Wading into the contentious issues of vaccine mandates and vaccine credentials, the American Medical Association (AMA) adopted policy that calls for strong protections for privacy and equity when considering these proposals.
At the Special Meeting of its House of Delegates, the AMA said a well-designed education and outreach effort is necessary to promote vaccinations and to protect public health and public trust.
Before mandating Covid vaccinations, the AMA recommended that:
- The vaccine receive full approval from the Food and Drug Administration through a Biological Licenses Application.
- The mandate follow the recommendations of the Advisory Committee on Immunization Practices as approved the by CDC director.
- Individuals subject to the mandate be given meaningful opportunity to voluntarily accept vaccination.
- Implementation of the mandate not exacerbate inequities or adversely affect already marginalized populations
All states employ vaccine mandates in some form, most notably vaccine requirements for students. Many states require staff of health care institutions to be vaccinated for a range of infectious diseases. While mandating Covid vaccination is a pathway toward achieving herd immunity, a mandate also may further alienate individuals who are mistrustful of authority, the AMA policy noted.
"Given the high rate of asymptomatic transmission in COVID-19, vaccinating the greatest number of individuals possible is critical. While vaccines are highly effective public health tools, vaccine mandates are a blunt instrument and may carry the risk of eroding trust and undermining public health goals," said AMA President Gerald E. Harmon, M.D. "We can reach herd immunity with a robust public campaign which would have the benefit of respecting patients' autonomy and minimize disproportional burdens on marginalized communities. Failure to achieve herd immunity is more likely to result in mandates."
As for digital vaccine credentials (often referred to by the misnomer "vaccine passports"), the AMA called for the federal government to play a role in establishing, publicizing and enforcing guidelines for use of digital credentials.
The AMA policy said that prior to implementing use of digital vaccine credentials, the following must occur:
- Vaccine is widely accessible.
- Equity-centered privacy protections are in place to safeguard data collected from individuals.
- Provisions are in place to ensure that digital vaccine credential do not exacerbate inequities.
- Digital credentials have a way to address the situation of individuals for whom vaccine is medically contraindicated.
"The Biden administration has said it is not creating federal digital vaccine credentials. Nonetheless, the federal government must be vigilant on issues of equity and privacy. We can't leave these decisions to the app marketplace which profits by exploiting user data," Harmon said.