The following article was originally published in the Ohio Capital Journal and published on News5Cleveland.com under a content-sharing agreement.
Through PSAs, press appearances with doctors, and even launching an unheard of $1 million lottery for immunized residents, GOP Gov. Mike DeWine wants to persuade Ohioans to choose to get vaccinated against COVID-19.
He said the facts on vaccines, which are credited with saving millions of lives and eradicating smallpox from the face of the earth, will win out.
Republicans in the state General Assembly, meanwhile, are pushing sweeping legislation to weaken Ohio’s vaccination laws — for all vaccines, not just COVID-19. On Tuesday, anti-vaccination activists crammed into the House Health Committee hearing room to testify in support of House Bill 248.
The legislation would ban vaccine requirements on customers, employees or students from businesses, hospitals, nursing homes, K-12 schools, colleges, daycares, or others. It would also prevent governments, insurers, or businesses from offering incentives for people to get vaccinated, or even requesting that people get vaccinated.
In interviews, public health experts warned the legislation would hold the door open for infectious diseases to spread among Ohioans.
Under the bill, a small business owned by asthmatics or cancer survivors — both of whom are at higher risk of serious COVID-19 complications — would have no legal right to require or even request that employees or customers who come inside be vaccinated. That’s according to Dorit Reiss, a professor with a focus on vaccine policy from the UC Hastings College of Law.
“It’s against business rights, it’s against the individual rights of private businesses, it’s against safety, and it’s in support of the virus,” she said.
On Wednesday, state officials are scheduled to announce the first of five winners of a $1 million lottery drawing for vaccinated adults and a college scholarship lottery for vaccinated minors. Four more of each lottery are scheduled over the next four weeks.
DeWine pitched the sweepstakes as a means of nudging Ohioans toward a societally desirable goal of herd immunity, rather than any kind of mandate to meet the requisite level of vaccine coverage. He has recently crisscrossed the state, hosting media events at mass vaccination sites urging Ohioans to get vaccinated.
The political dynamic amounts to a tug of war in which DeWine forgoes mandates for incentives, while his fellow Republicans seek to kill his incentives and legally prevent any mandates.
Since its May 12 announcement, the lottery partially reversed a trend of plummeting demand in the state for COVID-19 vaccinations. Only 44% of Ohioans are vaccine-started compared to about 49% nationwide. But its not just COVID-19: state and federal data shows vaccination rates of Ohio children across the board dropped between 2010 and 2017.
For instance, in 2010, roughly 94% of Ohio children were vaccinated against measles. By 2017, that fell to 88%.
Ohio is one of only 15 states that allows nonmedical (religious or philosophical) exemptions to school immunization laws. HB 248 would further expand this, forcing schools to expressly notify parents of the exemption. A similar bill from 2019 to this effect failed.
James Colgrove, a Columbia University professor who has written several books on vaccine politics and public health, said the effects of legislation like HB 248 are simple.
“The easier a state makes it to opt out, the more parents will opt out,” he said. “In turn, the more parents who opt out, the greater the likelihood you have outbreaks of vaccine-preventable diseases. It’s pretty intuitive.”
Despite his pro-vaccination tone, DeWine avoided offering any substantive answer Monday when asked about HB 248 or a separate proposal to remove the “reasons of conscience” exemption from school immunization laws.
He is also navigating a General Assembly dominated by Republicans who have demonstrated their willingness and ability to override his veto on pandemic policy; and competing in a gubernatorial primary in a Republican party that has recently taken an adversarial stance to vaccination.
Pandemic politics
House Bill 248 wouldn’t exist in a vacuum; it would intertwine with preexisting weak school immunization requirements and recent legislation that defanged the Ohio Department of Health’s pandemic power.
That legislation, set to take effect next month, prohibits health authorities from quarantining or isolating individuals who have not been “medically exposed” to a disease. It would also allow lawmakers to vote down public health orders without the governor’s approval.
Experts said the next pandemic (and there will be a next pandemic) may be of a virus more lethal or more transmissible than COVID-19. Or like COVID-19, officials may be unable to medically diagnose the new illness as it emerges, and thus be unable to issue quarantine or isolation orders to limit its spread.
“It’s when you take all of these provisions together that you start to think there could be really serious repercussions on the ground in the face of the next epidemic, which might look entirely different from covid,” said Jill Krueger, a regional director for the Network for Public Health Law.
“Maybe it’s not respiratory, maybe it’s foodborne, waterborne, vectorborne."
Reiss offered a similar opinion.
“The fact that these are now the laws leaves Ohio in a position where the default won’t be as strong a reaction to the pandemic, and you’re going to lose valuable time that may make a difference, a dramatic difference between life and death,” she said.
Health care groups oppose
The Ohio Association of Health Plans, which represents health insurers in Ohio, issued a statement opposing the bill Tuesday.
“HB 248 would put put all Ohioans at risk while increasing the cost of health care for families, individuals and businesses,” said its spokesman Dan Williamson. “This proposal applies to all immunizations, including childhood vaccines. If passed, this legislation could reverse decades of immunity from life-threatening, but vaccine-preventable diseases such as measles, mumps, hepatitis, meningitis and tuberculosis.”
The bill would especially hurt insurers, as it would remove their ability to require, request, or incentivize vaccination among the pool of clients whose health care costs they pay for.
On Tuesday, the “Ohio Vaccine Coalition” — a consortium of hospitals, insurers, public health and business groups — announced opposition to the legislation they say would reverse decades of progress in fighting vaccine preventable diseases.
“At its core, this proposal would destroy our current public health framework that prevents outbreaks of potentially lethal diseases, threaten the stability of our economy as it recovers from a devastating pandemic, and jeopardize the way we live, learn, work and celebrate life,” the coalition said in a statement.
Two Democrats on the committee issued statements Tuesday criticizing the bill as well.
“This legislation is based on fear and misinformation and would hinder the ability of our hospitals and long-term care facilities to protect our most vulnerable citizens from contagious and deadly diseases,” said Rep. Allison Russo, D-Upper Arlington.
The House Health Committee hosted its second hearing on the bill Tuesday. One proponent of the bill, a Black woman, decried business or government’s distinguishing between vaccinated or unvaccinated people as “medical apartheid.” The language echoes comments made last week from Rep. Jennifer Gross, who sponsored the bill, comparing vaccine mandates to the Holocaust.
On Wednesday, Sen. Andrew Brenner, who himself promised he wouldn't let the state health director turn Ohio into Nazi Germany last summer, is scheduled to introduce similar legislation to a Senate panel.
