For months, public health officials have repeated the message that a vaccine is essential to achieving the herd immunity necessary for a return to pre-COVID freedoms. It’s possible that two vaccines will be available by the end of 2020. Dozens more are in development, with several expected to be approved early in 2021.

Estimating the number of people who will need to be vaccinated to achieve herd immunity is difficult, involving several factors, including the average number of people infected by each person who has COVID-19, the efficacy of the vaccine involved and how long the protection that it provides will last.

Setting aside questions about availability, there’s another variable that could impact progress on mass immunization: the willingness of Americans to be vaccinated. A study by the Pew Research Center found that between May and September, the percentage of all adults willing to get vaccinated dropped from 72 percent to 51 percent. The major concerns that had emerged were worries about side effects and uncertainty whether a vaccine would really work.

A more recent Gallup poll seemed to show increased interest, with an average 58 percent willing to get a COVID-19 vaccine. Even if the vaccine was provided at no cost, however, only 49 percent of Republicans surveyed would be willing to accept it, compared to 69 percent of Democrats.


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While President Trump has been taking personal credit for the work of researchers who have developed candidate vaccines, groups that support him are tapping into a pre-existing anti-vaccination movement to foment distrust and spread conspiracy theories. Their concerns range from worries that safety corners may have been cut to speed the arrival of a vaccine to paranoid delusions that immunization is merely an excuse for Bill Gates to inject trackable microchips into citizens. (A May YouGov poll found that 44 percent of the Republicans surveyed believed this to be true.)

Once vaccines are actually approved and available, it’s likely that an increasing number of bills will be proposed relating to priorities and guidelines for their administration. Several dozen bills relating to vaccination have been introduced in recent weeks, addressing a variety of issues relating the authority of public health or government officials to require immunization. Some examples:

New Mexico HM1 references vaccinations in two ways. It notes that child vaccination rates have decreased as a consequence of lockdown policies, contributing to future health risks. It also states that vaccination, in combination with natural infection, will lead to herd immunity against COVID-19. It calls for the governor to adopt policies that will allow those who are not a high risk to resume life as normal, as well as the resumption of sports and cultural activities and the opening of schools and universities for in-person learning. (At present, New Mexico is among the states with highest COVID death rates per 100,000 residents.)

HB35 in Missouri establishes immunization requirements for students in the state, making it unlawful for a parent to fail to adhere to the vaccination rules established by the state’s Department of Health and Senior Services. Parents are allowed to object in writing to this requirement for reasons of religious beliefs or medical contraindications. Public schools may not require immunizations not included in health department guidelines, or the immunization of children who have been exempted.

Kentucky BR301 strikes language from an existing law authorizing the state to require all persons in the area of an epidemic to be immunized against the disease causing the epidemic. It states that nothing in existing law authorizes the Cabinet for Health and Family Services or any other state entity to require that any person be immunized.

HB0013 in Tennessee would prohibit governmental or law enforcement entities, or state or local executive orders from “forcing, requiring or coercing” a person to receive a COVID-19 vaccination against their will.

Louisiana SB65 calls for the state’s medical disclosure panel to review any federally-approved vaccine to identify any risks or hazards associated with its use. It is to create a disclosure form that health-care providers must provide to patients prior to administering the vaccine. However, if a patient requests a vaccine that has federal approval before a disclosure form has been published, a health-care provider is authorized to administer it.

HB2973 in Pennsylvania, the “Immunization Freedom Act,” establishes guidelines through which patients and caregivers may diverge from vaccination schedules established by the CDC. Pediatric caregivers would not be allowed to refuse care if a parent of a patient chooses to follow a vaccination schedule that varies from a CDC schedule if the patient receives at least one vaccination per year. Health-care practitioners would not be allowed to refuse care to patients over 18 who do choose not to receive vaccinations intended to bolster their immune systems. Insurers are ordered to provide compensation for vaccinations in cases where the schedule varies from recommendations.

New York A1129 would require every resident and employee of long-term care facilities to be immunized annually against COVID-19, influenza and pneumococcal disease. The commissioner of health is ordered to develop a plan to prioritize distribution of COVID vaccinations to these populations. Persons who have religious objections or medical contraindications will not be forced to be immunized, as well as those who refuse a vaccine after being informed of its health risks.

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