Medical Examiner

Proof That Vaccine Mandates Work

People look down from the pedestrian part of the bridge onto the road, where a crowd carries a large U.S. flag and protest signs.
Municipal workers march across the Brooklyn Bridge during a protest against the COVID-19 vaccine mandate on Oct. 25. Ed Jones/AFP via Getty Images

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When I asked Eric Lach how he ended up marching across the Brooklyn Bridge shoulder to shoulder with city workers protesting the mayor’s COVID vaccine mandate, he said, it all started with a flyer. Lach writes for the New Yorker, and a firefighter had forwarded him this invitation. “It said: ‘NYC Workers Anti-Mandate March for Choice, Monday, Oct. 25, 11:30 a.m. Make signs, bring your families. There are tens of thousands of us. This is our last stand,’ ” Lach said.

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It was a dramatic statement, but Lach wasn’t sure if anyone would really show up. It turns out: They did. Thousands of New York municipal workers came out to give speeches and wave placards. When Eric joined them, he says, it wasn’t quite what he expected. “It wasn’t just a right-wing political rally,” Lach said. “I’ve been to Trump rallies, and this was not that. It was colleagues standing around, everybody saying hi to each other, hugging each other, high fiving each other. There was some guys smoking cigars.

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“I probably had conversations with 50 people, and five or six of them said they were vaccinated, and that they were just there to support their colleagues’ right to choose,” he added.

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“These are people who were deemed essential workers who went into work through the pandemic. Sanitation workers were on the backs of garbage trucks in March and April and May 2020, when nobody knew if COVID was transmitted by surfaces, and they’re handling everybody’s garbage,” Lach said. “I talked to one EMS worker who was there. She was vaccinated, but she was just pissed. She was like, ‘We worked through the pandemic. They told us just to reuse our masks at the beginning when there wasn’t enough PPE to go around, and we got shunted this way and sent that way. And then now we’re being forced to do something.’ The frustration that her peers were expressing was totally resonating. She was mad. She was tired.”

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On Monday’s episode of What Next, I spoke with Lach about how the debate over who can dodge a vaccine—and who can’t—is heating up. What happened with these workers in New York reveals how the fight could end. Our conversation has been edited and condensed for clarity.

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Mary Harris: The latest vaccine mandate in New York City applies to all kinds of people: EMTs, firefighters, sanitation workers, cops. The mayor announced it just a few weeks ago, and he gave these city employees just nine days to get their shots. 

Eric Lach: The mandate did come with a carrot-and-stick component, where the stick was that you go on unpaid leave if you don’t get a shot. The carrot was that you would get $500 if you did get the shot on time. A lot of the city workers seemed to just dismiss this $500—at least the ones at the march. I’m sure there were plenty of city workers who were grateful for the $500, but the ones who were most vocally against the vaccine almost wanted to treat their $500 with suspicion. Like, Why are we being bribed to get this vaccine?

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This latest rule came down after months of back-and-forth over the vaccine. Back in the summer, the city had given workers a gentler mandate: They could choose to get the vaccine or show up for weekly COVID tests. 

The idea with that policy was that the weekly tests were going to be so annoying that people would eventually just give in and get the shot.

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Is that how it worked?

In certain departments, particularly ones that turned out big for the march last week—the fire department, the sanitation department, and to a certain extent, the New York Police Department—those numbers proved more stubborn than you might have expected. Those departments were in the 60s, percentage-wise, in terms of vaccinations.

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By the end of the summer, an average city resident was more likely to be vaccinated than a city worker. So the mayor and the governor began to crack down, starting with teachers and health care workers.

In September, City Hall had announced that teachers and health care workers were going to have to be vaccinated. And this all coincided with the FDA switching over the vaccine approval from emergency use authorization to just regular authorization.

I remember this because I have kids in school and it was a few weeks before school started—really up to the wire.

It was in the swirl of back to school. It was in the swirl of how are we going to make school safe? How are we going to get everybody back to school? What’s this going to look like? And in that mix is when this mandate comes out.

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And the mandate gets rid of the weekly testing option. It just says you have to be vaccinated.

You have to be vaccinated. And there was an outcry from those workers, and there were lawsuits that were filed in response to that mandate. Those lawsuits just didn’t work out in the courts in the workers’ favor. And eventually what the city government did is they worked out a deal with the unions representing those workers that said there was a slight carve-out for medical and religious exemptions. You could apply for the specific exemptions, and you wouldn’t have to get the shot without those exemptions were being reviewed.

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So the bulk of people were buying time. And then in the end, a few of those workers would actually get an exemption.

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Yeah. Those departments ended up at over 95 percent vaccinated. That’s where they are today.

When the mayor noticed his vaccine mandate for teachers and health care workers seemed to be working, he decided to expand it—as quickly as possible—to everyone else. That’s how you ended up in a sea of firefighters and cops and sanitation workers on the Brooklyn Bridge.

