19 go up quite a bit. I can't choose to just not be around you and the rest of anti-vaxxers. Not to mention there are people who have legitimate medical reasons who are unable to get vaccinated who are put at substantially higher risk by being forced to be around conspiracy theory anti-vaxxers.
It's clearly not an established process since Biden's mandates is being struck down.
The court really has nothing to do with whether or not something is well-established. The judge who blocked the mandate is an ideological, inexperience trump appointee.
I'm talking about 'well-established' in that it's been happening for 200+ years. The conservative right-wing theocratic extremists that trump appointed will destroy our judicial norms for the next 50 years but that doesn't make them right.
You're aware that we've had vaccine mandates for decades, right? Were you also upset about requiring kids get (for example) MMR vaccines before allowing them to attend public school? If so, then congratulations: some diseases we'd thought we'd eradicated have been coming back because of anti-vax nutjobs.
You are not an island. You live in a society, a community of people that requires individuals to give up some personal liberties for the good of the whole. Those who don't like that should go move to an isolated island where their harm to others can be limited.
Greater good of society out weighs people's individual rights. These are basic constitutional tenets. Why you can't yell fire in a crowded theater even though you have the right to free speech. Why the SCOTUS has ruled vaccine mandates are constitutional.
Schenk was overturned because it was a bad decision. In general, “fire in a crowded theater” is my heuristic for “this person doesn’t know what they’re talking about”.
This is the top Google result for “fire in a crowded theater”: https://www.theatlantic.com/national/archive/2012/11/its-tim...
Use the more modern version it and yell “I have a bomb”.
You got the premise wrong, not the phrasing.
With firecodes what they are today, a bomb is a more comparable danger to what a fire was 100 yrs ago, anyway.
You actually can yell fire in a crowded theatre and no, the the US doesn’t automatically weigh the “greater good” over individual rights.
Society is a cultural framework and does not in any way supercede individual rights. There is no greater good. The SCOTUS has ruled that states have the authority to mandate vaccination not the federal government. The federal government is extremely limitited in its authority by the Constitution.
"Greater good" has been the justification for the worst atrocities committed in history.
Be careful about so willingly giving up your right to self-ownership.
You may not ever get it back.
Greater good is what it makes it possible to have individual rights. Imagine if you had an absolute right to free speech. You could write or speak anything without legal recourse. Trademark law and copyright law wouldn’t work. Fraud wouldn’t be prosecutable.
Apply that to other rights like the right to bear arms. If government couldn’t set standards and people could procure any weapon, how does society function? How does air travel even exist with people owning anti aircraft missiles.
That’s why our founders made our constitution a living document with courts interpreting the constitution and balancing individual rights with our collective rights.
I see the "living document" argument made a lot, and I don't think it means what some people think it means.
The founders were purposefully vague in several areas of the constitution because they absolutely did want circumstances to determine interpretation, however they were not vague at all about delegated and reserved powers. These things are not "living" in a sense of judicial review.
By "living" document, it was intended that the constitution could be modified by an amendment process. There was never a provision for judicial review.
In fact, then entire concept of judicial review arose from Marbury vs Madison [1] where the court claimed this power.
The purpose of the U.S. Constitution, and one of the things that makes it unique in history, is to limit the powers of the government. The founders believed that individual rights were innate (granted by God), not granted by government and certainly not granted by the federal government.
All powers other than those specifically Delegated to the federal government are reserved for the States - the 10th Amendment makes this clear.
It is not the role of the federal government to decide on "greater good" mandates, those powers are very specifically reserved for the states, who are constrained on what they may do by the Constitution and its amendments.
We, as a country, have allowed the federal government to overstep this in many areas. The DEA, for example, only exists because of a very bad interpretation of the Interstate Commerce Clause, which arose from a bad Supreme Court decision (Wikard vs Filburn)[2] about whether or not you were allowed to grow your own wheat.
you can indeed yell fire in a crowded theater.
Then just ban men from having them as well.
> Women have a constitutional right to get an abortion.
Do they? Where is that written?
EDIT: the vague "life, liberty, or property" clause as interpreted by Roe vs Wade. This is such a blank-cheque it may as well not be in the constitution as in hands all power to the interpretation of the courts.
" the vague "life, liberty, or property" clause as interpreted by Roe vs Wade. This is such a blank-cheque it may as well not be in the constitution as in hands all power to the interpretation of the courts."
If you read federalist papers or any of the writings of founders on the constitution. The constitution is a living document that is decided by the courts. It is really hard to have a fruitful debate without people having even basic knowledge on this subject.
No, it’s not a living document open to the whims of interpretation or flavor of the month.
That’s how you end up with Russia taking over Odessa due to “national security” reasons.
If it’s a living document it’s not worth the paper it’s written on.
I didn't say the courts couldn't interpret the constitution, but "living document" doesn't need to imply vague - RvW carved out a limited clarification without supplying a general rule of what is and isn't covered. The courts shouldn't have the power to totally skewer the constitution, ad-hoc.
> having even basic knowledge on this subject
That's your opinion. People debate in echo chambers all the time, if that's what you'd prefer.
Sure, that’s the loophole. What’s happening here is yet another end-run around the democratic process. People are tired of emergency powers, executive orders, and delegated authority being used to enact some of the most impactful laws of our time. We want the Schoolhouse Rock version of law-making because we at least get something of a say in it.
Should Congress also pass laws regarding which vaccines are mandated for military personal serving in which areas of the world? For example, if the risk of yellow fever increases in Yemen, should Congress pass a law requiring special forces deployed in that area must acquire the vaccine? Or should that decision be left to the appointed heads of those branches of the military?
Congress has delegated the authority to make these decisions to regulatory agencies. If congress wants that authority back, they can get it back via legislation. The responsibility for the current situation starts and stops with congress. The executive branch is doing what congress has asked it to do, and the executive branch would stop doing those things the moment that congress legislated the authority back to themselves.
> Congress has delegated the authority to make these decisions to regulatory agencies
Yes, but at some point there must be a limit to how much power they can delegate. If Congress created a new Super-Congress that it granted all the powers of Congress, I would contend that would be unconstitutional. It clearly goes against the founding principles of having three branches of government. That would be akin to the government creating a fourth branch without amending the constitution.
Amending the constitution is a process that is clearly defined by the constitution. If that process isn't needed to create a fourth branch of government, a change that changes the core of the constitution, what would it ever be needed for and why would they have included it?
It would be up to the judicial branch to make those determinations. So far, they are broadly OK with the delegation that has happened.
...except for the delegation of power to mandate vaccines apparently, which is the focus of this discussion.
If we are going to talk about what's the right answer from a position of "if the court says it that's how it goes" then I can assume you're happy with this court decision?
Yes, I'm happy with it from a "balance of power" perspective. I would like a different outcome, regarding vaccine mandates, but that responsibility lies with congress, and unfortunately one of our political parties is anti-science and anti-vaccine, which means it won't happen.
Still, I'm happy that we're not breaking the rules for the convenience of getting an outcome I'd like better.
Does the CDC have regulatory mandates to ensure vaccination? Does this extend to "get vaccinated or get fired?"
People very broadly give power to the CDC that I don't think they have.
Why are you mentioning the CDC?
