Small employers also need the vaccine mandate

Last month, President Biden ordered the Occupational Safety and Health Administration (OSHA) to require all businesses with 100 or more employees to institute COVID-19 vaccine mandates. Some, including some governors, view this as an overreach of federal power. Others, including many employers, welcomed the policy as critical to ensuring workplace safety, and workplace peace of mind. And, it seems, some smaller employers would have welcomed the OSHA requirement imposed on them as well.  

Since then, we have spoken with multiple small business operators. From a small trucking business operator to a boutique caterer to a small non-profit director, all have said they wish that they, too, were mandated to require the vaccine. They want to be safe, they want to assure their clients and customers that interacting with the organization is safe and they want to let the rest of their employees — most but not all of whom are vaccinated — know that coming back to work is safe.  

Why don’t these small employers just do it? Some have spent years fostering good relationships within their small organizations and worry a mandate would lead to resentments. They don’t want to alienate the few employees who don’t want to be vaccinated. For others, it’s more practical. If they mandate vaccination and others in their sector do not, they fear losing lose employees. Without a more universal mandate, hesitant employees may just leave and work for the competition.  

Leveling the marketplace for small employers who want to do the right thing on vaccine mandates is itself a sufficient reason for the expansion of the Biden rule. There is a larger reason as well: The country just needs it. Too many kids are still being sent home from schools that cannot operate normally, and — tragically but predictably — people continue to be hospitalized and die from COVID-19.

We have tried to get this pandemic under control through voluntariness. Good governance — and ethical public health policy — always starts by asking whether voluntary influence is sufficient to achieve common goals. We hoped that encouraging people, providing the vaccine for free and offering incentives would get enough of the country vaccinated for everyone to be safe. It didn’t. We hoped that at least those who got the vaccine could be fully protected even if others around them chose to forego vaccination. That didn’t happen either. We tried a voluntary and multi-pronged strategy for almost a whole year, and the answer is no.  

The narrative that vaccination is a personal choice whose consequences affect only oneself is seductive: It just turns out in this case to be a complete and blatant lie.  

Having too much to drink in your own home is a choice people are free to make themselves. But drinking too much and getting behind the wheel of your car affects everyone else on the road. You can do target practice at a firing range. You can’t do it in your crowded neighborhood. When your preferences obviously threaten the safety of others, you no longer get to claim that you should be able to do whatever you want. For centuries it has been established in American jurisprudence, in political philosophy and in ethics that when your individual desires threaten the health, security, or safety of others, you need to stop.

You can’t just drive 70 mph through a residential neighborhood where kids are playing. You can’t just get behind the wheel when you’re drunk. As we have done for centuries with our very American history of responding to typhoid, tuberculosis and Ebola, you can’t walk around crowded spaces and give someone else a deadly disease.  

President Biden waited. He waited patiently, sent vaccines to all corners of the country, ensured its availability at no cost through pharmacies and in congregate settings. But the president rightly concluded that his voluntary policies were not meeting his responsibility to protect the country against known threats, restart the economy, get restaurants back in business and get kids safely back in school. His policy is sound, but with 48 percent of employees working for a small business, it leaves gaping holes.  

If we are to contain this pandemic, we need every policy tool at our disposal to increase vaccine uptake. And that includes helping all employers, small and large, to become part of the solution. 

Nancy Kass is deputy director for Public Health at the Johns Hopkins Berman Institute of Bioethics. Ruth Faden is the founder of the Berman Institute.