with Alexandra Ellerbeck

In the past, judges have given governments and private companies wide latitude to mandate vaccines.

Now, at least two courts have reaffirmed those broad powers as states and employers — including a federal agency — rush to require the shots in hopes of stemming a variant-fueled rise in coronavirus cases.

Federal judges in Texas and Indiana have given a nod to vaccine requirements.

Last month, a federal district court in Texas dismissed a lawsuit filed by 117 staffers at Houston Methodist over the hospital system’s vaccine mandate for employees — a decision that could hint at future wins for hospitals trying to ensure all their workers are protected from the virus.

And last week, another federal district court — this one in northern Indiana — upheld Indiana University’s vaccination requirement for staff and students. While students have significant liberty to refuse unwanted medical treatment, Judge Damon R. Leichty wrote, the 14th Amendment allows the university to pursue “a reasonable and due process of vaccination in the legitimate interest of public health for its students, faculty and staff.”

The rulings don’t come as a huge surprise. 

As my colleague Alex Ellerbeck recently noted, there’s a long history of private employers requiring immunizations for their employees. And as for states, the Supreme Court affirmed their authority to compel vaccination in a 1905 ruling involving a smallpox vaccine being used in Massachusetts — although the court could certainly decide to revisit the issue.

Still, expect to see lots of new litigation and rulings on the subject.

Dozens of lawsuits are pending as requirements pile up.

Yesterday brought a round of announcements: California Gov. Gavin Newsom (D) and New York Mayor Bill DeBlasio (D) both said they’ll start requiring public workers to either show proof of vaccination or submit to weekly coronavirus testing. California's requirement also includes health workers.

“We’re just not going to tolerate unvaccinated city employees doing the wrong thing,” de Blasio said at his morning news briefing. 

And the Department of Veterans Affairs became the first federal agency to mandate that front-line workers — including physicians, dentists, podiatrists and registered nurses — must be vaccinated, The Post’s Dan Diamond reports. 

Veterans Affairs Secretary Denis McDonough said employees will have eight weeks to comply, explaining that the directive was driven by considerations for the safety of veterans as the delta variant surges across the country.

“Since the pandemic began, we have tragically lost tens of thousands of Veterans to this deadly disease,” said VA spokesperson Randal Noller. “This action is aimed at ensuring that we are doing everything we can to protect our veterans and the system that serves them.”

Noller cited an unprecedented plea by medical associations.

For the first time, the major medical establishment has unified around the idea of mandating vaccines for those who work in hospitals, clinics, doctor offices and other medical settings.

“We call for all health care and long-term care employers to require their employees to be vaccinated against covid-19,” the American Medical Association, the American Nurses Association and 55 other groups wrote in a joint statement issued yesterday. “The health and safety of U.S. workers, families, communities, and the nation depends on it.”

Signers of the letter said they were in part motivated by the shockingly large population of medical professionals who still refuse the vaccines. Twenty-five percent of hospital workers who had contact with patients hadn’t been vaccinated by the end of May, according to an analysis by WebMD and Medscape Medical News.

“The statement — issued by many groups urging a mandate for the first time — represents an increasingly tough stance by the medical and public health establishment amid the sluggish pace of national vaccinations,” Dan writes.

Senate veteran Mike Enzi has died.

The 77-year-old Wyoming Republican – who led the Senate's leading health committee during part of his 1997-2021 tenure – died yesterday after suffering serious injuries in a bicycle accident. 

“Enzi was riding his bicycle near his home in Gillette, Wyo., when he was injured Friday and flown to UCHealth Medical Center of the Rockies in Loveland, Colo.,” The Post's Paul Kane reports. Enzi “passed away peacefully today surrounded by his family,” a statement posted to his Twitter account late Monday said. 

“The genial, low-key conservative was elected to the U.S. Senate in 1996 after serving as mayor of Gillette and a member of the Wyoming legislature. He decided not to seek a fifth term in 2020,” Paul notes. 

“A fairly staunch conservative, Enzi had friends across the aisle and during a prolonged summer and fall negotiation in 2009, Democrats on the Senate Finance Committee tried to lure him into supporting what became the Affordable Care Act, a process that ended with no GOP support for the 2010 health law, President Barack Obama’s signature domestic achievement.”

Ahh, oof and ouch

AHH: FDA is asking vaccine makers to expand trials for coronavirus shots in school-age children.

The move is intended to assess the risk of a rare inflammation of the heart muscle for young children. Myocarditis, inflammation of the heart, has been seen after vaccination in roughly 1,200 cases out of about 300 million mRNA doses administered to adolescents and adults. It is most commonly seen in young men. 

“The changes to ongoing pediatric trials run by Moderna and Pfizer and its German partner, BioNTech, could delay the availability of the vaccines to children between 5 and 11 beyond the hoped-for timeline of early fall, although it is unclear by how much,” The Post’s Laurie McGinley, Carolyn Y. Johnson and Yasmeen Abutaleb report. “As the country faces a surge fueled largely by cases in unvaccinated people and the school year approaches, pediatricians and families have impatiently awaited shots of protection.”