Do you know that the two federal mandates were issued by CMS and by OSHA, two completely different organizations from the CDC?
BTW, the law as written gives very broad powers to OSHA and other agencies. This is controversial mainly because one political side in the country is anti vaccine right now.
Bodily autonomy is perhaps the central tenant of liberty. There is plenty of room to be for vaccines and against (federal) mandates.
Why reference federal mandates if your argument is bodily autonomy? That would equally apply to state and corporate mandates.
People have remedy of sorts in the case of a functioning local market. If some employer requires you to get vaccines and you aren't in to that, you can work somewhere else. If a state has requirements you don't like, you could potentially leave that state. Its different when its the federal government giving the mandate and it covers the entirety of your industry.
Ok, then CMS or OSHA.
My point still stands. Vaccine enforcement and mandates was not even considered as under their purview. It's quite hair-splitting to say "there's nothing that says they _can't start enforcing vaccine mandates_."
“Vaccine enforcement and mandates was not even considered as under their purview.”
Even if the law as written allowed it? Since the OSHA act and Social security acts that give OSHA and CMS regulatory authority passed, the USA has never faced a deadly virus pandemic that could be combated with a vaccine.
If Congress specifically wrote the law to allow flexibility for new situations it doesn’t make sense to me to argue that because the situation didn’t arise in the 20th century that the authority and law has lost its power.
Right, that's my point -- this is unprecedented and thus falls under "Congress needs to allow these agencies to do this" _not_ "these agencies can do this by default."
Even though Congress already wrote a law that gave the agencies authority to do unprecedented actions?
What I'm not seeing is engagement with the actual text of the statutes that Congress already wrote and put on the books. For instance, the OSHA Act specifically gave OSHA power to regulate "new hazards".
https://www.govinfo.gov/content/pkg/USCODE-2019-title29/html... "1) The Secretary shall provide, without regard to the requirements of chapter 5 of title 5, for an emergency temporary standard to take immediate effect upon publication in the Federal Register if he determines (A) that employees are exposed to grave danger from exposure to substances or agents determined to be toxic or physically harmful or from new hazards, and (B) that such emergency standard is necessary to protect employees from such danger."
Similarly the Social Security act already gave broad power to issue regulations. https://www.law.cornell.edu/uscode/text/42/1395hh# "such regulations as may be necessary to carry out the administration of the insurance programs under this subchapter" "No rule, requirement, or other statement of policy (other than a national coverage determination) that establishes or changes a substantive legal standard governing the scope of benefits, the payment for services, or the eligibility of individuals, entities, or organizations to furnish or receive services or benefits under this subchapter shall take effect unless it is promulgated by the Secretary by regulation under paragraph (1)."
the Act clearly envisions the secretary having authority to change standards for benefits, payment for services, and eligibility. There's no limitation saying that eligibility criteria can be based on other safety measures, but not vaccines.
EDIT: and SCOTUS precedent interpreting this language in the past was clear about the scope of authority it gave. See page 34 of the PDF here https://drive.google.com/file/d/1dGiMcVAxfziaoecQtd40-nERZr_...
Literally any power can be constituted as appropriate under such a broad interpretation. At that point, why have congress at all?
Not really, for instance courts did examine the CDC eviction mandate and found it was overreaching the language of the law and voided it. I agree with that as the law provided examples of the power it was giving and the eviction mandate clearly didn’t fit with the others (fumigation, quarantine of positive cases, etc).
A mandate for vaccinating healthcare seems a lot closer to existing regulations that the law was designed to allow. It’s clearly a health and safety regulation just like the dozens of previous health regulations regulating quarantine, mask wearing, sanitation, safe handling of items, etc.
The reason congress doesn’t reserve this power is because in our system congress can’t react quickly or sometimes at all. It has to pass laws giving up this type of authority to the executive branch because it knows its own processes don’t work quickly or efficiently enough.
Congress did give itself instead the authority to veto regulations it doesn’t like, using the Congressional Review Act. It used to give itself even stronger authority using the one-house legislative veto, but the Supreme Court struck that down. < https://scholarship.law.duke.edu/cgi/viewcontent.cgi?article...>
Except this isn’t about almost anything else. This is about control over one’s body.
This is from someone who chose freely to get the vaccine. Even at my own peril I support other’s freedom to choose.
These are healthcare workers. Jobs have requirements. They're free to quit instead of increasing the dangers of disease for their sick and older patients who are at highest risk for covid. No one is controlling their body any more than making it show up at work in order to get paid. Coal miners are forced to work in dangerous conditions around the world in order to keep their job. Getting a vaccine is far less risk, there have been 8 billion plus vaccine doses given against covid around the world.
> Jobs have requirements
Most of the argument is whether this requirement is in the "employee must wash hands before surgery" category, which is about the patients' right to be safe not the employee's (in theory the patients didn't "choose" to be there).
The people complaining are reacting as if the ruling sounds like "male high school teachers get vasectomies, to keep teenage pregnancies down", because the effects are "permanent, * upto six months" and directly to your body without it being an on-the-job requirement.
The part that makes me leery is that these sort of "are your vaccines upto-date" checklists have always existed, but this time it is controversial (or maybe it was for MMR - but it wasn't news).
>checklists have always existed
this is also the first time where the vaccine industry and the broader public health space have been put under this kind of scrutiny and the combination of politicization, outright lies and deception over masks and policy in both directions and the overall visibility of the sausage making process happens to be occurring alongside a decline of trust in institutional expertise. when most people got their tetanus shots, the faces of the medical profession were not acting as explicitly political agents.
I don't think you can argue that it's the medical profession's fault that this issue has become politicized without acknowledging that the GOP deserves most of the blame here.
Nearly every common-sense measure implemented during this pandemic has been derided by the right as some sort of unacceptable infringement on individual rights.
Not saying those in power have gotten it all right 100% of the time; I'm especially disappointed with the mask fiasco you mention, but... c'mon. Doctors are not acting as "political agents" in the vast majority of situations that have caused the US's pandemic response to be as lacking as it's been.
> Nearly every common-sense measure implemented during this pandemic has been derided by the right as some sort of unacceptable infringement on individual rights.
It's not common sense if a plurality of people don't agree with it. Denying children in-person schooling for a year wasn't "common sense", cancelling elective procedures like cancer screenings wasn't "common sense", forcing people to wear masks outdoors wasn't "common sense", and so on. Lots of people were denied rights in these cases and would consider those measures unacceptable.
It's common-sense in that the large majority of medical professionals agree that those measures are a good idea. Those ideas are non-controversial amongst experts.
frankly there is plenty of blame to go around among partisans starting with the complete and total looting of our pandemic response capabilities that occurred during the obama years or the bipartisan offshoring of nearly all our capacity to produce medical supplies and allowing consolidation to make hospitals utterly brittle in the face of a crisis. the lies and poor decisions are numerous enough from all sides that it really is not interesting to play the blame game about who is worse, residents of either team will always believe their lies were noble and mistakes justified while the 'other' is the source of all the real problems. the end result is the same, efficacy and legitimacy of administrators has cratered and i cannot honestly blame anyone who does not trust these institutions to act in good faith anymore.
so you'd be cool with employers banning employees who get an abortion.
something, something, consequences.
