The news: President Joe Biden has signed an executive order that will require millions of American workers to get vaccinated against covid-19. The order mandates all companies with more than 100 workers to require employees to be vaccinated or get tested weekly. Employers will have to provide paid time off for employees to get their shots. The order also covers most health-care workers and workers at nursing homes, plus people who work for the federal government or a government contractor. 

Government workers could face disciplinary action if they refuse. If properly enacted, the mandate will reach about two-thirds of American workers (although it’s unclear how many of them have already been vaccinated). It’s part of a multi-pronged plan to try to get the pandemic under control in the US, which includes measures like requiring employers to offer paid time off for vaccination and ordering large, indoor venues to require proof of vaccination or a negative test. 

Falling through the gaps: As we’ve written before, paid time off may be one of the best vaccine incentives. But again, Biden’s order only covers larger employers of 100 or more. Gig workers aren’t mentioned in the policy, even though they stand to benefit the most from policies that would offset the loss of hourly income, and they make up a significant and growing proportion of the US workforce. The mandates also won't help people who are out of work, which adds up to 8.4 million Americans. 

Why he’s doing it: Biden has previously bet that incentives like money, food, and beer might help to nudge people to get vaccinated, yet 80 million people still haven't got their shots. Just 177 million Americans are fully vaccinated, which is just 62.5% of those eligible, and only 52% of the total population. In short, he’s tried the carrot approach—now he’s opting for the stick. 

With the US still reporting about 150,000 new cases a day, Biden seems to be placing responsibility for the dire situation on the unvaccinated, and he’s betting that many people in America feel the same way. Addressing unvaccinated people directly, he said: “We’ve been patient. But our patience is wearing thin. And your refusal has cost all of us.” 

Lessons learned: Biden's plan also includes measures to make it easier for people to find places to get vaccinated. In the initial vaccine roll-out in December, many Americans were confused about available vaccination sites and supplies. But now, when the booster shots are approved, individuals will be able to find a vaccination site at Vaccines.gov, including what vaccines are available at each site and, for many sites, what appointments are open. A toll-free number will also be available in over 150 languages.