Court filing
Georgia Sdga 1 21 Cv 00163 11Th 21 14269 Doc 086 Att 0
Summary
A brief of the American Medical Association as amicus curiae in opposition to plaintiffs' amended motion for a preliminary injunction, dated November 29, 2021, in The State of Georgia, et al. v. Joseph R. Biden, et al., Civil Action No. 1:21-cv-163-RSB-BKE, in the U.S. District Court for the Southern District of Georgia, Augusta Division. A corporate disclosure statement identifies the association as a non-profit entity with no parent corporation and no publicly owned corporation holding 10% or more of its stock. The argument is in four parts: that COVID-19 endangers the health of federal contractor employees; that vaccines are a safe and effective way to reduce workplace transmission; that wider vaccination makes the workplace safer; and that widespread vaccination is the most effective protection. The brief urges the court to deny the motion and closes with a certificate of service.
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IN THE UNITED STATES DISTRICT COURT
FOR THE SOUTHERN DISTRICT OF GEORGIA
AUGUSTA DIVISION
THE STATE OF GEORGIA, et al.,
Plaintiffs, Civil Action No.
1:21-cv-163-RSB-
v. BKE
JOSEPH R. BIDEN, in his official capacity as
President of the United States, et al.,
Defendants.
BRIEF OF THE AMERICAN MEDICAL ASSOCIATION
AS AMICUS CURIAE IN OPPOSITION TO PLAINTIFFS’
AMENDED MOTION FOR PRELIMINARY INJUNCTION
Jarred Klorfein
Michael A. Caplan
CAPLAN COBB
75 Fourteenth St. NE, Suite 2750
Atlanta, Georgia 30309
Rachel L. Fried (pro hac vice pending)
Jessica Anne Morton (pro hac vice pending)
Jeffrey B. Dubner (pro hac vice pending)
DEMOCRACY FORWARD FOUNDATION
P.O. Box 34553
Washington, DC 20043
Counsel for Proposed Amicus Curiae
American Medical Association
CORPORATE DISCLOSURE STATEMENT
The American Medical Association (“AMA”) is a non-profit entity
and has no parent corporation. No publicly owned corporation owns 10%
or more of the stocks of the AMA.
i
TABLE OF CONTENTS
TABLE OF AUTHORITIES .................................................................... iii
INTEREST OF AMICUS CURIAE ........................................................... 1
INTRODUCTION ...................................................................................... 1
ARGUMENT ............................................................................................. 3
I. COVID-19 poses a grave danger to the health of federal contractor
employees. ........................................................................................ 3
II. Vaccines provide a safe and effective way to help reduce
transmission of COVID-19 in the workplace. .................................. 6
III. The more federal contractor employees who get vaccinated, the
safer the workplace becomes. ........................................................... 9
IV. Widespread vaccination is the most effective way to protect federal
contractor employees from COVID-19. .......................................... 12
CONCLUSION ........................................................................................ 14
CERTIFICATE OF SERVICE................................................................. 15
ii
TABLE OF AUTHORITIES
Other Authorities Page(s)
Alyson M. Cavanaugh et al., Reduced Rick of Reinfection
with SARS-CoV-2 After COVID-19 Vaccination —
Kentucky, May–June 2021 70 Morbidity & Mortality
Weekly Rpt. 1081 (2021) ..................................................................... 13
Am. Med. Ass’n, AMA, AHA, ANA urge vaccinations as U.S.