Would you please stop posting flamewar comments and otherwise breaking the site guidelines? You've unfortunately done it a lot lately. We ban that sort of account because it destroys what this site is supposed to be for.
If you'd please review https://news.ycombinator.com/newsguidelines.html and stick to the rules when posting here, we'd appreciate it.
If having had an abortion materially negatively impacted a healthcare worker's ability to safely provide healthcare to a sick person, then yes, that should probably be grounds for disallowing those people from working as healthcare practitioners. Thankfully that's not the case.
That's actually quite likely legal already.
If expect there are certain Catholic organizations who would fire you if you admitted to having had an abortion.
Your intuition is correct (in that there's no over-arching precedent or Constitutionally-derived right that makes it illegal), but it's specifically banned under Title VII of the Civil Rights Act as per a 1978 law modifying the act. https://www.eeoc.gov/statutes/pregnancy-discrimination-act-1...
... Which goes to the court ruling that's the topic of the article: Congress has the power to decide these issues.
Does that mean you support a rollback of all vaccine requirements? For example the MMR, TDap, HepB, polio, chicken pox vaccines required for school children? Or the numerous vaccines required for military personal?
And would you be comfortable having a pediatrician who wasn't inoculated for diphtheria knowing that an infection could be fatal for your baby?
Your freedom to control over one's body ends when it comes to the safety and health of other people's bodies. That's why herd immunity is a thing.
There is no right to not receive another's germs. If we take your argument to its logical conclusion, then the flu vaccine would be mandated. But it's not. So if you say that Covid is different, then what is your threshold or cut-off for when a medical procedure should be mandated?
There is no right to not receive another's germs. If we take your argument to its logical conclusion, then the flu vaccine would be mandated. But it's not. So if you say that Covid is different, then what is your threshold or cut-off for when a medical procedure should be mandated?
Why not? if the cost & benefit ratio is worth it, maybe we should. The same for any other diseases you can think of. If the answer is yes, then there are no reason for any of us to refuse unless we have good excuses.
>There is no right to not receive another's germs
Intentionally coughing on someone is a prosecutable crime in many parts of the world --- What do you think makes it a crime?
You are smart enough to know that intentionally coughing on someone is not what I meant.
Tell me again what percent of people need to be immune before we get to herd immunity?
Identical arguments are made around abortion. Or mandatory organ/blood donations. Actually, nobody argues for mandatory blood donations because we can all tell that would be icky.
“herd immunity is a thing.”
It is? By Easter right? With what other coronavirus have we ever reached herd immunity?
Not in the case of current covid vaccines and variants.
> safety and health of other people's bodies
Does that not include the unborn?
The case for that line of reasoning is extremely weak given that vaccines provide dramatically low protection against infection and vaccinated people also infect others at high rates.
If that's true, how come several federal judges have come to the opposite conclusion in their rulings?
I can only assume they're allowing their personal politics to get in the way of making a sound legal decision.
That's the key problem with the US now. Elected representatives are allowed to delegate law making. It breaks the line of accountability. It makes contentious issues worse.
> the key problem with the US now. Elected representatives are allowed to delegate law making.
Congress does not delegate lawmaking, Congress delegates the execution of its powers to the Executive branch. This is how the country has functioned since the beginning, for it would be impractical for it to work otherwise.
Say more: delegation will happen at some level, by definition. In military matters, every step or shot a soldier takes is a decision that has been delegated through a chain of command from Congress. Since Congress is not ever going to be in a position to execute every decision for every individual over which Congress has power, Congress inevitably will delegate the execution of its powers. It has always been this way, and will be this way as long as we have a republic.
> Congress delegates the execution of its powers to the Executive branch
That's the Constitution, not Congress. Regulation, as well, is not execution. Thomas's concurrence on Whitman v. American Trucking Ass’ns signals where things might go.
> Regulation, as well, is not execution.
This is an opinion that was not widely held for most of the last 100 years or so.
> Thomas's concurrence on Whitman v. American Trucking Ass’ns signals where things might go.
Definitely agree that our legal regime looks headed for major changes. I consider it likely that SCOTUS will reverse itself on a set of major principles, creating uncertainty for citizens and businesses until a new equilibrium is reached.
I'd say the key problem is that our electoral system and the structure of our government are broken in a few very serious ways, most of which are nearly impossible to fix, in no small part because fixing most of them would require at least one of our two major political parties to be OK with voting themselves into a weaker position (since some of the most important problems cause there to be only two viable parties at a time and fixing them would weaken the position of both those parties), or else they'd require a constitutional amendment, which is even less likely.
Most of our other problems are a consequence of that.
I think it’s actually reasonable for an agency (CMS) to decide eligibility criteria for receiving federal Medicare and Medicaid dollars. This was authority granted to the agency by Congress. Requiring employees to be vaccinated as a condition to accepting Medicare seems pretty reasonable to me. Just as I would hope hospitals need to meet basic care standards to be eligible as well.
Congress often delegates their power to other agencies. It’s an important regulatory function that allows agencies to adapt to a changing world even in a gridlocked legislature.
> Requiring employees to be vaccinated as a condition to accepting Medicare seems pretty reasonable to me.
That's just a backdoor for giving more power to the federal branch. Its like 'interstate commerce' where anything that has interstate implications (pretty much everything) can be influenced by the federal government. What if an anti-abortion president elected someone to this board and told them that no health care provider that accepts medicare or medicaid can offer abortions?
I don't see mandating people to get a vaccine that they don't want as non-political bureaucratic action, especially considering its coming from the president's office. It's mandating a medical treatment. Take a step back and ask under what authority and supervision should we require a government to be mandating a medical treatment.
It's interesting you bring up both commerce clause and abortion as I'm currently taking a constitutional law class covering both issues. The commerce clause did wildly expand through the 20th century, but I just want to point out that US v Lopez substantially cut back Congress' Commerce power. It laid out clear restrictions to what and when Congress has the power to regulate interstate commerce. Further cases like NFIB v Sebelius (Obamacare) also cut down on commerce power.
The difference I see with abortion is that the SCOTUS held in Roe v Wade that women have an affirmative right to an abortion under substantive due process of the 14th amendment. If the government coerced healthcare providers to stop providing abortions, this would be a direct infringement on a right protected by the constitution. Conversely, there is no constitutional right to /not/ get a vaccine. Of course, the demographics of the court has changed, so it's very possible the SC will rule that not getting vaccinated is also a constitutional right conferred by substantive due process.
Thanks for the insight. I wasn't aware of US v Lopez. The most egregious use I found of the commerce clause was Wickard v Filburn. It was a depression era ruling that said the federal government had the right to prevent a farmer on growing food on his own land to feed his livestock in opposition to a law meant to 'stabilize wheat prices' by having farmers not grow food. Ever since then I was no a fan of commerce clause. Would something like this be possible today or did US v Lopez make this impossible?
> Conversely, there is no constitutional right to /not/ get a vaccine
Doesn't it need to be framed as the government having the right to apply a medical treatment to me against my will?
I have a constitutional right to bare arms but presumably the federal government can decry that I do not have the right in certain places. Or is that not an affirmative right.
[EDIT] It appears that is what US v Lopez is about (federal restriction of guns near schools)
Lopez overturned Filburn for the most part.
