In an interview with NBC News released Friday, April 30, Biden said it was a "tough call" on whether COVID-19 vaccination should be required for service members. But he made it clear that giving such an order is not off the table.
"I'm not saying I won't," Biden said.
The rate by which members of the various branches of the armed forces have opted to take the COVID-19 vaccine has ranged widely. For example, more than a third of the Marines offered the vaccine have declined to take it. More than 92,000 have yet to be offered one. (Related: US military halts use of Johnson & Johnson vaccine amid blood clot reports.)
The president remains optimistic that more service members will voluntarily get vaccinated without him having to intervene.
"I think you're going to see more and more of them getting it," he said. "And I think it's going to be a tough call as to whether or not they should be required to have to get it in the military, because you're (in) such close proximity with other military personnel, whether you're in a quarters where you're all sleeping or whether you're out in maneuvers."
It is not clear whether Biden has the political mandate to make COVID-19 vaccination a requirement among service members.
"That is something the DoD is looking at in consultation with the interagency process," national security adviser Jake Sullivan Friday following the release of the interview. "We don't have anything to add on that subject here today."
Most members of the military are required to receive a series of vaccinations as part of their service. But the Department of Defense (DoD) is currently not mandating that they receive COVID-19 vaccines because they're still only under emergency use authorization by the Food and Drug Administration (FDA).
Moderna, Pfizer and Johnson & Johnson have not yet applied for actual licenses from the FDA for their vaccines.
"We are offering the COVID-19 vaccine on a voluntary basis in accordance with the emergency use authorization," said Pentagon spokesman Army Maj. Cesar Santiago, noting that all members of the military have been eligible to receive the vaccine since April 19. "When formally licensed by the FDA, the DoD may require a vaccine for military personnel or personnel in specific fields, as is the case for the influenza vaccine."
When asked about the orders the White House is considering, Santiago said such a requirement would require "a waiver to make the vaccine mandatory."
"The U.S. military has successfully continued operations and kept our forces safe during the pandemic by implementing other force health protection guidelines. We are focused on making the vaccine available as supply permits and do everything we can to inform and educate our people about vaccine safety and efficacy, so our service members can make an informed decision for themselves and their loved ones," he said.
Service members are required to give "informed consent" before receiving a vaccine under emergency use authorization. They are also allowed to refuse to give that consent.
But according to an analysis from Duke University's Lawfire blog in February, a president may override that rule in the "interests of national security."
Robert Sanders, chair of the National Security Department at the University of New Haven, points to prior emergency circumstances during which the military required all service members to receive similar medical treatments – such as to protect against the threat of anthrax. Under those circumstances, military commanders have specific authority to issue orders in the interest of safeguarding their troops.
A resulting case found that those orders did not violate troops' constitutional rights because: "The requirement to place the needs of the nation above a service member's personal welfare applies in peacetime as well as in war."
Sanders believes potential challenges on the COVID-19 vaccination order Biden is considering "will fail on the merits under the history of the anthrax vaccine's military litigation." (Related: SHOCK FINDING: 30 percent of U.S. military damaged by anthrax vaccine.)
Adm. Mike Gilday, the Navy's top officer, said last month the Navy "can't pressure anyone to take it," so it has instead begun offering vaccines to crews when they are all assembled. "Peer pressure tends to bend things in a positive direction," Gilday said.
As of April 28, the DoD had administered more than 2.7 million vaccine doses to beneficiaries, including service members, family members of the latter, eligible civilian employees and retirees. More than 779,000 troops across all three components – active duty, reserve and National Guard – have gotten at least one vaccination and nearly 500,000, or 23 percent of the total force, are fully vaccinated.
The Navy has the highest vaccination rates among the services. Some 224,225 sailors, or 55 percent of the service, have received at least one dose. Nearly 40 percent of all sailors have been fully vaccinated. The Marine Corps is next in the race, with 81,274 or 37 percent of Marines, including reservists, receiving at least one dose. Nearly 27 percent of all Marines are fully vaccinated.
Almost 187,600 or 36 percent of the Air Force, Space Force, Air Force Reserve and Air National Guard have received at least one shot, with 25 percent fully vaccinated. Vaccination rates are lowest in the largest of the armed services – the Army. Only 286,557 or 28 percent of the Army, including reservists, have received a shot, with 14.5 percent fully vaccinated.
The uniformed military has experienced almost 189,000 cases of coronavirus, in addition to 51,000 Defense Department civilians, 29,000 military dependents and 18,000 contractors. The Army comprises a third of all cases, and roughly double the case count for the Navy and Air Force.
Follow Immunization.news for more news and information related to coronavirus vaccines.