reaches 750,000 COVID-19 deaths, https://bit.ly/3C07CIS.................. 9
Am. Society for Microbiology, How Effective Are COVID-19
Vaccines in Immunocompromised People (Aug. 12, 2021),
https://bit.ly/3F24HBh ........................................................................ 10
Apoorva Mandavilli, C.D.C. Internal Report Calls Delta
Variant as Contagious as Chickenpox, N.Y. Times (Jul. 30,
2021), https://nyti.ms/3wxXaHB. ......................................................... 4
Carlos del Rio et al., Confronting the Delta Variant of SARS-
CoV-2, Summer 2021, 326 J. Am. Med. Ass’n 1001, 1002
(2021), https://bit.ly/3bVL5Cj ............................................................. 10
Catherine H. Bozio et al., Laboratory-Confirmed COVID-19
Among Adults Hospitalized with COVID-19-Like Illness
with Infection-Induced or mRNA Vaccine-Induced SARS-
CoV-2 Immunity – Nine States, January–September 2021,
70 Morbidity & Mortality Weekly Rpt. 1539 (Nov. 5,
2021), https://bit.ly/3kvoBwR ............................................................. 12
CDC, Benefits of Getting a COVID-19 Vaccine (Nov. 5, 2021),
https://bit.ly/3H6BsiF ........................................................................... 6
CDC, COVID Data Tracker, CDC (Nov. 23, 2021),
https://bit.ly/3FINeyk. ......................................................................... 4
CDC, COVID Data Tracker Weekly Review: This is Their
Shot, Centers for Disease Control and Prevention (Nov.
19. 2021), https://bit.ly/3EYAdAb ......................................................... 3
iii
CDC, Delta Variant: What We Know About the Science (Aug.
26, 2021), https://bit.ly/3plAmcy ........................................................... 4
CDC, Disease Burden of Flu (Oct. 4, 2021),
https://bit.ly/3ocAuZA ........................................................................... 4
CDC, How Well Flu Vaccines Work: Questions & Answers
(last visited Nov. 9, 2021), https://bit.ly/3HifLMP ............................... 7
CDC, Investigating and Responding to COVID-19 Cases in
Non-Healthcare Work Settings (Oct. 25, 2021),
https://bit.ly/3qC74XN .......................................................................... 5
CDC, Rates of COVID-19 Cases and Deaths by Vaccination
Status (last visited Nov. 9, 2021), https://bit.ly/3F3YMLV.................. 8
CDC, Rates of laboratory-confirmed COVID-19
hospitalizations by vaccination status, (last updated Aug.
28, 2021), https://bit.ly/3oIwsZ4. ......................................................... 8
CDC, United States COVID-19 Cases, Deaths, and
Laboratory Testing (NAATs) by State, Territory, and
Jurisdiction (Nov. 23, 2021), https://bit.ly/3kui8SL ............................ 4
CDC, Use of Cloth Masks to Control the Spread of SARS-
CoV-2 (May 7, 2021), https://bit.ly/30inWYx........................................ 4
Charisse Jones & Matt Wynn, Coronavirus and the
Workplace: The Virus Causes Record Numbers of Job
Absences in 2020, USA Today (Jan. 21, 2021),
https://bit.ly/3C39lgx ............................................................................ 5
COVID-19 Vaccination and Testing; Emergency Temporary
Standard, 86 Fed. Reg. 61,402 (Nov. 5, 2021) ...................................... 8
Donatella Sarti et al., COVID-19 in Workplaces: Secondary
Transmission, 65 Annals of Work Exposures & Health
1145 (2021), https://bit.ly/3Cj6oJ3...................................................... 13
iv
Federal Acquisition Regulatory Council, Memorandum to
Chief Acquisition Officers et al. re: Issuance of Agency
Deviations to Implement Executive Order 14042 (Sept. 30,
2021), https://bit.ly/3qAlUha ................................................................ 2
FDA, COVID-19 vaccine safety surveillance (Jul. 12, 2021),
https://bit.ly/3wxPlB ............................................................................. 6
Frank Fenner, et al., World Health Org., Smallpox and Its
Eradication (1988) ............................................................................. 10
Kathy Katella, Comparing the COVID-19 Vaccines: How Are
They Different?, Yale Med. (Nov. 3, 2021),
https://bit.ly/307jEU5 ........................................................................... 7
Kevin M. Malone & Alan R. Hinman, Vaccination Mandates:
The Public Health Imperative and Individual Rights, in
Law in Public Health Practice 262 (1st ed., 2003),
https://bit.ly/3BUviyg.......................................................................... 11
Kiva A. Fisher et al., Telework Before Illness Onset Among
Symptomatic Adults Aged ≥ 18 Years With and Without
COVID-19 in 11 Outpatient Health Care Facilities —
United States, July 2020, 69 Morbidity & Mortality
Weekly Rpt. 1648 (Apr. 28, 2020), https://bit.ly/3F5Ybt8 .................... 5
Lucy A. McNamara et al., Estimating the Early Impact of the
US COVID-19 Vaccination Programme on COVID-19
Cases, Emergency Department Visits, Hospital
Admissions, and Deaths Among Adults Aged 65 Years and
Older: An Ecological Analysis of National Surveillance
Data, Lancet (Nov. 3, 2021), https://bit.ly/31NqTRq ........................... 8
Marissa G. Baker et al., Estimating the burden of United
States workers exposed to infection or disease: A key factor
in containing risk of COVID-19 infection, PLoS ONE
(2020), https://bit.ly/3BWDoq8 ............................................................. 5
v
Mark W. Tenforde, Association Between mRNA Vaccination
and COVID-19 Hospitalization and Disease Severity, J.