> Doesn't it need to be framed as the government having the right to apply a medical treatment to me against my will?
This will be tested in litigation in cases like OP, but remember, these vaccine mandates are NOT the government forcing you to accept medical treatment. These mandates have been coercing private employers to require vaccination as a condition of employment. This indirection muddies the water and I can't speculate as to what the courts will ultimately decide on.
> Of course, the demographics of the court has changed.
Thats a problem when the demographics of a ruling body affect rights protected by the Constitution.
Wisely the Constitution also provides remedy for when that gets too out of hand: “the right of the people to keep and bear Arms, shall not be infringed."
I think one area the Constitution missed the boat is that when a politician or someone in delegated power makes a law or rule that infringes on someone’s freedom that person should be charged and punished for treason. I would think that you would see so many fewer laws a much stronger and law abiding Country.
Are there any laws that don't infringe on someone's freedoms in some manner? Speeding, theft, discrimination, environmental protections, that's all infringing on one party's freedoms for the protection of themselves or others. That's basically what a law does, it restricts some form of freedom in an effort to provide some form of safety or equity.
There are plenty of laws that affect someone’s freedom as you pointed out. I’m talking about Constitutional rights such as free speech or the right to bear arms.
If you don’t agree with those provisions there is a method to change them and too often short cuts are made that are only corrected after the fact in the courts. Take for instance Biden's vaccine mandate. He knew that was unlawful yet he knowingly did it anyhow. There should be a personal consequence to that beyond not being re-elected.
Ah, ok, those aren't freedoms, those are right. You started talking about rights and then started saying freedom, so I was confused. Especially when you talked about having fewer laws because of it.
And I don't believe if the precedent is set regarding freedom from vaccinations being a fundamental right. Won't that have to be decided by the higher level courts? I don't think we're at that stage of treason yet, are we? After all, there will be appeals, and I don't know if a district judge should have the power to charge and punish POTUS.
Perhaps it should be specific to certain specific infringements.
The vaccine is mandated as a condition for employment. Is it different from universities requiring vaccines for their students (Indiana University already won a legal challenge -- https://www.scotusblog.com/2021/08/barrett-leaves-indiana-un...) or military personnel having to get a battery of shots when they enlist? All those requirements should survive or fall together.
Mandated not by their employer, but by the federal government's executive branch is the question at hand.
Public schools in many (most? all?) municipalities require kids be vaccinated against several things before being allowed to attend school. This has been the case since well before I was born. This is a government setting the requirement. Now, perhaps it is not legal for the federal government to set this sort of requirement. But maybe it is.
Which is state-mandated, not federal, and done by passed law, not by executive order IIUC. That's still a huge difference.
Commerce clause is a valid reason for federal government to make rules. Imagine each state having their own EPA with their own rules and regulations. Or each state had their own FAA. Or OSHA. It would kill interstate commerce because it would be too costly for businesses to operate at the national level.
Regarding the EPA, I can imagine it not existing. In fact, EPA did not exist when some here were children. https://www.epa.gov/history
The pollution solution is defending property rights. In the short term, the USA pollution solution is to offshore manufacturing pollution to other countries.
and whose head is appointed by one person
Note that while the position is appointed by POTUS, it is a Senate confirmed position - she was approved with a vote of 55-44 [0] (with five R votes).
[0] https://www.senate.gov/legislative/LIS/roll_call_lists/roll_...
Not to mention, this is exactly how representative government works. It's not controversial that we do not have a direct vote on Secretary of Defense, a position that arguably has more human impact as the head of CMS.
Why are you moving the goal posts? No one said the population should directly vote on it. They said the representatives (who the people voted for) should be deciding through the legislature, not through a single appointed person.
> it is a Senate confirmed position - she was approved with a vote of 55-44 (with five R votes).
The elected representatives chose to delegate this power to the person they approved as the head of CMS. What principle would be involved in requiring Congress to execute its powers in a different manner (i.e. by not delegating), simply because one does not like the outcome in this case? Who would decide which powers Congress could delegate and which it had to exercise directly? Has someone already drafted the Amendment to the Constitution which would limit the powers of Congress in this way?
There's no reason in principle for Congress to directly make this decision about requirements placed on CMS contractors and not other aspects of vendor relations handled by CMS. (The narrow issue here is whether CMS can require its contractors to enforce vaccine mandates.)
> The elected representatives chose to delegate this power to the person they approved as the head of CMS.
The courts clearly disagree with you.
They haven't decided yet, but it sometimes happens that I disagree with a court ruling! Courts have known to get things wrong, too.
No they don't. They've issued an injunction while they decide.
That's true. My impression is that this is more or less a rubber stamp and the head is acting on behalf of the president. I can't imagine someone getting elected to this position that wouldn't take marching orders from her appointee. It's a lot of power to give one person.
In that case I don't understand your objection; the president is an elected official, so if this department head is acting on behalf of the president, the argument that this was done by an unelected official is kinda irrelevant.
> You can agree that its within the federal authority to mandate vaccines, but it really should be a decision made and explicitly endorsed by elected representatives rather than some agency
I'm from a country (UK) where parliament has absolute power, but also where the populace largely trusts the civil service. Health decisions, prosecution decisions, and so on are explicitly devolved from the government so that they don't become politicized. To me, that seems better, rather than asking politicians to intercede in what should essentially be decisions for experts to make.
I'M in the UK and I absolutely do not trust the civil service at all.
> Health decisions, prosecution decisions, and so on are explicitly devolved from the government
Yes, although UK Govt ministers tend to retain accountability when things go wrong, at least in the eyes of the media.
this is why it becomes a severe legitimacy problem when experts can no longer be rationally seen as apolitical actors.
In London they are taking butter knifes from people and bragging about it on social media.
Except in the US, the civil service is politicized and its employees are 95% in favor of one party, as shown by their political donations history.
> Except in the US, the civil service is politicized and its employees are 95% in favor of one party, as shown by their political donations history.
That's not at all generally true historically, even if you drop the made up specific number and say something like “vast majority", of US civil servants; it is true of some states, localities, or agencies, and reversed for others.
2020 looks like that, but the 2020-2021 election and transition cycle were rather outside of historical norms. [0]
There is some historical imbalance, but then, that people who adhere to the party that consistently demonizes government, government work aside from military and law enforcement, and government workers, aside from military and law enforcement don't tend to choose to work for government as much as people who don't adhere to that party is...somewhat unsurprising.
[0] https://www.opensecrets.org/industries/indus.php?ind=W03
Thanks for the link!
I'm referring to the Federal government. I will amend down to 85%!
I think 2020 is more representative:
https://www.opensecrets.org/industries/indus.php?ind=W03&cyc...
I'd say the Federal civil service starts at Health and Human Services and below.
> I think 2020 is more representative
The historical chart on my first link shows that 2020 is wildly nonrepresentative.
Unless you think that Trump vs. the present Democratic party is somehow a new stable political alignment.
> I'd say the Federal civil service starts at Health and Human Services and below.
It does not. Department of State and USPS are largely federal civil service, whereas Los Angeles County and the City of New York are entirely not, for instance.
Well, look at 2018 compared to 2020 - they are similar.
State and the USPS are a little different - State looks outwards, unlike the rest of the agencies, and the USPS is quasi civil service and a bit of a political football. Not only that, but it has a strong local presence across the country.
