Coronavirus

“This is still America, and we still believe in freedom from tyrants.”

President Joe Biden delivers remarks on the Delta variant and Covid-19 vaccinations from the State Dining Room of the White House in Washington, Sept. 9, 2021. Resistance to vaccine mandates, once a fringe position, has entered the Republican mainstream but the governors fighting President Biden’s COVID-19 vaccine requirements impose mandates of their own. (Al Drago/The New York Times)

By Sheryl Gay Stolberg, New York Times Service

WASHINGTON — Like other Republican governors around the country, Tate Reeves of Mississippi reacted angrily to the coronavirus vaccine mandates President Joe Biden imposed on private businesses. Declaring the move “terrifying,” he wrote on Twitter, “This is still America, and we still believe in freedom from tyrants.”

There is a deep inconsistency in that argument. Mississippi has some of the strictest vaccine mandates in the nation, which have not drawn opposition from most of its elected officials. Not only does it require children to be vaccinated against measles, mumps and seven other diseases to attend school, but it goes a step further than most states by barring parents from claiming “religious, philosophical or conscientious” exemptions.

Resistance to vaccine mandates was once a fringe position in both parties, more the realm of misinformed celebrities than mainstream political thought. But the fury over Biden’s mandates shows how a once-extreme stance has moved to the center of the Republican Party. The governors’ opposition reflects the anger and fear about the COVID-19 vaccines among constituents now central to their base, while ignoring long-standing policy and legal precedent in favor of similar vaccination requirements.

“Republicans care about getting beyond this pandemic every bit as much as Democrats do,” said Dr. Ashish Jha, dean of the Brown University School of Public Health. But, he added, “politicians are certainly happy to exploit this issue for political gain, which is why I think the Republican governors are up in arms.”

Biden also imposed vaccine mandates on federal workers and many health care workers. But Republican outrage is really boiling over his plan to require all private-sector businesses with more than 100 employees to mandate vaccines or weekly testing for their workforces.

Gov. Greg Abbott of Texas called the president’s move “a power grab.” Gov. Henry McMaster of South Carolina promised to fight Biden in court, to “the gates of hell.” Gov. Greg Gianforte of Montana called it “unlawful and un-American.” Gov. Kay Ivey of Alabama called the move “outrageous” and “overreaching.”

But each of these states — indeed, every state in the country — already mandates certain vaccinations for children and sometimes for adults, including health care workers and patients in certain facilities.

Mississippi, which has one of the lowest coronavirus vaccination rates in the nation, has consistently led the United States in childhood vaccinations — a point of pride for its health officials and many of its lawmakers. Alabama, similar to Mississippi, also refuses to acknowledge “philosophical, moral or ethical” exemptions to mandatory childhood vaccinations.

Experts in public health law agree that Biden is on solid legal footing because his actions are grounded in federal workplace safety laws. They say Republican governors who insist that vaccine mandates are an intrusion on personal liberty need a refresher on their own state policies.

“That is pure hypocrisy,” Lawrence Gostin, a public health law expert at Georgetown University, said of Reeves’ remarks. “Even religious exemptions are swept away in the state of Mississippi, so how can he say that an order that a president makes to keep workers safe, with authorization by Congress, is an overreach or in any way unconstitutional?”

A spokesperson for Reeves, Bailey Martin, rejected Gostin’s assertion. “The only people being hypocritical are President Biden and his administration, who for months have said they would not mandate the vaccine,” she said in an email, adding that Reeves would use “every tool at his disposal” to block the mandates.

Republican suspicion of vaccines was building before the pandemic; when Donald Trump was running for president in 2016, he rejected established science by raising the debunked claims that vaccines cause autism. Now some of the governors argue that given the country’s outsize divisions and widespread suspicion of Washington, federal intervention would be counterproductive. It would be best, they say, to let state officials continue making the case that the vaccines are safe and effective and to allow people to make decisions themselves.

“I’m trying to overcome resistance, but the president’s actions in a mandate hardens the resistance,” Arkansas Gov. Asa Hutchinson, a Republican, said Sunday on NBC’s “Meet the Press.” School mandates, he said, “have always come at the state level, never at the national level. And so this is an unprecedented assumption of federal mandate authority that really disrupts and divides the country.”

Jha said Biden had in fact done Republicans a favor.

“What the president does is, he creates political cover for Republican leaders, who will scream loudly because it’s politically expedient,” he said. “But I think many of them are actually feeling relieved, because now they don’t have to do the hard work of convincing their constituents.”

Indeed, when the highly infectious delta variant began ripping through their communities and overwhelming their hospitals, many elected Republicans — notably, Sen. Mitch McConnell, R-Ky., the minority leader — started pleading with people to get vaccinated. Most of the Republican governors criticizing Biden have said much the same.

