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With the Northern Hemisphere heading into winter and COVID-19 cases on the rise across Europe and North America, political leaders from Washington to Brussels are struggling to persuade a pandemic-weary public to get vaccinated against the disease that has killed more than 5 million people and sickened hundreds of millions around the world.

In the United States, a high-profile push by President Joe Biden to force all businesses with more than 100 employees to require workers to get vaccinated or submit to regular testing is snarled in court challenges. Across Europe this week, protests, some violent, flared as various governments announced that they would implement stricter measures to combat the disease, including many that limit the ability of unvaccinated people to take an active part in public life.

Worldwide, countries have responded to the continued presence of COVID-19, now nearly two years after it was first detected, with a variety of measures, from blanket vaccine mandates for all eligible individuals to more targeted requirements for people at particular risk, like health care workers.

Plentiful vaccines, variable uptake

According to Johns Hopkins University’s Coronavirus Resource Center, nearly 7.5 billion doses of vaccine have been administered since shots became available. Those doses have not been spread evenly around the world. The bulk of vaccines have been purchased by wealthy countries, like the United States and much of Europe.

That would seem to suggest that Europe and North America would be well protected from a winter surge of the virus, but even among countries where vaccines are plentiful, the percentage of the population that has chosen to get vaccinated against COVID-19 varies sharply.

According to data collected by Johns Hopkins University, only 59.7% of the American public is fully vaccinated, compared with 76.9% in Canada and 50.4% in Mexico. In Europe, vaccine uptake varies widely, from 86.9% in Portugal to just 12.6% in Armenia.

In Central Europe, cases are spiking in Germany and Denmark, where the rates of vaccination are 68.1% and 76.4%, respectively. Both countries are well above the global average in the percentage of people vaccinated, indicating that the disease can still spread rapidly, even where vaccination rates are relatively high.

This has leaders around the world searching for ways to compel more people to get vaccinated, with varied success.

Different approaches to vaccination

A handful of countries — Indonesia, Micronesia, and Turkmenistan — have implemented blanket requirements that all adults receive a vaccination.

This week, Austria became the first European country to announce that vaccination will be compulsory, with a requirement that all adults be vaccinated by February. The announcement came as the government announced it would be enforcing a fourth national lockdown to reduce the spread of the virus, prompting protests across the country.

Many other countries have taken a less extensive approach, tying vaccination status to the ability to work and take part in public activities, including going to restaurants, concerts, and other events.

With other European countries announcing stricter limits on what the unvaccinated are able to do, as well as broader restrictions on public life in general, protests broke out this week in the Netherlands, Belgium, Germany, and Croatia, among other nations.

Many European countries have adopted a “vaccine passport” system that limits access to public venues to people who can show proof of vaccination or of recent recovery from COVID-19.

Government employees face requirements

Among the most common measures being taken around the globe is the requirement that government employees be vaccinated in order to remain in their jobs. In addition to the U.S., countries with a requirement that public sector workers be vaccinated include Canada, Costa Rica, Denmark, Fiji, Hungary, Italy, Latvia, Russia, Saudi Arabia, Tunisia, Turkey, and Ukraine.

Of those, many have added a mandate for private sector workers as a whole; others have limited the requirement to private sector workers who deal with customers.

Some countries, among them Denmark, France, Lebanon, Morocco, and the Netherlands, have limited mandates to health care workers but have implemented restrictions on the activities of the unvaccinated.

US vaccine resistance

In the United States, President Biden’s attempt to require private businesses with more than 100 employees to require vaccination or testing is in limbo. The proposal, which would take effect in January, would affect about 84 million U.S. workers, on top of existing mandates on health care workers, federal employees and contractors, and the U.S. military.

However, the push by the Democratic president has been met with pushback from Republican politicians across the country. Multiple Republican state attorneys general have filed lawsuits to stop the mandate from coming into force. A federal judge placed a stay on the mandate, preventing its enforcement.

The cases have been consolidated before the 6th U.S. Circuit Court of Appeals, in Cincinnati, where the Biden administration is requesting that the stay on the mandate be lifted.

Supreme Court-bound

Brian Dean Abramson, an adjunct professor of vaccine law at Florida International University and the author of the BloombergLaw/American Health Law Association treatise Vaccine, Vaccination, and Immunization Law, told VOA that the fate of the mandate remains unclear.

According to Abramson, the Occupational Safety and Health Administration, the bureau within the Labor Department that crafted the mandate, left itself open to a number of challenges. For example, it is claiming that the new mandate is necessary to protect workers from a dangerous disease, but simultaneously claiming that health care workers can continue to observe a standard put in place earlier this year that is considerably less stringent.

Regardless of its fate in the 6th Circuit, Abramson said, the case is probably headed for the highest court in the land.

“What I do think is fairly inevitable, is that this will get to the U.S. Supreme Court rather quickly,” he said. “And I think we could see the Supreme Court receiving this, having some kind of expedited argument, and issuing a decision before the end of the year.” 


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