Supreme Court decision on vaccine, testing requirements leaves next steps 'in businesses' hands'

“Businesses can still do it,” Benjamin said, though he added that the federal requirement would have helped “level the playing field” across all large businesses when it comes to what types of Covid-19 protocols they have in place for their employees.

Now, “unions could pressure those businesses who don’t want to do this to protect their members,” Benjamin said. “I think the individual employees can demand that their employer do this.”

“These businesses are going to have an important decision to make, and hopefully they will prioritize the health of their workers,” Sharfstein said.

“I think that some employers will decide to impose a similar policy on their own,” he said. “There are many employees who are reassured by the policy, and so they may be supportive of their employers putting in place a policy program that protects their health.”

For instance, the Supreme Court decision “does not affect the ability of state or local governments to require vaccinations in businesses, and we’ve seen a lot of places around the country where that continues to happen,” McClellan told CNN. “It does not restrict businesses’ ability to require vaccination of their employees or their customers, for that matter.”

Overall, “it’s now in the businesses’ hands,” Benjamin said.

He added that the Biden administration “could pursue a more narrow strategy and put out another standard,” as one of the criticisms of the original approach was that the administration didn’t issue such Covid-19 requirements industry by industry.

For now, the health care industry is still under the original vaccine requirements — specifically health care workers in hospitals, nursing homes and other facilities that participate in Medicare and Medicaid programs.

What happens next for health care workers

According to government estimates, the health care worker mandate regulates more than 10.3 million workers in the United States. Covered staff were originally required to get the first vaccine dose by December 6, and the mandate allows for some religious and medical exemptions.

Now, health care workers covered by the Biden administration’s vaccine mandate will have until March 15 to be fully vaccinated in the 24 states where the mandate was reinstated by the Supreme Court. Twenty-five other states and DC continue to face the February 28 deadline for health care workers to be fully vaccinated that already was in place, as the mandate had not been blocked in those states before the Supreme Court order that came down Thursday.

This means there will continue to be “very high vaccination rates” among health care workers, McClellan said, and they could increase further since some health care workers have not previously been vaccinated.

The mandate — issued by the US Department of Health and Human Services’ Centers for Medicare and Medicaid Services — remains blocked in the lone state of Texas. Texas brought its own lawsuit challenging the mandate separate from the cases that were before the Supreme Court, and a preliminary injunction in that case still stands.

What happens next for public health

There is growing concern that without some workplaces requiring vaccinations, fewer unvaccinated people could move forward with their Covid-19 shots.

“One thing that will happen as a result of the requirement not going through in general for businesses — it’s an opportunity to kind of take the volume down, or reduce the heat a little bit, and think about what are some other ways to engage and getting to more consensus locally on vaccinations,” McClellan said.

After the Supreme Court decision, Benjamin said, it is even more important for public health officers to continue communicating the benefits of Covid-19 vaccinations to the public and focus on getting unvaccinated people vaccinated — including through the workplace.

“I think we should continue to adamantly articulate the value of vaccinations,” Benjamin said.

He added that public health departments also can help businesses set up in-house vaccine and testing protocols, strategies and even vaccine clinics.

“We can work with the business community to make sure they have access to tests and that their employees know how to get tested, not just when they’re symptomatic, but routine testing as part of a test or vaccine strategy. If a business decides it wants to do that anyway, the health department can help them with strategies and how to get access to tests,” Benjamin said. “And if a business wants to have a vaccine mandate, they can have mass vaccination clinics at their site of business.”