U.S. Supreme Court Upholds Health Care Worker COVID-19 Vaccine Mandate


Health care workers who work at facilities that care for patients who have Medicare or Medicaid must get the COVID-19 vaccine.

Health care professionals who work at the approximately 76,000 health care facilities in the United States that accept patients who have Medicare or Medicaid coverage must be vaccinated against COVID-19 if those facilities impose such a mandate, the U.S. Supreme Court ruled yesterday. That’s 1 of 2 major decisions the Top Court handed down, and it’s viewed as a win for the Biden administration and its Department of Health and Human Services (HHS). The department issued the health care worker vaccine mandate on November 5, 2021.

However, the Biden administration lost in its bid to impose a vaccine-or-test mandate on private employers with 100 or more workers. The administration argued that the mandate supports the mission of the Occupational Safety and Health Administration (OSHA) to ensure safe work environments. OSHA issued the guidance on January 29, 2021, and updated it June 10, 2021. More than 80 million people would have been affected, and OSHA argued that the rule would have prevented 6500 deaths and 250,000 hospitalizations over 6 months.

The Top Court ruled that in trying to impose the mandate on private companies, the Biden administration overstepped Constitutional boundaries by giving OSHA regulatory powers that it does not have. “Although Congress has indisputably given OSHA the power to regulate occupational dangers, it has not given that agency the power to regulate public health more broadly,” the Court ruled. “Requiring the vaccination of 84 million Americans, selected simply because they work for employers with more than 100 employees, certainly falls in the latter category.”

About the vaccine mandate for health care workers, the Court ruled: “The challenges posed by a global pandemic do not allow a federal agency to exercise power that Congress has not conferred upon it. At the same time, such unprecedented circumstances provide no grounds for limiting the exercise of authorities the agency [HHS] has long been recognized to have.”

Both rulings will affect infection preventionists (IPs). IPs are often at the forefront of trying to encourage their fellow health care professionals who are vaccine hesitant to get the vaccine. IPs also strive to keep their colleagues safe from infection by patients.

Linda Spaulding, RN-BC, CIC, CHEC, CHOP, a member of Infection Control Today®’s (ICT®’s) Editorial Advisory Board (EAB), calls the Top Court’s ruling about the employer mandate “disgusting.”

“The Supreme Court has decided that human life is not worth saving,” says Spaulding. “Their ruling assures that the death toll of 844,562 Americans will continue to rise. Children will lose more parents. Parents will lose more children.”

IPs and other health care professionals currently fight an unprecedented COVID-19 surge fueled by the Omicron variant that’s breaking records for infections and hospitalizations and makes the death rate rise as well, despite the fact that 62.7% of the population is fully vaccinated, and more than a third of those have received booster shots, according to the Centers for Disease Control and Prevention (CDC). According to the Johns Hopkins Coronavirus Resource Center, 1777 individuals died from COVID-19 yesterday, and 786,064 people were infected by the disease. The number of people hospitalized with COVID-19 has more than doubled in 2 weeks to 155,935, according to the HHS.

Spaulding says that “the message from the Supreme Court is, ‘Too bad. We are OK with the unvaccinated continuing to spread COVID-19 until we have a variant that no one has protection against, and even more can die just because being vaccinated and wearing a mask is too much to ask to protect life.”

Kevin Kavanagh, MD, another ICT® EAB member, has long called for vaccine mandates for health care workers. In a Viewpoint in April 2021, Kavanagh wrote: “If you work in a health care facility, you need to be vaccinated against SARS-CoV-2. If you choose not to become vaccinated, then you should choose not to be working in a health care setting.”

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