The rest of the agencies are, unfortunately, politicized and biased.
Edit: Not all the charts in your link show cumulative data.
But, look at the chart for "Party Split, 1990-2022" in the election years - that's when the civil service donates heavily to get "their party" into power: 2012: Dem 69% 2016: Dem 77% 2020: Dem 76%
That chart includes both "Public Officials" and "Civil Servants". The former group is far more balanced, since the Republican/Democratic split is pretty even. If there was a similar chart for just the Civil Servants, it would be a lot more biased.
You can agree that its within the federal authority to mandate vaccines, but it really should be a decision made and explicitly endorsed by elected representatives rather than some agency (Centers for Medicare & Medicaid Services) that I have never heard of until now and whose head is appointed by one person.
If the CMS does it, it is a public health decision. Doing it in Congress makes it a political decision.
IMO, the better route is that the CMS issues the mandate, but that Congress ratifies it. Ie, they have to provide a clear reason why the public health decision should be overruled.
I disagree. It is a political decision to force 2 million Americans to get a vaccine that they don't want under threat of not being allowed to work in their profession. If you disagree with the decision at least you can vote the bastards out.
You're acting like its a trivial procedural matter. These people obviously feel very strongly about it since they're under immense pressure everywhere to get it and they still refuse. Or they may have other reservations, but to dismiss that and just have some nameless faceless un-elected organization intrude in their lives in such a meaningful way is really gross
congress could have acted here, they could still act. they didn't. Not doing something is a choice when it occurs in reaction to someone else doing something.
Whether it is a 'trivial' procedural matter simply isn't affected by people's strongly held beliefs
Strongly held beliefs don't exempt you from seat belt laws, from tax rules, or from any other law unless congress doing the thing congress is designed to do allows for it. It shouldn't.
CMS isn't unelected...it is an arm of the executive branch headed by the, elected, president and run by someone confirmed by the elected senate. It is given the authority to make rules in specific areas by the elected congress.
Your entire thread or argument is predicated on a false assumption...
If fewer people dying/getting sick is a political goal, then more people dying/getting sick so that the current administration gets voted out can also be a political goal.
I'm not a fan of the situation, but you're acting like it's forced sterilization. It's just a vaccine with a very safe profile. For God's sake, all healthcare workers including the cleaning staff have to get flu shots and show their immunizations every year, or they can't work. Even as a college student I had to get a meningitis shot.
>For God's sake, all healthcare workers including the cleaning staff have to get flu shots and show their immunizations every year, or they can't work. Even as a college student I had to get a meningitis shot.
The difference is that those examples aren't mandated by the federal government (as far as I know). I think most people are fine with companies and universities requiring people to be vaccinated.
It's a 'new' tech with a lot of shady political hand waving that impacts your body. Like redefining vaccine, a rushed testing process and... oh yea the feds waived all legal liabilities for the private entities that developed it.
I think given the context that if your under 65 you are more likely to have medical complications driving to the grocery store its a pretty understandable perspective.
Also the mandate has no exception for natural immunityI. It is I had it and no symptoms of it except I couldn't taste anything, given above, I why would I get a vaccine.
> Could you imagine a news report about how the much touted vaccine efficacy of 95% didn't really pan out? It's true.
Do you mean like "Efficacy of Pfizer/BioNTech Covid vaccine slips to 84% after six months, data show" (https://www.statnews.com/2021/07/28/efficacy-of-pfizer-biont...) or "Covid-19 Vaccine Efficacy: What Do the Numbers Really Mean?" (https://www.wsj.com/articles/covid-19-vaccine-efficacy-what-...)? Or did you have something else in mind?
I thought this was pretty well-discussed as VRBPAC/ACIP began to review the data guiding their third dose/booster recommendations but maybe I've misunderstood.
> Too often we look at the end results (e.g. will this increase vaccination rates) rather than the means of getting there.
Strongly agree. Tangentially, I felt this way about net neutrality. It should have been law passed by Congress. Instead, everyone cheered when an unelected executive board passed a net neutrality bill that the public wasn't allowed to read.
And then, everyone had the audacity to be surprised when the FTC undid net neutrality as fast as it did it. There is a reason we have a legislature and not just an executive branch that can do anything it wants.
Because the chance of a net neutrality bill making it through the Senate is roughly equivalent to guessing Satoshi's wallet. We can barely pass debt ceiling increases to avoid national default.
The net neutrality PR did work though, the FCC was under a lot of pressure . ATT didn't pay all of those marketing firms to fraudulently post thousands of anti-net-neutrality comments for nothing.
OK, but then the answer is to fix Congress, not to bypass it.
And what if it is fundamentally unfixable? Do we just allow everything to grind to a halt and pretend that everything is working as designed as the country crumbles beneath us? I guess that's easier to do when it's the working class and not most HN-type folks who would get hit the hardest by that plan.
Congress has been delegating rule-making authority to the executive branch since before all of us were born. You may not like that, or you may think some amount of delegation is appropriate, but we've passed that point. But this is the reality here, and the functioning of our federal government pretty much has this baked in at this point, for better or worse.
If it's fundamentally unfixable, then the Constitution fundamentally doesn't work, or at least doesn't work with the society we have now. I think the first step is to figure out why. Did this ever work, or were we just kidding ourselves for two centuries? If it worked then but not now, what changed?
Then, once the cause is understood, the next step would be to figure out an appropriate system that would work, or at least work better, and amend the Constitution to reflect that new system.
The alternative is to just let things continue as they are going, and I don't like that choice. It results in the president becoming more of a ruler and less of an executive. I expect less freedom down that road (and eventually none), and I don't like it.
My take on the questions I posed is this: Yes, it did work, at least adequately, and now it doesn't. What changed? I suspect that it was Roe v Wade. Since then, the right has been trying to get control of the Supreme Court to overturn Roe, and the left has been trying to block them. So both are fighting over control of the nomination process, which means the presidency and the Senate. I suspect that that's the cause of the trench warfare in Congress.
If I'm right, then it is in fact ultimately unfixable. Neither side is going to compromise, ever. You can't even fix it by amending the Constitution, because then there's going to be a battle about undoing the amendment.
"some agency"? It's an agency put in place and managed (budget, appointments, etc.) BY ELECTED REPRESENTATIVES. Did you want a direct vote on vaccine mandates? Sometimes it seems people fail to understand what a representative government is.
"Representative".
> Could you imagine a news report about how the much touted vaccine efficacy of 95% didn't really pan out? It's true. Everyone was around 6 months ago and remembered the efficacy levels being thrown around. Now people are being gaslit to thinking they didn't hear what they heard and its about hospitalization. All because being honest could hurt the cause. And yes, vaccine efficacy was 95% and yes it does mean what you think it means [0]
This is not true at all. Media has been talking openly about "waning immunity" and "declining effectiveness" all along.
> Could you imagine a news report about how the much touted vaccine efficacy of 95% didn't really pan out?
It didn’t pan out because of Delta, a way more infectious variant that became common well after the 95% figure was determined.
And it’s fully accurate to say that despite Delta, the vaccines are effective at preventing severe disease, hospitalization, and death. I think that’s a very good thing!