The Food and Drug Administration is expected to require two months of follow-up data for the 5-to-11 age group, as it did for adults and adolescents. A federal official who spoke on the condition of anonymity told The Post that authorization of a coronavirus vaccine for children in that age group might come by late October or early November. The agency may require six months of follow-up data for children under 5.

OOF: Biden said "long covid," or the long-term symptoms of covid-19, can be considered a disability under federal civil rights law.

The announcement was set to coincide with the 31st anniversary of the Americans With Disabilities Act, a landmark law that prohibits discrimination based on disability and requires employers to make reasonable accommodations for employees with disabilities.

“Many Americans seemingly recovered from the virus still face lingering challenges like breathing problems, brain fog, chronic pain and fatigue,” Biden said during a ceremony in the Rose Garden at the White House, where he signed a proclamation commemorating the 1990 law that passed with bipartisan support. “These conditions can sometimes rise to the level of a disability.”

President Biden on July 26 said Americans with “long covid” will have access to rights and resources offered by various federal agencies. (The Washington Post)

A diagnosis of long covid will not automatically be considered a disability and an individualized assessment will be required to determine whether a person’s symptoms “substantially limits a major life activity.”

“In remarks before signing the proclamation, Biden seemed wistful for the way Washington used to work, pointing to leaders from both parties who made the ADA a reality,” The Post’s John Wagner writes.

“This was a Democratic bill signed by a Republican president, a product of passion and compassion, not partisanship progress,” said Biden, who as a senator from Delaware was a co-sponsor of the legislation. “It wasn’t political, but personal to millions of families.”

OUCH: Democrats are broadening a probe of political interference at the CDC under Trump.

“The expanded investigation centers on efforts to blunt the CDC’s Morbidity and Mortality Weekly Reports (MMWRs), which offer public updates on scientists’ findings. The reports had been considered sacrosanct for decades and untouchable by political appointees in the past, but Trump appointees pushed last year to edit the findings, worried that they undermined Trump’s more optimistic spin on the coronavirus pandemic,” The Post’s Dan Diamond reports.

The House’s select subcommittee on the pandemic is requesting interviews with Anne Schuchat, a former CDC deputy director; Nancy Messonnier, a former senior official who held a variety of leadership roles at the CDC during the pandemic, six current career staff members at the CDC and the Department of Health and Human Services; and former Trump appointees Kyle McGowan, Amanda Campbell and Nina Witkofsky.

House Democrats also released a newly obtained email sent by a career CDC official on Aug. 9, 2020, suggesting that senior officials should meet to discuss next steps after Trump appointee Paul Alexander demanded “an immediate stop on all CDC MMWR reports.”

“Our public health institutions must never again be compromised by decision-makers more concerned with politics than keeping Americans safe. It is therefore imperative that the Select Subcommittee’s investigations into the prior Administration’s response to the pandemic provide full accountings of what occurred,” Rep. James E. Clyburn (D-S.C.), the subcommittee’s chairman, and fellow Democrats wrote in letters to top health officials.

More in coronavirus news

The delta variant has become the dominant strain of coronavirus in the United States, resulting in a rise in infections and hospitalizations. (John Farrell/The Washington Post)

Elsewhere in health care

More than 400 health organizations are calling on Congress to make permanent pandemic-era telehealth measures.

The Alliance for Connected Care, the American Telemedicine Association and other organizations are calling on Congress to make it easier for doctors and patients to continue using telehealth after the end of the covid-19 public health emergency. 

“Telehealth is not a COVID-19 novelty, and the regulatory flexibilities granted by Congress must not be viewed solely as pandemic response measures,” they write in a letter to lawmakers.

Missouri has joined the other 49 states in approving a statewide prescription drug monitoring program.

The state, which ranked 16th in opioid deaths between 2010 and 2019, approved a law in June aimed at monitoring prescription opioids and other controlled substances. Health and law enforcement officials say that such programs help prevent opioid overprescribing and make it harder for patients to doctor-shop to obtain a particular prescription.

But some public health experts say these programs can have unintended consequences. 

“Some in public health now argue that when providers use such monitoring programs to cut off prescription opiate misuse, people who have an addiction instead turn to heroin and fentanyl. That means Missouri’s new toll could cause more people to overdose and leave the state with buyer’s remorse,” Kaiser Health News’s Eric Berger writes.

Three conservative Senate Republicans are urging the Supreme Court to overturn Roe v. Wade.

Sens. Josh Hawley (R-Mo.), Mike Lee (R-Utah) and Ted Cruz (R-Tex.) filed a brief asking the court to use an upcoming Mississippi case as a vehicle to overturn the landmark abortion ruling and other subsequent decisions, such as the court’s 1992 decision in Planned Parenthood v. Casey, the Hill's John Kruzel reports

“Roe and Casey should be overruled, and the question of abortion legislation should be returned to the states,” they wrote.

Court precedent dating back to Roe has upheld a woman’s right to terminate a pregnancy before fetal viability, but antiabortion advocates are hoping to see this long precedent toppled when the conservative-dominated court considers the Mississippi case, which centers on a 15-week abortion ban.

Sugar rush