Can employers mandate vaccines in Iowa? Controversial Senate bill would say no

Sen. Jim Carlin, R-Sioux City, volleyed several debunked anti-vaccination talking points at Iowa Department of Public Health’s Dr. Caitlin Pedati during a Tuesday afternoon meeting.

Carlin asked why there were so many vaccinations now, noting he only got three or four shots as a child. He asked why more children seem to be sick with chronic diseases and whether vaccines could contribute to sudden infant death syndrome. He brought up the long-disproven theory that vaccines could cause autism.

“When I was a kid, I don’t think we had any autistic kids in my entire class … The autism numbers have exploded,” Carlin said. “I know that’s a classic argument, and I get that, but I’m bringing it up just to have a conversation.”

Pedati told Carlin and the Zoom audience of over 100 people that vaccines were safe, effective and do not cause autism or sudden infant death syndrome. As for chronic diseases, she responded, children today face different problems due to more complex factors than just infectious diseases.

The extensive discussion of vaccines sprang from consideration of Senate File 193, a bill that would prohibit employers, schools, health care providers and other organizations from discriminating against people who are not vaccinated or requiring them to be vaccinated. 

Public testimony ranged from health care organizations trying to keep patients safe to moms concerned about their children who had experienced adverse reactions to vaccines. 

The subcommittee voted 2-1 to move the bill forward.

Health care providers, employers say vaccines aid workplace safety

Several lobbyists spoke on the first two sections of the proposed bill, which would prevent employers — including health care providers — from requiring their employees to be vaccinated.

JD Davis, a representative for the Iowa Association of Business and Industry, said he recognized the rights of Iowans to decide whether to be vaccinated. However, he said, that right should not take precedence over employers who have the right to “arrange their businessplace in any way they see fit.”

“Decisions have consequences,” Davis said. “If someone decides that they wish not to have a vaccination, then there are some consequences they’re going to have to weigh when they make that decision.”

Dennis Tibben, a lobbyist for the Iowa Medical Society, objected to the second division of the bill that says health care providers cannot mandate employee vaccinations.

“Putting in place that division, we believe, would unnecessarily restrict the ability for a health care setting to set up protocols to keep their patients safe,” Tibben said.

Lina Tucker Rinders, executive director of the Iowa Public Health Association, opposed the bill more broadly. She noted that Iowa already allows for medical and religious exemptions for vaccines. Senate File 193 would be a philosophical exemption, she said, which could increase vaccine hesitancy in Iowa, especially as individuals are already surrounded by misinformation on social media.

“It only has to plant a seed of doubt, regardless of how unfounded, and hesitancy begins to take root,” Tucker-Rinders said. “Iowa’s public health and medical professionals and scientific community are experts, dedicated to the protection, care and safety of our children and all Iowans.”

Anti-vaccine groups support the bill

Proponents of Senate File 193 argued that the bill would be an important step forward for those who choose not to be vaccinated.

Shanda Burke, a lobbyist for vaccination-skeptical group Informed Choice Iowa, said she was treated differently and threatened with termination because she refused to get a flu shot as a certified medical assistant. She eventually quit.

“No other health decisions are like that,” Burke said. “It (should be) completely up to you, between you and your doctor, not between you and your employer.”

Carlin, who has announced plans to run for U.S. Senate in 2022, spent nearly 10 minutes asking Burke about her concerns with the COVID-19 vaccine and the slate of childhood vaccines. 

Several mothers also spoke in support of the bill. Emily Lewis said her child had been injured by a vaccine and she strongly believes employers should not be allowed to mandate vaccinations.

“My husband should not have to choose between his job and keeping himself safe,” she said.

Lewis also spoke of the difficulties of finding a pediatrician who would see her son, who was not fully vaccinated. Under the bill, health care facilities could not deny treatment to patients who refuse to be vaccinated.

What does this mean for the COVID-19 vaccine?

The Legislature has considered similar bills in previous sessions. In 2019, a Senate bill would have allowed parents to opt their children out of vaccines due to “conscientiously held beliefs.” A subcommittee voted against it, stalling the bill for the rest of the session.

But with the COVID-19 vaccination effort well underway in Iowa, concerns over who must be vaccinated have come to the forefront. 

Dawn Richardson, a lobbyist for the anti-vaccine group National Vaccine Information Center, said the COVID-19 pandemic has introduced discrimination based on mask-wearing and testing. She worried that allowing institutions to mandate vaccines would create similar problems.

“We’ve seen travel restrictions, employment discrimination and right of access to public venues over masking and testing, and now it has started over vaccination,” she said.

Under current federal guidance from the Equal Employment Opportunity Commission, employers can require employees to be vaccinated against COVID-19 if it does not violate their sincerely held religious beliefs or a medical exemption.

If the bill passes, employers in Iowa would be unable to require employees to be vaccinated against COVID-19 or any other disease. Even in health care settings where employees may interact closely with patients, those staff members could not be required to be vaccinated.

That could mean large percentages of health care workers and nursing home staff will decline to be vaccinated. In January, the Iowa Veterans Home said over 40% of their staff were refusing the vaccine. 

Asked about the hesitancy at the Iowa Veterans Home, Gov. Kim Reynolds declined to say whether employees at state-run care facilities should be required to get the COVID-19 vaccine.

Among the general population, confidence around the COVID-19 vaccine is growing but far from universal, according to a February CDC report. Only 39.4% of Americans said in September that they intended to get the COVID-19 vaccine. By December, that figure had jumped nearly 10 points to 49.1%.

Health experts do not know yet what percentage of Americans must be vaccinated in order to achieve herd immunity.