Am. Med. Ass’n (Nov. 4, 2021), https://bit.ly/3bZBHhb ....................... 8
Michelle A. Waltenburg et al., Coronavirus Disease among
Workers in Food Processing, Food Manufacturing, and
Agriculture Workplaces, 27 Emerging Infectious Diseases
243 (2021), https://bit.ly/3kp3Lip ......................................................... 5
M.P. Cassar et al., Symptom Persistence Despite
Improvement in Cardiopulmonary Health – Insights from
longitudinal CMR, CPET and lung function testing post-
COVID-19, EClinicalMedicine (2021),
https://bit.ly/3H7AeDB ......................................................................... 3
Nakia S. Clemmons, et al., Measles — United States,
January 4–April 2, 2015, Morbidity & Mortality Weekly
Rep., Vol. 64 Issue 14: 373–376 (Apr. 17, 2015),
https://bit.ly/3l3bkvK. ........................................................................ 11
Nicola P. Klein et al., Surveillance for Adverse Events After
COVID-19 mRNA Vaccination, 326 J. Am. Med. Ass’n
1390 (Sep. 3, 2021), https://bit.ly/3F1XQYM........................................ 6
Paul Fine et al., “Herd Immunity”: A Rough Guide, 52
Clinical Infectious Diseases 911 (2011)................................................ 9
Pfizer, Pfizer and BioNTech Announce Phase 3 Trial Data
Showing High Efficacy of a Booster Dose of Their COVID-
19 Vaccine (Oct. 21, 2021), https://bit.ly/3EXQa9K ............................. 7
Rajaie Batniji, Historical Evidence to Inform COVID-19
Vaccine Mandates, 397 Lancet 791 (2021) ......................................... 10
Safer Federal Workforce Task Force, COVID–19 Workplace
Safety: Guidance for Federal Contractors and
Subcontractors (Nov. 10, 2021), https://bit.ly/3Cd6vFG ...................... 2
Sara Y. Tartof et al., Effectiveness of mRNA BNT162b2
COVID-19 Vaccine Up to 6 Months, 398 Lancet 1407, 1407
(Oct. 16, 2021) ....................................................................................... 7
vi
Stanley Xu et al., COVID-19 Vaccination and Non–COVID-
19 Mortality Risk — Seven Integrated Health Care
Organizations, United States, December 14, 2020–July 31,
2021, 70 Morbidity & Mortality Weekly Rpt. 1520 (Oct,
29, 2021), https://bit.ly/3D1ZRn4 ......................................................... 6
Tahmina Nasserie et al., Assessment of the Frequency and
Variety of Persistent Symptoms: A Systematic Review,
JAMA Netw. Open (2021), https://bit.ly/3qocFkk ................................ 3
World Health Organization, Update 64—COVID-19
Prevention at the Workplace (Jul. 28, 2021),
https://bit.ly/307J1V6 ........................................................................... 5
vii
INTEREST OF AMICUS CURIAE
The American Medical Association (“AMA”) is the largest
professional association of physicians, residents, and medical students in
the United States. Additionally, through state and specialty medical
societies and other physician groups seated in its House of Delegates,
substantially all physicians, residents, and medical students in the
United States are represented in the AMA’s policy-making process. The
AMA was founded in 1847 to promote the art and science of medicine and
the betterment of public health, and these remain its core purposes. AMA
members practice in every medical specialty and in every state. The AMA
has an interest in providing evidence-based guidance on public health
issues and working to reduce the spread of contagious illnesses.1
INTRODUCTION
The United States is in an unprecedented and ongoing public health
crisis. SARS-CoV-2, the causative agent of COVID-19, has wreaked havoc
in communities across the country, taxed hospitals to the point of
rationing care, upended the lives of countless families, and killed over
1 Amicus certifies that no party’s counsel authored this brief in whole or in part, no
party or party’s counsel contributed money intended to fund this brief, and no person
other than amicus, its members, and their counsel contributed money intended to
fund this brief.
