Understanding COVID-19 Vaccine Mandates

As the vaccine rollout continues across the country, a key question is whether and how far governments and employers can go to require the public and workers to get vaccinated. A new issue brief explains the legal basis for vaccine mandates and what limitations might apply.

KFF’s COVID-19 Vaccine Monitor shows that while a growing share of adults have gotten vaccinated or intend to as soon as possible, a small but persistent group (7%) say they would only get vaccinated if required to do so.

It remains unclear if the federal government has the authority to issue a general vaccine mandate, though it is also considered unlikely such a broad mandate would be sought for COVID-19. The authority for general vaccine mandates at the state-level to protect public health has been well-established since the 1905 case, Jacobson vs. Massachusetts. No states have a COVID-19 vaccine mandate in place, as of April 5, 2021.

Some employers have instituted COVID-19 vaccine mandates in the context of health care settings, and universities and colleges are starting to do so for students, though these efforts do not yet seem to be widespread. At the same time, some states are considering legislation that would prohibit an employer’s ability to create a vaccine mandate. Our latest COVID-19 Vaccine Monitor report found that half of the public believes employers should be allowed to require the vaccine for employees. As seen with other vaccine mandates, such as the influenza vaccine, disability or religious objections may give employees the ability to opt out of a vaccine mandate.

All three COVID-19 vaccines were authorized under the U.S. Food and Drug Administration’s (FDA) Emergency Use Authorization (EUA). It remains unclear if COVID-19 vaccines could be legally mandated while under an EUA, and this is currently being tested in the courts. However, the legal basis for vaccine mandates is clearer for vaccines that receive full FDA approval.

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