The Police Benevolent Association, which is the largest union that represents NYPD officers, has been a vocal, vocal presence in New York City politics for a long time. It’s no surprise to see them fight with City Hall. They hate this mayor. It was more of a surprise to see the firefighters union and the sanitation workers and parks department workers, and NYCHA, the public housing agency, has one of the worst vaccination rates in the city. This involved city workers that haven’t played very vocal roles in some of the political fights of the past few years in the city. So to that extent, it was surprising to see how widespread this was.

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I wonder how you think about the politics of this nine-day warning that the mayor gave. I think that giving such a short timeline certainly led people to really burn hot in terms of their emotions, but they also seem to burn fast. We had a big protest. We had a lot of worry. And then it was here.

No matter what, there was going to be a vocal contingent of people who didn’t want to do this. There was going to be some people who just refuse to get the shot. And regardless of the timeline you put on it, there was going to be ugliness. There was going to be this expression of political rage that threatens violence. You had some firefighters that went in uniform to the office of the state senator in the city here and demanded to know what was going on.

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They told them that they’d have blood on their hands if the mandate went forward.

That seems like it would have been expressed no matter what—if there was a three-month deadline or a nine-day deadline or a two-day deadline. There was some contingent of city workers that would feel that way and that would respond in this way.

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As of right now, who are the main holdouts when it comes to getting vaccinated?

FDNY, the firefighters. FDNY includes firefighters and EMS workers, and the EMS workers are close to 90 percent vaccinated at this point. The firefighters are still under 80 percent.

Why firefighters?

I think that the firefighters have a really strong job identity. The other thing that we haven’t really quite touched on yet is that a lot of firefighters who I talked to say, “A lot of us already had COVID. We have antibodies, and therefore we shouldn’t be forced to get the vaccine.”

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They believe in a previously acquired immunity.

Yeah, exactly. And so that argument really seems to have taken hold in the fire department.

And we should say: The evidence shows that that immunity is not as strong as vaccine immunity.

The public health recommendation is to get vaccinated anyway, but they dismiss that.

I think of firefighters as risk takers. They run into burning buildings.

And risk assessors.

Yeah.

Just talking to some, especially the older firefighters, there’s still this legacy of 9/11 and this special class that first responders were put in after 9/11. Some of them will say, “We were told that working down on the pile after 9/11 was safe, and then a lot of us got sick.” And there’s been a multidecade fight with Congress for proper funding for people who got sick. There’s this institutional memory and residual feeling that this is a particular kind of job and we are a particular kind of city worker.

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There were other ways that New Yorkers were feeling this resistance from municipal employees who just weren’t comfortable with the shot. Like, my trash wasn’t picked up for a day or two. I know that 311 complaints quadrupled. And union heads were warning, like, “Oh, we’re not going to have enough people to send to fires,” or “We’re not going to have enough people to respond to medical calls.”

Yeah, obviously that was one of the big questions going into the deadline: Is this going to affect the functioning of city government? Even if it’s a fraction of the total city worker population that holds out.

Was the government worried about that?

Mayor de Blasio seemed pretty sanguine about that all week, saying, “Friday is the deadline. The city workers have to get their shots by then. And after that, we move on.”

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There have been some anecdotal reports of trash piling up on city sidewalks. And then last week, many, many firefighters called in sick. But so far, there haven’t been signs that this is really going to mess with the functioning of the city government in some visible or troubling way.

So where do we stand now? I think the latest I saw was 9,000 workers were on leave, but then 12,000 workers have applied for a religious exemption.

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There’s about 20,000 unvaccinated city workers and about half have applied for some kind of exemption. Those cases will be evaluated and then resolved one way or the other. It’s yet to be seen whether this is the kind of holdout that is relatively temporary and a lot of those people come back or if they just hold out indefinitely.

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There’s a Facebook page for firefighters that I have been reading where they’ve been posting tributes to people who retired, people who already had their 20 years—and in some cases, much longer than that, 30 years, 40 years—and they just opted to retire instead of getting vaccinated.

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There were reports that the Police Benevolent Association held an event where people could donate to people who would rather take early retirement than get vaccinated.

Definitely those people exist. We still don’t know how many people those are. And over the next week or two, I think it’s going to be a lot more clear if we’re talking about a couple of hundred versus a couple thousand.

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As of Thursday, 91 percent of all municipal workers in New York City had been vaccinated. That means that after lagging behind the rest of the city for months, municipal workers are now more likely to be vaccinated than everyone else. Does that mean the vaccine mandate is working? 

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That’s the outcome that City Hall was looking for. They just wanted everybody vaccinated.

So I think this is a success story.

Obviously the people who are holding out don’t feel that way. But overall, this is a city policy that was put in a place in relatively short order that got the results they were looking for.

When you called back some of the sources you’d met at that march, once the mandate was in effect, what did they sound like?

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I don’t think anybody who I kept in touch with is holding out. On Friday morning, at fire department headquarters, people were lined up waiting for their vaccine. This was hours before the deadline. I went down there trying to catch people on their way out. And I talked to one firefighter who was like, “I didn’t think I would ever get it. I didn’t want to get it. But you know, I have a car, I have a mortgage, I have a family. I can’t afford to not get it. So I just did it.” He was sad. And he said to me, “You want to stand with your colleagues. But sometimes, unfortunately, you have to look out for yourself.”

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