1
770,000 Americans. Widespread vaccination is essential to ending the
COVID-19 pandemic and preventing thousands more needless deaths.
Many COVID-19 outbreaks have occurred in workplaces, inducing
an occupational health emergency. Needless to say, workers—including
federal contractor employees—who contract the SARS-CoV-2 virus, or
worse, develop COVID-19 symptoms, disrupt workplace efficiency and
must stay home from workplaces during recovery. For nearly two years,
the AMA has monitored the COVID-19 pandemic and advocated for
evidence-based public health measures to end it. The AMA’s extensive
review of the medical literature demonstrates that COVID-19 vaccines
authorized or approved by FDA are safe and effective, and the
widespread use of those vaccines is the best way to keep COVID-19 from
spreading within workplaces. Enjoining the Safer Federal Workforce
Task Force’s Guidance for Federal Contractors and Subcontractors2
would therefore severely and irreparably harm the public interest.
2 See Safer Federal Workforce Task Force, COVID–19 Workplace Safety: Guidance for
Federal Contractors and Subcontractors (Nov. 10, 2021), https://bit.ly/3Cd6vFG;
Federal Acquisition Regulatory Council, Memorandum to Chief Acquisition Officers
et al. re: Issuance of Agency Deviations to Implement Executive Order 14042 (Sept. 30,
2021), https://bit.ly/3qAlUha.
2
ARGUMENT
I. COVID-19 poses a grave danger to the health of federal
contractor employees.
COVID-19 presents a severe risk to public health in Georgia and
throughout the nation. Although most people infected with the virus will
experience mild to moderate symptoms, individuals with COVID-19 can
become seriously ill or die at any age. As of November 19, 2021, there
have been over forty-seven million confirmed cases of COVID-19 in the
United States, leading to more than 3,300,000 hospitalizations. 3
Even those who recover from COVID-19 may experience post-
COVID conditions with debilitating symptoms lasting for several months
after the acute phase of infection. A systematic review of forty-five
studies including 9,751 participants found that 73% of infected
individuals experienced at least one long-term symptom.4 Over half of
previously hospitalized patients continue to experience cardiopulmonary
symptoms and abnormalities six months later. 5 And over 770,000 people
3 COVID Data Tracker Weekly Review: This is Their Shot, Centers for Disease Control
and Prevention (“CDC”) (Nov. 19, 2021), https://bit.ly/3EYAdAb.
4 Tahmina Nasserie et al., Assessment of the Frequency and Variety of Persistent
Symptoms: A Systematic Review, JAMA Netw. Open (2021), https://bit.ly/3qocFkk.
5 M.P. Cassar et al., Symptom Persistence Despite Improvement in Cardiopulmonary
Health – Insights from longitudinal CMR, CPET and lung function testing post-
COVID-19, EClinicalMedicine (2021), https://bit.ly/3H7AeDB.
