In a sign that the United States has reached a “tipping point” in its campaign to vaccinate Americans, California and New York City announced vaccine or testing mandates for their employees on Monday while the Department of Veterans Affairs said its frontline health care workers must get immunized or face possible termination.

The VA becomes the first federal agency to issue a mandate, and experts believe it signals that the country is moving closer to requiring vaccinations.

California and New York City will give workers a choice: Get vaccinated or face weekly testing. At the same time, a group of nearly 60 leading medical organizations on Monday backed vaccine mandates, while many hospitals, including Mayo Clinic, did the same, the Washington Post reported.

The VA’s mandate applies to more than 100,000 front-line workers, New York City’s applies to about 45,000 city employees and contractors, and California’s applies to more than 2.2 million state employees and health workers, the Post reported.

“You can call it a tipping point,” California Health Secretary Mark Ghaly told the Post, noting that millions have declined the shots despite public health experts’ appeals and a range of incentives. “For so many Californians and Americans, this might be the time to get vaccinated.”

Fueled by the rapid spread of the highly contagious Delta variant, new cases per day have risen fourfold in the United States over the last month, leading some public health experts to call for stricter measures to boost lagging vaccination rates, The New York Times reported.

Yet the logistical challenges of enforcing these mandates became clear quickly in New York City when several major unions representing city workers warned that the rules had to be collectively bargained, the Times reported.

In California, the new rules were generally welcomed by health care organizations and public employee unions. The requirement will begin on Aug. 2 and be implemented by Aug. 23, the Times reported.

“We are exhausted by the right-wing echo chamber that has been perpetuating misinformation around the vaccine and its efficacy and safety,” California Governor Gavin Newsom said Monday, the Times reported. “We are exhausted by its politicization of this pandemic, and that includes mask wearing that has been equated to the Holocaust. It’s disgraceful, it’s unconscionable and it needs to be called out.”

California has been averaging almost 6,400 new virus cases per day, an increase of more than 200 percent in the past two weeks, the Times reported.

The order in New York City, affecting teachers and police officers among others, would begin for most workers on Sept. 13, the day when nearly 1 million students in the nation’s largest school district return to class, the Times reported.

The Biden administration has said it is not the federal government’s role to impose a nationwide mandate. But the risk to veterans, who tend to be older, sicker and possibly more vulnerable to illness, was becoming too great, Secretary of Veterans Affairs Denis McDonough told the Times.

“I am doing this because it’s the best way to keep our veterans safe, full stop,” said McDonough.

Doctors, dentists, registered nurses, physician assistants and some specialists in the sprawling VA system will have eight weeks to get fully vaccinated or face penalties including possible removal, he said. About 70 percent of workers in the VA’s health care centers have been fully vaccinated, the Times reported.

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: Associated Press; The New York Times

Source: HealthDay