Tips for Physicians on How to Talk to Patients Who Are Hesitant about the COVID-19 Vaccine

by Thomas R. Collins •

 Thomas R. Collins is a freelance medical writer based in Florida.

Legality of Vaccine Mandates

As COVID-19 vaccines are rolled out and some groups remain hesitant to get them, what are the chances—and the legality—of a vaccine mandate? 

Dorit Reiss, LLB, PhD, a professor at the University of California Hastings College of the Law in San Francisco and an expert in laws relating to vaccines, said that she doubts that an adult vaccine mandate is on the horizon.

“I don’t expect states to go to a universal adult mandate any time soon,” she said. “However, I do expect to see some professional mandates, either from the states or from the specific employer.” Any mandate would be subject to exemptions for medical reasons or even philosophical reasons, she added.

These employer-mandates could apply to nursing homes and to corrections officers, she said. Schools, where other types of vaccinations are already required, are another story at this point because the vaccine trials did not include participants under the age of 16. Such a mandate, she said, would be “a hard call,” in part because the risk of serious illness is lower in children.

“I think [a vaccine mandate] will be very controversial in states because you’ll have, on one hand, some parents who are very nervous about a vaccine for their children and, on the other hand, parents who are very nervous about their children going back to school without a vaccine,” she said. “I think this is going to have to play out in the states. Legally, states have a lot of leeway to mandate vaccines in schools, but it’s going to be a tricky political question.”

Sufficient uptake in adult vaccinations is pivotal, she said. “If we’re very lucky and the adult vaccination is enough to get the pandemic under control, that will work against having a school mandate,” she said.

Vaccine mandates would be rolled out by state, with a greater need, of course, in the states where vaccines have been administered to a lower percentage of the population. But there is a paradox.

“It’s partly vaccine coverage, but it’s also political because if states have a political environment that leads to a lower vaccination rate it will probably prevent the mandate as well,” she said. “In a state where you have 60% of people who believe the pandemic is a hoax, and that the vaccine is a Bill Gates microchipping tool, the legislature there probably isn’t going to pass a mandate.”

A more tailored, localized approach to vaccine mandates is more feasible than mandates over a large area, Dr. Reiss said. A severe outbreak in a specific area followed by the local authority imposing a vaccine mandate, she said, is probably on pretty solid ground.