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Biden Weighs 'Vaccine or Testing' Mandate for Federal Employees

By Ernie Mundell and Robin Foster HealthDay Reporters

WEDNESDAY, July 28, 2021 (HealthDay News) -- President Joe Biden is considering a mandate that would require all civilian federal employees to get a COVID-19 vaccine or submit to regular testing, masking and travel restrictions.

White House officials said Tuesday they would reveal more about the president's plans later this week, while Biden said he would deliver a speech on Thursday about "the next steps in our effort to get more Americans vaccinated," The New York Times reported.

The latest news illustrates the growing concern among top federal health officials about the spread of the highly contagious Delta variant, but that concern must be balanced against the possibility that mandates could fuel further opposition to vaccination, officials told the Times.

The idea being debated is similar to a mandate New York City announced on Monday, which would require all 300,000 city employees to be vaccinated or to have to do weekly testing, officials told the Times.

It was not clear if Biden was planning to do the same with the military, although he does have the authority to do so, the Times said. Defense Secretary Lloyd Austin III has said he would not be comfortable with a vaccine mandate until the U.S. Food and Drug Administration fully approves COVID-19 vaccines.

The lack of full approval hasn't stopped mayors, chief executives, hospital administrators and college presidents around the country from requiring vaccinations. In California, Gov. Gavin Newsom said Monday that the state's 246,000 employees would have to be vaccinated by Aug. 2 or would be tested at least once a week.

With the Delta variant threatening a surge of cases in the fall, Biden must decide how far he should go to protect the American people from the coronavirus.

"You want to be careful," Dr. Marcus Plescia, chief medical officer of the Association of State and Territorial Health Officials, told the Times. "You don't want to put wind in the sails of the anti-vax movement."

But other experts say Biden must protect Americans first and foremost. Dr. Paul Offit, director of the Vaccine Education Center at the Children's Hospital of Philadelphia, told the Times that Biden should mandate vaccines to the degree that he can, among federal employees and the military.

"Sure, it will cause a backlash -- so what?" Offit said. "It isn't a personal choice. It's a choice for others. It's not an American's right to potentially catch and spread a fatal infection."

In the last six months, nearly half of the country -- 163.3 million people -- has been vaccinated, including 80 percent of those 65 and older, data from the U.S Centers for Disease Control and Prevention shows. But tens of millions of people remain unprotected against what CDC Director Dr. Rochelle Walensky has described as one of the most contagious respiratory diseases known to scientists.

Experts say a refusal to get vaccinated puts others at risk — especially those who cannot get shots for medical reasons, or whose immune systems are too weak to respond to the vaccine.

"The ongoing transmission of this virus is in fact largely due to the unvaccinated," Dr. Michael Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota, told the Times.

On Tuesday, Biden made his frustration with people who refuse to get a shot clear.

"The more we learn about this virus and the Delta variation, the more we have to be worried or concerned," Mr. Biden said. "And only one thing we know for sure: If those other 100 million people got vaccinated, we'd be in a very different world."

Fauci pushes ambitious plan to guard against future pandemics

In an effort to avoid another pandemic in the coming years, Dr. Anthony Fauci wants to launch an ambitious plan to make prototype vaccines that could protect against pathogens from 20 families of viruses that threaten human lives.

It won't come cheap, with the cost totaling "a few billion dollars" a year, Fauci said, and the first round of results wouldn't emerge for at least five years. Also, a huge number of scientists would be needed to conduct the necessary studies.

"It would require pretty large sums of money," Fauci told theTimes. "But after what we've been through, it's not out of the question."

Using research tools that have worked with COVID-19, scientists would study the molecular structure of each virus, searching for the spots where antibodies must strike it, and figuring out how to prompt the body to make those antibodies.

"If we get the funding, which I believe we will, it likely will start in 2022," Fauci said, adding that he has been pushing the idea "in discussions with the White House and others."

Dr. Francis Collins, director of the U.S. National Institutes of Health, said he thought the necessary funds would be allocated and added that the project is "compelling."

"As we begin to contemplate a successful end to the COVID-19 pandemic, we must not shift back into complacency," Collins told the Times.

Much of the financial support would come from the agency that Fauci heads, the National Institute of Allergy and Infectious Diseases (NIAID), but additional funds that would have to be allocated by Congress, the Times reported. The institute's budget is a little over $6 billion this year.

If a new virus was detected spilling over from animals into people, scientists could immunize people in the outbreak by quickly manufacturing the necessary prototype vaccine.

"The name of the game would be to try and restrict spillovers to outbreaks," Dr. Dennis Burton, a vaccine researcher and chairman of the department of immunology and microbiology at Scripps Research Institute, told the Times.

The prototype vaccines project is the brainchild of Dr. Barney Graham, deputy director of the NIAID's Vaccine Research Center. He presented the idea in February of 2017 at a private meeting of institute directors, the Times reported.

Year after year, viruses had threatened to turn into pandemics, Graham noted: the H1N1 swine flu in 2009, Chikungunya in 2012, MERS in 2013, Ebola in 2014, Zika in 2016. Each time, scientists scrambled to try to make a vaccine. Their only success was a partial one, with an Ebola vaccine that helped control the epidemic but would not work against other Ebola strains, he said. The other epidemics waned before vaccines could be made or tested.

But researchers now have new tools developed over the past decade that allowed scientists to view the molecular structures of viruses, isolate antibodies that block the viruses, and then find out where they bind. The result: An ability to target each emerging pathogen more precisely.

Now, the institute has created a spreadsheet for each of the 20 virus families showing what is known about each pathogen's anatomy and vulnerabilities, Dr. John Mascola, director of the Vaccine Research Center at the institute, told the Times.

"For each virus family, we are in a different state of knowledge and vaccine development," Mascola said. Vaccines for Lassa fever and Nipah virus, for example, are in early stages. Vaccines for Chikungunya and Zika are further along, the Times reported.

More information

The U.S. Centers for Disease Control and Prevention has more on COVID-19.

SOURCES: The New York Times

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