Anyone who took a biology class and paid attention could have told you that an efficacy-killing variant was an inevitability. Hell, even tinfoil hat Alex Jones said the same thing, and was for that specific instance, vindicated entirely. The top virologists didn't just "not take this into account", they willfully withheld this truth of how viruses operate in order to push a flakey, quickly-deteriorating product into people's arms.
So that "95%" figure was a lie to begin with, because those who touted it knew exactly what was going to happen. Viruses evade, and any non-sterilizing vaccine will be evaded by a virus. This is how you get delta, this is how you get omicron (which, by the way, was first found in fully vaccinated individuals and likely created through this evolutionary pressure).
Thanks
> Anyone who took a biology class and paid attention could have told you that an efficacy-killing variant was an inevitability
On what basis? It's proved impossible so far to make a strongly efficacious flu vaccine because of constantly shifting variants. But on the other hand, there are many examples of successful vaccines that have never had an efficacy-killing variant emerge (polio, smallpox, chicken pox). How would anyone who has taken a biology class know a priori whether COVID-19 would be a flu or a polio?
Those vaccines are/were sterilizing, meaning the vaccinated person cannot carry or spread the illness after vaccination. Covid-19 Vaccines are non-sterilizing and only lessen-symptoms. As we can clearly see, vaccinated individuals still spread the virus. Not only that, but vaccinated individuals are an added evolutionary pressure for the virus, which causes the emergence of vaccine-evading variants. This means new variants can bubble up within vaccinated individuals, like we've seen with Omicron (and most likely the case for Delta as well).
Thanks!
This cannot be used as an argument against vaccination though. The same thing happens if the population has a high percentage of people who got sick with covid, except that in that case there is a much higher death toll.
It's not that simple. The Salk polio vaccine did not prevent infection/transmission, but remained highly effective at preventing disease.
The initial studies on vaccine efficacy were designed to study efficacy at preventing serious illness, not transmission. So it was not known at the time how effective the vaccines would be on that dimension. To answer these questions requires novel research, it is not settled, freshmen biology knowledge.
If virologists weren't talking about it, how did you learn about it? Do you know enough about virology (or immunology as this would be) that I should listen to you over them?
If the vaccines don't work, why do people in the real world die much, much less often from covid once they are vaccinated?
If you are so sure an immune-evading variant will emerge, why hasn’t one? (There is no evidence at all that omicron evades the vaccines).
You shouldn't listen and believe anyone solely on the basis of their person. Many "scientists" or "experts" that you might believe in have financial ties and liabilities / political liabilities that prevent them from utilizing their expertise to full capacity. The world, money, and politics naturally suppress truth. The government told you the vaccines would stop the spread, limit deaths, and bring us back to "normal". Have you seen the numbers? Have you seen the quarantine camps? Upwards of 50% of COVID cases in some countries are among the vaccinated. Not mentioning vaccine injuries / deaths which the "experts" have told us are rare, but are bleeding more and more into each person's living reality.
Vaccine evasion is happening, and it doesn't matter whether it's delta or omicron. Would Pfizer pay for a study that proves their vaccines are worthless? Would Fauci, who hands down government money in the form of grants, give a grant for a study that would demolish the pharma companies that he has his money tied to?
The vaccines obviously have SOME efficacy, but just enough to make a product that sells. If someone sold you a new car, and didn't tell you it would break down 6 months down the road, wouldn't you be angry? They polished the car just enough for you to buy, without telling you what lurked in the shadows the entire time.
Virologists knew the roll-out of a non-sterilizing vaccine would end in the scenario we currently have. Period.
And the people peddling misinformation have no financial benefit? They don’t want you to subscribe to their patreon or their newsletter? Watch their YouTube videos?
Also the reason Pfizer or other people pay for studies that may disprove their drugs is because they actually don’t know whether the drugs work or not! They are paying to find out. Studies fail all the time. You’ve picked one of the most successful studies and treatments of all time to show the system is rigged. Look at all the ones that didn’t work. Why doesn’t Merck, the largest pharma company, have a vaccine? If it’s so easy to fabricate the data, why didn’t they? Why didn’t their virologists lie? Is Merck the only honest pharma company?
Delta was first detected on india where at that time there was barely any vaccination coverage. And nobody knows from where omicron originated. You claim it could be leaky vaccines but it could have easily been from an immune compromised individual. Do you have any sources for the claim it was first found in a vaccinated individual ? I couldn't find any online
The 95% efficacy claim was the result of a scientific study of the efficacy of the vaccine against COVID infection. It was definitely not a lie unless you are an insane person with an outrageous definition of what a "lie" is.
Or did they just not run the trials long enough to detect the efficacy dropping?
> that I have never heard of until now
CMS is one of the largest government agencies (by budget, >$1T annually).
Technically, perhaps. But really it's a small government agency whose major task is to disburse oodles of cash to people not employed by it.
Either way, ignorance of the existence of CMS is more indicative of a person's general level of ignorance about the US government. If I was just learning about the existence of CMS, I would at least learn a little more about the basics of the existing US government before making proclamations about how it should operate.
Person on the internet preaches about something they're entirely unqualified to talk about, news at 11.
(To be clear, I agree with you 100%)
>Too often we look at the end results (e.g. will this increase vaccination rates)
Even that might not be quite the best end result to be looking for (unless you own the jab patents).
Shouldn't we be looking at clinical outcomes of covid patients, or counts of severe covid cases instead?
If we optimized for marriage rate in the world we might end up with a whole lot of unhappy couples and/or broken homes.
Vaccinated people have far, far fewer cases of severe covid and far fewer deaths. What else do you want them to look at?
Is that true for all ages?
It is.
Do you mind sharing the data that supports that?
The studies that got the vaccines approved in the first place had to show that they were effecitive for all adults. I'm sure that with some digging it should be possible to find the data split by age group.
More recently, we've also gotten data for many vaccines showing that they're also effective for children and adolescents.
Lastly, another important group is the elderly. Some studies suggest that they respond more poorly to the vaccine and that the protection may last a shorter time. In response, many countries have prioritized the elderly for receiving booster shots (3rd dose).
>More recently, we've also gotten data for many vaccines showing that they're also effective for children and adolescents.
This is my principal area of concern. If I recall correctly, the studies that were submitted to FDA for approval for young children did not show improvement in hospitalizations or deaths, in fact there was not a single death in any of the groups, rather they relied on showing the jabs successfully produced antibodies (a much lower standard).
Recently some of the data touted here actually showed increase death counts at times in children that were vaccinated than those that weren't.
> did not show improvement in hospitalizations or deaths
Well, it's not surprising that there would be fewer deaths in children. We'd need a much larger study and I expect that this data will become available now that the vaccines are started to be more widely distributed.
> rather they relied on showing the jabs successfully produced antibodies (a much lower standard)
IIRC the study also found that the vaccine was effective at preventing infections.
> That's a good point. You can agree that its within the federal authority to mandate vaccines, but it really should be a decision made and explicitly endorsed by elected representatives rather than some agency (Centers for Medicare & Medicaid Services) that I have never heard of until now and whose head is appointed by one person.
Jacobson v. Massachusetts[1] established that it is within the State's power to mandate vaccinations, so shouldn't this be up to individual states? I'm also pro- nationwide mandatory vaccinations, but Congress also doesn't seem to be the right way to do it.
