Even though the F.D.A. and independent medical experts have found Covid vaccines to be extremely safe and highly effective, a sizable portion of the eligible population has chosen not to be vaccinated. In this context, Covid-19 vaccine mandates — much like mask mandates — are public health measures necessary to protect people from severe illness and death. They are therefore permissible in many settings where the unvaccinated pose a risk to others, including schools and universities, hospitals, restaurants and bars, workplaces and businesses open to the public.
While limited exceptions are necessary, most people can be required to be vaccinated. Any vaccination mandate should have exceptions for those for whom the vaccine is medically contraindicated, such as people who have allergies to it. The absence of such exceptions would directly undermine the public health goals of a mandate, although other mandatory precautions, like masking, social distancing, regular testing or working remotely, may be appropriate. Where a vaccine is not medically contraindicated, however, avoiding a deadly threat to the public health typically outweighs personal autonomy and individual freedom.
What about those who object to vaccination on religious grounds? Like personal autonomy, religious freedom is an essential right, but not an unfettered license to inflict harm on others. As the Supreme Court explained more than 75 years ago in Prince v. Massachusetts: “The right to practice religion freely does not include liberty to expose the community or the child to communicable disease or the latter to ill health or death.”
In the employment context, federal law requires religious accommodations in some circumstances, but not if they would cause an “undue hardship” to the employer. Refusing a Covid-19 vaccination poses a direct threat to the health and safety of others in the workplace and likely amounts to an undue hardship unless the employer can devise some other accommodation for the employee, such as working from home.
Some have objected that in practice, vaccine mandates may have disparate effects on disadvantaged communities or individuals. Such concerns need to be taken seriously. But they don’t justify refusals to be vaccinated.
Every effort should be made to ensure that vaccines are equally available to all without obstacles posed by cost, race, immigration status, geography or job responsibilities. Some undocumented people reportedly have been turned away from vaccination sites because they lack a government ID, for instance, while others have confronted obstacles related to cost, transportation or additional requirements imposed by vaccination clinics.
Public health officials should take concrete steps to counter vaccine hesitancy among communities of color whose past discriminatory treatment has understandably sown mistrust. Employers imposing mandates should afford workers paid time off as needed to obtain a vaccine and to manage potential side effects. And people should be permitted to offer written proof of vaccination rather than requiring proof via a smartphone app, so as not to disadvantage those who can’t afford a smartphone.