Sweeping new vaccine mandates for 100 million Americans

The requirement for large companies to mandate vaccinations or weekly testing for employees will be enacted through a forthcoming rule from the Occupational Safety and Health Administration that carries penalties of $14,000 per violation, an administration official said.

The rule will require that large companies provide paid time off for vaccination.

Meanwhile, the Centers for Medicare & Medicaid Services will extend a vaccination requirement issued earlier this summer — for nursing home staff — to other healthcare settings including hospitals, home-health agencies and dialysis centers.

Separately, the Department of Health and Human Services will require vaccinations in Head Start Programs, as well as schools run by the Department of Defense and Bureau of Indian Education, affecting about 300,000 employees.

Biden's order for executive branch workers and contractors includes exceptions for workers seeking religious or medical exemptions from vaccination, according to press secretary Jen Psaki. Federal workers who don't comply will be referred to their agencies' human resources departments for counseling and discipline, to include potential termination.

An AP-NORC poll conducted in August found 55% of Americans in favor of requiring government workers to be fully vaccinated, compared with 21% opposed. Similar majorities also backed vaccine mandates for health care workers, teachers working at K-12 schools and workers who interact with the public, as at restaurants and stores.

Biden has encouraged COVID-19 vaccine requirements in settings like schools, workplaces and university campuses. On Thursday, the Los Angeles Board of Education voted to require all students 12 and older to be fully vaccinated in the nation’s second-largest school district.

Walmart, the nation’s largest private employer, said in late July it was requiring all workers at its headquarters in Bentonville, Arkansas, as well as its managers who travel within the U.S., to be vaccinated against COVID-19 by Oct. 4. But the company had stopped short of requiring shots for its frontline workers.

CVS Health said in late August it would require certain employees who interact with patients to be fully vaccinated by the end of October. That includes nurses, care managers and pharmacists.

In the government, several federal agencies have previously announced vaccine requirements for much of their staffs, particularly those in healthcare roles like the Department of Veterans Affairs, and the Pentagon moved last month to require all service members to get vaccinated. Combined, the White House estimates those requirements cover 2.5 million Americans. Thursday's order is expected to affect nearly 2 million more federal workers and potentially millions of contractors.

Biden’s measures should help, but what’s really needed is a change in mindset for many people, said Dr. Joshua Sharfstein, vice dean at the Johns Hopkins Bloomberg School of Public Health in Baltimore.

“There is an aspect to this now that has to do with our country being so divided,” said Sharfstein. “This has become so politicized that people can’t see the value of a vaccination that can save their lives. Our own divisions are preventing us from ending a pandemic.”

More than 177 million Americans are fully vaccinated against the coronavirus, but confirmed cases have shot up in recent weeks to an average of about 140,000 per day with on average about 1,000 deaths, according to data from the Centers for Disease Control and Prevention.

Most of the spread — and the vast majority of severe illness and death — is occurring among those not yet fully vaccinated. So-called breakthrough infections in vaccinated people occur, but tend to be far less dangerous.

Federal officials are moving ahead with plans to begin administering booster shots of the mRNA vaccines to bolster protection against the more transmissible delta variant. Last month Biden announced plans to make them available beginning Sept. 20, but only the Pfizer vaccine will likely have received regulatory approval for a third dose by that time.

Officials are aiming to administer the booster shots about eight months after the second dose of the two-dose vaccines.