> that I have never heard of until now and whose head is appointed by one person.
Odd, the fact that you have never heard about the CMS has no bearing on whether it has the authority to issue a vaccine mandate
> That's a good point. You can agree that its within the federal authority to mandate vaccines, but it really should be a decision made and explicitly endorsed by elected representatives rather than some agency (Centers for Medicare & Medicaid Services) that I have never heard of until now and whose head is appointed by one person.
Are you aware that Federal regulatory agencies are a result of Congress delegating their power, mostly to the executive branch? Congress has already delegated their authority…
Sidenote, if you haven't heard of CMS, that speaks more to your lack of experience in this area than the org's obscurity. I'm not saying everyone should know it, but your paranthetical downplaying of the org shows you're not deep in healthcare knowledge. Should it mean anything to us as readers that you personally never heard of a key agency?
In what universe should such important public health decisions be made by elected officials largely ignorant of basic science, whom also represent also represent some of the most uneducated and misinformed people alive?
There’s a reason, for example, why we don’t let the market or public opinion dictate the efficiency or safety of drugs.
And when some department of unelected officials test radioactive oatmeal on children or infects people with syphilis, we somehow ignore these issues and pretend like that it would never happen to us.
I agree with your facts, but I think its a little disingenuous to only highlight that one aspect of the context. It wasn't that many months before that when a lot of people were willing to accept 50+% VE and delighted if it could approach 70%.
I remember that too, and I think its needed context.
> Everything is a crisis and someone can solve it if they're just given the right permissions.
That's a facile statement. I'd have to bait an HN into playing devil's advocate just to get an opposing view.
What are the "Zig and Rust" of protecting democracy in a time of crisis? Or maybe more realistically-- if we want a "Zig and Rust" for making democracy "memory safe," what are the sources to start with? (Note: I'll filter any citations that rely on invisible hands or, "let's start by decentralizing all the thingies")
> All medical procedures should be voluntary, or we go back to the times of lobotomy and forced sterilizations of minorities (and that's not as many decades back as you may think).
Just wanted to add this comment from the middle of this discussion.
There is so much irrationality these days that we need to have a solid foundation for our decision making and not based on the whims of the panicked masses.
What I find most interesting is the private-sector scenarios and how they're playing out.
I have relatives who work in healthcare and refuse to get the vaccine. They're at risk of losing their jobs because regardless of external pressure, the hospital employing them is incentivized to let them go by the patients. They're a hospital focused on physical therapy, which is does as much elective business by volume as prescribed... And very few patients are willing to work with a physical therapist who isn't vaccinated, so they're simply losing business as word-of-mouth gets around that they don't require vaccines and patients sign up for their PT regiments with other hospitals in the region.
By the same token that the government (absent a law from Congress) perhaps can't force organizations to employ vaccinated staff, the government may have no say if an individual employee is fired because an organization requires vaccinated staff of their own accord.
This would be a good time for Congress to show some leadership and lay down some legal guidelines.
I'm not sure I agree that it's a good time. The current vaccine probably has very limited efficacy against the new omicron variant.
Better to wait for the updated booster before forcing more people to take it.
Oh I didn't mean pass a law authorizing the executive to force vaccines.
I mean this would be a good time for Congress to show leadership in general. As in, make a decision. Really, any decision that shows some reasoning behind it. Entirely too many people in the service of legislature are more worried about their electability than doing a good job. There's a reason that branch has, on average, a mid-teens approval rating most of the time.
This is a temporary injunction not a ruling on the merits. Just like Democratic judges doing this to Trump, it's far more likely to be influenced by politics of the particular Judge or Court of Appeals that any meaningful statement of the law (which it is not).
Also basically every response to this thread regarding this is claiming the courts have decided this, which is just sensational conversation. There very well could be something more to this, but it's more likely that the judge is just airing on "let's dig into this deeper before allowing this change" which makes sense. Nothing has been concluded, the status quo remains.
1. Judges are not supposed to be partisan 2. I'm not aware of any similar cases being brought under the Trump administration.
1. I'm a former Federal litigator. LMAO. And both Parties here. Welcome to America. That's why they filed this in LA + roll up to 11th Cir. Dems file in WA or HI which rolls to the 9th. State Courts are infinitely worse based on the different experience of close friends working in Chicago area v. Northern Indiana.
2. Every temporary injunction issued in the litigation surrounding the wall and Muslim ban was conducted with the Democratic version of this same strategy.
This is the game. Sound and fury, signifying nothing. We will learn the law in time.
LA is 5th cir.
Ooops, thanks, going from memory and I was never doing cases there. And the 5th is the most conservative.
One requirement for such an injunction is the high likelihood of winning on the merits.
Correct. Three other factors need to be balanced as well, although LOS definitely the big one. That doesn't make the PI correct, it doesn't even mean that the court will reach the same decision on the merits in Summary Judgement or after a bench trial, and it definitely doesn't make the PI decision the law.
If we can't convince medical workers to recieve a vaccine from their peers we are doing something wrong.
Convince or compel? Do you expect all healthcare workers to receive any widely prescribed treatment? Is there no room for dissent in your mind?
If you can't convince, compelling doesn't tend to work much better, unless you threaten something worse. Given that unvaxed people are worried the vaccine may kill them, threatening career change seems a bit pointless...it would be far better to listen to their concerns and talk to them, threats only confirm the conspiracies and force positions to become entrenched.
We require healthcare workers wash their hands.
We require other vaccines.
There is plenty of room for dissent, but it stops being “dissent” when it is simply denying reality.
> There is plenty of room for dissent, but it stops being “dissent” when it is simply denying reality.
Ah yes of course, when the common view gets the label of “reality” dissent is no longer “dissent.” /s
If only everyone could see the line in the same place, but well if that were the case I don’t suppose there’d be any dissent at all.
... cool, so if I can produce measurable numbers of objective fact is that now an opinion that is up for discussion?
I mean that is a common refrain among the various anti-basic science groups, but I'm curious if that is the view you take
And it’s a common refrain of “follow the science” dogmatists to attempt to paint things as “objective facts” in a decidedly unscientific way. Just what “measurable numbers” are you referring to and what “objective facts” do you think they reveal?
You would be very hard pressed to find a self respecting scientist who calls any of their work “objective fact.” There are several ways to display views that are “anti-basic science,” and you are displaying one of them.
But to try and wrangle your question into what I think it was intending (though severely misled such that I needed the above preamble): Do I believe established high probability scientific consensus and recommendations can be discarded or disagreed with as mere opinion? Absolutely not. I am not at all “anti-basic science” in the way that you think I am. I think it’s quite possible to accept the scientific consensus on COVID as it exists so far and still argue currently against mandatory vaccinations in different settings.
This was my initial gut thought, but an employment lawyer helped me seee that most healthcare workers are not university or college educated and they are basically lower middle class.
In other words most healthcare workers share the same demographics as those who currently have low uptake on the vaccine.
Yep. For every doctor or nurse with 4+ years of postsecondary education, there are 5+ people with 2 or fewer years of postsecondary education, I'd bet.
