While Russia and China have raised eyebrows with their very early public release of vaccines, several countries including the US, the UK, and India may have vaccines against SARS-CoV-2 as soon as this year. With questions being raised about our readiness to distribute the vaccine going as far as the inventory of glass vials, there is still the last mile of the equation—will enough people accept the vaccine?

Dr. Norman Oliver, the Virginia State Health Commissioner is one of the few to announce they'll make vaccinations mandatory saying bluntly “It is killing people now, we don’t have a treatment for it and if we develop a vaccine that can prevent it from spreading in the community we will save hundreds and hundreds of lives." The mandate would be subject to exceptions as in the case of special medical exemptions. The Virginia General Assembly is also reviewing a potential bill to include religious objections as a legal means to opt out.

Mandates like these are not without their retractors like the Virginia Freedom Keepers Facebook group who cite "medical freedom" and "choice" while shying from the "antivaccine" label. Supporters of mandatory vaccinations note the biological reality of widespread vaccinations, specifically the need for herd immunity where a critical percentage of the public would need to be innoculated for the vaccine to reach optimal efficacy.

In an article today in Yahoo Finance, Richard Hughes, the managing director and vaccines leader at Avalere, a DC-based health care consultancy weighed in on the legality of such a mandate. Hughes cited the political challenge with a state or federal mandate but asserts the same laws provide freedom for employers and schools to require their employees and students to be vaccinated. According to the article, Farley Cleghorn, a physician and global health practice head at consultancy Palladium, “Countries can legally mandate vaccination to cross borders, as with yellow fever, and schools from kindergarten to universities can legally require vaccination for entry, as in much of the world for the expanded program of immunization and with limited medical exemptions....If a vaccine is developed, employers may be able to require employees to become vaccinated and will have to evaluate accommodations for religious beliefs and/or disabilities,"