Even as Reeves blasted Biden on Twitter, he took care to declare the vaccine itself “lifesaving.” McMaster held a news conference last month to encourage South Carolinians to take the shots, saying, “Now is a great time to do it while we’re getting ready for the fall.” In Alabama, Ivey has adopted the same stance as Biden: “It’s time to start blaming the unvaccinated folks” for the deadly coronavirus surge, she said recently.

Three-quarters of American adults have had at least one COVID-19 shot, which suggests growing acceptance of the vaccine. Biden’s move is aimed at the roughly 80 million Americans who are eligible but remain unvaccinated. Experts call it an unprecedented exercise of presidential authority to encourage vaccination.

“It’s really uncharted waters,” said Claire Hannan, executive director of the Association of Immunization Managers, which represents state immunization officials.

Biden is pointing to childhood vaccine mandates to make his case.

“Parents, get your teenagers vaccinated,” he said Friday during a visit to a middle school in Washington. “You got them vaccinated for all kinds of other things — measles, mumps, rubella. To go to school and play sports, they have had those vaccinations.”

The Supreme Court has twice upheld vaccine mandates, beginning more than a century ago in the 1905 case of Jacobson v. Massachusetts, in which Justice John Marshall Harlan reasoned that a “community has the right to protect itself against an epidemic of disease” — in that case, smallpox — “which threatens the safety of its members.”

Both cases upheld state or city mandates and do not apply to Biden’s actions, according to Gostin. Because public health powers are reserved to the states under the Constitution, he said, the Supreme Court would almost certainly strike down a national mandate.

But Biden did not impose a national mandate. He took a series of specific, limited actions that legal experts agree are within his purview as president. The mandates he announced — for the federal workforce and federal contractors, for employees of health care facilities and Head Start programs that accept federal funding, and for large businesses — are grounded in powers that Congress has granted to the president, including the authority to ensure a safe workplace under the law that established the Occupational Safety and Health Administration.

And Biden gave businesses an out. Employees who do not want to get vaccinated can undergo weekly testing — a fact that his critics fail to note. Reeves, for instance, asserted that the president had “no authority to require that Americans inject themselves because of their employment at a private business,” without mentioning testing as an option.

Vaccine mandates are not new, nor is resistance to vaccination. As far back as 1721 in Boston, a vaccine opponent threw a small bomb through the window of Cotton Mather, who was promoting inoculation against smallpox during a deadly outbreak. By the early 1900s, smallpox vaccination again emerged as a contentious issue in Massachusetts, giving rise to the Jacobson case.

By the 1920s, many schools in the United States required vaccination against smallpox, according to the History of Vaccines, a project of the College of Physicians of Philadelphia. When vaccines for diseases like pertussis, polio and measles became widely available in the 1940s and ’50s, the American public, inclined to have faith in science and government, voluntarily accepted them, said David Rosner, a Columbia University historian who specializes in the intersection of politics and public health.

The 1960s brought social upheaval and an anti-establishment mood — and with it, the beginnings of the anti-vaccine movement, which led many states to enact mandates, Rosner said. Often, there is pushback, especially with newly developed vaccines.

When the varicella vaccine was developed to combat chickenpox in 1995, for instance, Idaho refused to mandate it. But it was ultimately added to the state’s list of required vaccinations for children born after Sept. 1, 2005.

“Throughout history, states have imposed vaccine mandates,” said Jha of Brown University. “It’s always a little noisy and uncomfortable in the period of time when it’s being done, and then people get vaccinated, and whatever infectious disease you are trying to deal with fades into the background, and people move on, and that’s what I expect to happen here.”

Still, never before has a vaccine been so caught up in partisan politics. Rosner sees something deeper at work.

“This is part of a much larger dissolution of American society,” he said. “It is part and parcel of the resistance to all forms of social harmony and sense of social purpose that the country is undergoing right now.”

Eleven states, including Arizona, Florida and Texas, have already expressly banned COVID-19 vaccine mandates, either through legislation or a governor’s order, and questions are bound to emerge over whether the president’s mandates will trump those state policies or laws. (The answer is yes, Gostin said.)

Some experts have expressed caution about Biden’s mandates, for fear that the backlash will have ripple effects.

“You want to be careful you don’t put winds in the sails of the anti-vax movement,” Dr. Marcus Plescia, chief medical officer of the Association of State and Territorial Health Officials, said in an interview last month. The concern, he said, is that state legislatures “could also tinker with the idea that maybe all of these childhood vaccines are an overreach of government.”

So far, at least, there is no indication of that. And even in Republican-led states where Biden’s mandates are inciting outrage, the delta variant is making the case for him. In Mississippi, one of the hardest-hit states, hospitals were so overwhelmed last month that the University of Mississippi Medical Center put up a field hospital in its parking garage.

Today, the state is no longer last in the nation for COVID-19 vaccination, as it was throughout the spring and into early July. More than half of Mississippi adults are fully protected against the coronavirus.

This article originally appeared in The New York Times.

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