The lower tiers of nurse only require 2 years, IIRC, and I think those are more like technical programs than typical liberal-arts-informed degrees. Then there's the clerks, the front-desk people (to include the ones at the "front desk" of each floor, department, or section of the hospital, plus the ones at the actual main entrance[s]) the cleaning and housekeeping staff (someone has to go around restocking supplies and such), the entire billing department, the people who come around to bug sick people about their insurance details, the security guards (hospitals have lots of them), and so on.
This assumes that only uneducated uninformed people are choosing to not get vaccinated. It couldn't possibly be that they understand natural immunity still provides immunity, or that the risk in their group and based on their health is very low, or that they've learned how bureaucracy can be used to influence the medical community... not like they had to learn about the atrocities committed by the medical community in the past, and how bureaucracy was used to promote things that are now seen as unethical and mistakes.
Or maybe they are aware of drugs that received authorization in the past and that the same companies that are making bank of the vaccines, don't have the best history with being honest and transparent.
If the vaccine were still as effective as it was a year ago, I'd agree with you, but it's likely that the current vaccine will have a muted effect on omicron variant, so I'm not as comfortable mandating a vaccine for a now-dead variant.
whether you think its right or wrong, its apparently not without precedence
https://www.kff.org/other/state-indicator/flu-vaccine-requir...
I worked on changing CMS regulation once and 80% of the time was spent proving CMS had the authority to do so.
Not surprised by this ruling at all.
What are the odds a healthcare worker hasn’t been repeatedly exposed to Covid by this point?
A bit under half of Americans have already caught covid.
Even without vaccines, that means nearly half of Americans already have natural immunity which is vastly superior to vaccine immunity.
https://www.cdc.gov/coronavirus/2019-ncov/cases-updates/burd...
>A bit under half of Americans have already caught covid
No- that many have had a positive test or other diagnosis confirming covid.
There were plenty of non-hospitalized, non-diagnosed cases before the tests existed. And plenty of people have had it and never saw a reason to get a test to confirm it.
I'd say we're far above that estimated number.
So that's not quite true. The CDC provides the estimate you're talking about which is what my post originally cites (~146mm Americans infected). That's their estimate based on the much smaller number of positive tests and hospitalizations, using their models about how many cases are missed by surveillance.
makes me wonder if repeated exposure that doesn't result in the virus replicating enough to take hold in the body gives you any kind of immunity, or if that is even a possibility. like how many viral bodies does it take, just 1?
It absolutely does. An very low dose initial infection can prime the immune system and give you an asymptomatic case.
...but even if you full blown covid, there is no exemption from the vaccine requirement - that's one of the main arguments of many health workers.
Wow... I thought it was just tinfoil hat types that were avoiding this vaccine because they were afraid Bill Gates was using it to implant a tracking chip inside them. But if healthcare workers - who actually know what's in this thing - are so vaccine-hesitant that the government has to mandate it to them, I'm suddenly worried whether or not I should think twice about getting a booster (or worse, giving it to my children).
as an anecdotal data point, my wife has a phd in a relevant field. her dissertation involved the lipid nanoparticles used by the pfizer vaccine as a delivery mechanism.
in her words no one really knows how the lipid nanoparticles actually work, and it is much too soon to be forcing this onto the public, and thats just the delivery mechanism. so you have a novel mRNA vaccine, with a novel delivery mechanism, and very little long term safety data. she does not feel like these have been tested to the same standard as other vaccines, we are at the point where if this is mandated for our children we will probably move somewhere they are not.
As a Britisher, is there an ELI5 explanation on why so many Americans are opposed to the vaccination, even educated people working in healthcare? It all seems very bizarre to me...
The problem that so many have is that the mandates completely ignore other ways to gain immunity and the fact that not everyone can get the vaccine. Right now the one single line from the government is "Everyone should get vaccinated, it's safe an effective".
To anyone paying attention it's obvious that this is not the case. Everyone should not get vaccinated, some folks can't get the vaccine. And not it's not safe and effective for everyone, some have had a bad reaction.
It would be one thing if the government realized this and placed reasonable exceptions for those who either can't get it or don't need to because they have natural immunity or immunity through monoclonal antibodies. But they don't and they continue to push this one way of getting immunity.
And that's where the distrust forms. More and more it seems that the government doesn't actually give a damn about these edge cases, all they want to do is check the box that says you have been vaccinated.
People dying from the virus is useful to an opposition party when they want to argue that the ruling party is doing a bad job and should be replaced.
Things like vaccines also threaten the status of people who use the virus in order to extract money from their audiences, like megachurch preachers and snake oil salesmen. Some people got really wealthy off Ivermectin and HCQ prescriptions during this whole thing.
I work near hospitals. You'd be surprised how many staff are outside on break smoking..
I don't know if you're being disingenuous, but health care workers is a very wide group of people; most probably have absolutely no idea about 'whats in this thing', and in my experience most doctors are vaccinated --- it's hospital staff that aren't.
The doctors here in Montana I've talked to about it are not exactly advertising it but are unvaccinated and have recommended to me to avoid the vaccine and one intimated it's insane to vaccinate children.
So that's not the case with all doctors.
Then again, I'm fit, healthy, great diet, low stress, eat well, lots of sunlight. Covid poses less risk to me than driving, my kids it doesn't rise to the level of conscious thought.
Covid's over here.
Also, it's not like doctors are doing it based on medical judgement.
Their jobs are being threatened too, and are more likely to have large debt from school and to be the primary breadwinner of their family than nurses.
Nurses just have more realistic freedom to say no.
Original title is much more accurate "Courts block two Biden administration COVID vaccine mandates", the edited one here "Courts block Covid vaccine mandates for healthcare workers nationwide" implies something much larger in scope.
Also if you're not US-based.. which nation?
The mandates blocked are for healthcare workers nationwide, it's factually correct.
Op didn’t disagree with you. You should re-read the comment they made. Do you disagree with the Op?
Ok, we've reverted the title above.
I wish headlines would include the country it refers to when it says nationwide
Please fix the headline to match the one on the article. The Hacker News headline is deeply misleading, because vaccine mandates imposed by US states and cities are not affected by this court action.
Fixed now. (Submitted title was "Courts block Covid vaccine mandates for healthcare workers nationwide")
Thanks.
*US Courts
This is an international forum.
Can we add the country in the title please?
Brilliant and timely decision. Good luck with Omicron, US.
Aren't the Omicron symptoms relatively mild?
I think that the death rate stays intake in the best case scenario. It could be higher than the Delta rate though, we don't know yet. But you know, I have no reasons to believe that we are so lucky, and even importantly, we deserve the best case scenario. US is crazy. Courts all over the country halt COVID protections measures. Republicans in the house don't want to prevent the government shutdown because of the vaccine mandates for private sector. Anti-vaxx rhetoric is stronger than ever before. So, people continue to die because dysfunctional government can't get their sh*t together. One party goes all-in with cultural war, conspiracy theories and sabotages everything. The other party is so weak that they can't execute the agenda of their own president.
So far we don't have enough data to say how it compares to previous variants. Even with the other variants, most cases are mild and it can take several weeks to start seeing the more severe cases getting worse.
And is only an increased concern because it might be more adept at evading the spike-based vaccines.
If you're not vaccinated or have natural immunity, there's likely zero increased reason for personal concern.