Thread by @LawrenceGostin

With #COVID19vaccine roll out, there is intense interest in high coverage, even w/ public distrust. Would vaccine mandates be lawful and ethical, and could they boost vaccine uptake?

Daniel Salmon, @ProfHeidiLarson, and I answer in

@JAMA_current:

jamanetwork.com/journals/jama/…

For starters, mandating vaccines under Emergency Use Authorization (EUA) is legally and ethically problematic. Less safety and efficacy data mean that people are more likely to distrust such mandates.

Instead, we must consider Biologics License Application (BLA) approval, which has a higher threshold, and how mandates could be imposed across different sectors. For example, health care facilities have an ethical and legal duty to keep their staff and patients safe.

Because businesses are obligated to safeguard their customers, it’s possible that ones in high-risk settings could require proof of vaccination as a condition of service. Local or state governments could do the same, but their unlikely to mandate adult vaccines.

While #COVID19 vaccine mandates would help achieve community immunity, they could also undermine public support.

What we should consider are limited vaccine mandates with public support and longer-term safety data to return society to pre-pandemic life.