In July, President Joe Biden issued a series of rules requiring that federal workers, and workers at companies that receive federal contracts, must be vaccinated. That included health care workers who work for hospitals that receive Medicare or Medicaid payments. However, earlier this month, a three-judge panel in Texas blocked the implementation of the mandate for many large companies. Now, as The Washington Post reports, a federal district judge in Missouri has acted to block even the mandate for health care workers. That includes workers dealing face-to-(hopefully-masked-)face with COVID-19 patients in emergency rooms and workers caring for those most vulnerable to bad outcomes in nursing homes.

What both rulings have in common is simple enough: Trump-appointed judges.

Unsurprisingly, the ruling from District Judge Matthew Schelp is filled with the kind of political language that might be expected from a Trump appointee, with statements including claims that implementing the rule would create a “…politically and economically vast, federalism-altering, and boundary-pushing mandate…” The ruling also flatly accepts unsupported claims by a group of Republican state attorneys, headed by radical right Missouri attorney general Eric Schmitt, that the mandate would cause a collapse of the health care system. According to Judge Schelp, it’s the mandate that’s the threat that “significantly understates the burden that its mandate would impose on the ability of health care facilities to provide proper care, and thus, save lives.”

In fact, Judge Schelp ultimately echoes right-wing talking points by claiming that vaccine mandates mean that people will just walk off the job. “The loss of staffing in many instances will result in no care at all,” writes Schelp, “as some facilities will be forced to close altogether.” This isn’t just untrue; it’s a massive lie.

Vaccines work. Vaccine mandates work. And this ruling will directly contribute to the death of Americans. But even that is just one part of what makes this so notably wrongheaded.

Tuesday, Nov 30, 2021 · 4:47:13 PM +00:00 · Mark Sumner

Just to make it clear how unjustified this ruling is, Judge Schelp provides two examples of why the mandate is dangerous. One is a single Nebraska anesthesiologist who says he will quit rather than take a shot. The second is a Missouri nursing home where Republican AG Schmitt claims that the administrator says “out of about sixty-five employees, twenty have indicated that they are opposed to taking the vaccine, and if the mandate is imposed, that they will quit.”

The same kind of claim was made about tens of thousands leaving the New York City Police Department. It didn’t happen. And thousands more abandoning the military. It didn’t happen. And planes grounded by crews leaving the airlines. It didn’t happen. In the widely publicized case of a healthcare system in Houston, where headlines blared those 150 workers who quit, they failed to mention that over 99% of workers did not.

If that Missouri nursing home actually lost workers at the same rate as Houston Methodist, which was subject to months of Republican-supported protest and lawsuits, they would lose … not a single person. But judges are still making rulings supported by this kind of claim.

Schelp’s ruling will halt the implementation of mandates across 10 states: Alaska, Arkansas, Iowa, Kansas, Missouri, Nebraska, New Hampshire, North Dakota, South Dakota, and Wyoming. This includes some of the states with the lowest vaccination rates, and not surprisingly, the highest rates of COVID-19 deaths.

COVID-19 vaccines work. That effectiveness has been demonstrated both in the thousands who participated in controlled trials and in the relationship between rates of vaccination and rates of serious illness worldwide and within the United States. Multiple long-term surveillance studies continue to show that vaccines are highly effective at preventing hospitalizations and deaths, even in the face of delta and other variants.

Vaccine mandates work. That’s been demonstrated from the airlines to education to the military, where vaccine requirements have all but eliminated anti-vax holdouts. Despite dire predictions that thousands would walk off the job rather than take a jab, in New York City, only 34 out of over 35,000 police actually went on unpaid leave when they failed to meet vaccine deadlines. A company mandate resulted in at least 99% of United Airline employees getting vaccinated. Schools across the country have seen that mandates increase vaccination for both students and staff.

Mandates have also made a huge difference among health care workers. As NPR reported in September, health care workers were not immune to being influenced by vaccine misinformation and disinformation. As a result, 27% of those on the front lines of the crisis remained unvaccinated just three months ago. Then companies began enforcing mandates. While The New York Times ran headlines such as “Over 150 Texas Hospital Workers Are Fired or Resign Over Vaccine Mandate,” that headline deliberately obscured was the fact that the 153 fired or suspended came from a system that employed just under 25,000. Thanks to a vaccine mandate, Houston Methodist hospitals went from 75% vaccinated, to 99.4% vaccinated. That change absolutely saved lives.

Around the world, differences in vaccination rates are among the biggest factors in determining the number of COVID-19 deaths. In Russia, where vaccination rates are below 40%, despite the home-grown and widely trumpeted “Sputnik” vaccine, death rates have continued to rise dramatically as the delta variant became dominant. Currently, Russia is seeing case fatality rates well above 3%—twice that of the United States. On the other hand, even during the worst of the delta surge, the rate of deaths in Israel, where vaccine rates are higher than in the U.S., stayed well below 1%. And while the daily rate of cases in the U.K. may seem terrible, a combination of widespread testing and a vaccination rate 10% higher than the U.S. means that the case fatality rate there has remained around 0.4% throughout the delta surge.

Around the world, the World Health Organization estimates that between 115,000 and 180,000 health care workers have died from COVID-19. Kaiser Health News found over 3,200 U.S. health care workers had died in just the first year of the pandemic. That number was as of March, well before the delta surge. With a quarter of those workers still unvaccinated as of this fall, misinformation means that thousands more are likely to die—and that’s not considering their families, friends, or others who become infected from contact with these unvaccinated workers dealing directly with COVID-19 infections.

The “burden” imposed by mandates is fantastically small. That’s been demonstrated again and again. However, Republicans—including Judge Schelp—ignore that truth to maintain a pretense that vaccines will either cause massive disruptions or generate widespread walkouts. Neither of which is at all true,

The success enjoyed by Republican attorney generals appealing mandates to Trump-appointed judges will open the floodgates on lawsuits from former employees against companies, universities,  hospitals, and local governments that imposed vaccine mandates. The result is likely to be a legal chaos that goes on for years.

The specific means by which Republicans have been fighting these mandates—by arguing that federal agencies don’t have the right to set the rules how such steps are implemented—has much broader implications. Rulings such as those from Judge Schelp are another step in making it impossible for executive branch agencies to effectively implement policy, whether it comes from legislation or executive order. 

Finally, the pliancy demonstrated by these Trump-appointed judges is another huge warning for what comes next, when these same attorney generals stand in front of the same judges, to restrict voting, defend gerrymandering, and overturn any election that doesn’t fall their way.