3
in the United States have died from COVID-196—more than twenty-four
times the number of people in the United States who die from influenza
in the average year.7 As of November 23, 2021, over 30,000 people have
died from COVID-19 in Georgia alone.8
SARS-CoV-2 is highly transmissible. The original strain was more
contagious than the flu, and the Delta variant of SARS-CoV-2, now the
leading strain, is more than twice as contagious as the original.9
Crucially, over 50% of the spread of the virus may be from individuals
who have no symptoms at the time of transmission.10
Workplace transmission has been a major factor in the spread of
COVID-19. COVID-19 outbreaks have occurred among workers—
including federal contractor employees—in numerous industries,
including service and sales, education, hospitality, construction, domestic
work, meat-processing, transportation, prison, and of course healthcare
6 COVID Data Tracker, CDC (Nov. 23, 2021), https://bit.ly/3FINeyk.
7 Disease Burden of Flu, CDC (Oct. 4, 2021), https://bit.ly/3ocAuZA.
8 United States COVID-19 Cases, Deaths, and Laboratory Testing (NAATs) by State,
Territory, and Jurisdiction, CDC (Nov. 23, 2021), https://bit.ly/3kui8SL.
9 Delta Variant: What We Know About the Science, CDC (Aug. 26, 2021),
https://bit.ly/3plAmcy; Apoorva Mandavilli, C.D.C. Internal Report Calls Delta
Variant as Contagious as Chickenpox, N.Y. Times (Jul. 30, 2021),
https://nyti.ms/3wxXaHB.
10 Use of Cloth Masks to Control the Spread of SARS-CoV-2, CDC (May 7, 2021),
https://bit.ly/30inWYx.
4
industries. 11 Studies found widespread COVID-19 outbreaks in meat-
and poultry-processing facilities and “identified high proportions of
asymptomatic or presymptomatic infections.” 12
Forty-five percent more people reported missing work for medical
reasons during 2020 than the previous twenty-year average. 13 Another
study found that adults who tested positive for SARS-CoV-2 were
significantly more likely to report going to an office or school setting than
adults who tested negative. 14 Protecting workers from COVID-19 is
especially important given that “a large proportion of the United States
workforce, across a variety of occupational sectors, are exposed to disease
or infection at work more than once a month.”15 Requiring federal
11 Update 64—COVID-19 Prevention at the Workplace, World Health Organization
(Jul. 28, 2021), https://bit.ly/307J1V6; Investigating and Responding to COVID-19
Cases in Non-Healthcare Work Settings, CDC (Oct. 25, 2021), https://bit.ly/3qC74XN.
12 Michelle A. Waltenburg et al., Coronavirus Disease among Workers in Food
Processing, Food Manufacturing, and Agriculture Workplaces, 27 Emerging
Infectious Diseases 243 (2021), https://bit.ly/3kp3Lip.
13 Charisse Jones & Matt Wynn, Coronavirus and the Workplace: The Virus Causes
Record Numbers of Job Absences in 2020, USA Today (Jan. 21, 2021),
https://bit.ly/3C39lgx.
14 Kiva A. Fisher et al., Telework Before Illness Onset Among Symptomatic Adults
Aged ≥18 Years With and Without COVID-19 in 11 Outpatient Health Care Facilities
— United States, July 2020, 69 Morbidity & Mortality Weekly Rpt. 1648 (Apr. 28,
2020), https://bit.ly/3F5Ybt8.
15 Marissa G. Baker et al., Estimating the burden of United States workers exposed to
infection or disease: A key factor in containing risk of COVID-19 infection, PLoS ONE
(2020), https://bit.ly/3BWDoq8.
5
contractor employees to be vaccinated is not just an efficiency-promoting
practice; it is life-saving.
II. Vaccines provide a safe and effective way to help reduce
transmission of COVID-19 in the workplace.
COVID-19 vaccines are safe. Before FDA authorized/approved and
CDC recommended use of the COVID-19 vaccines in the population,
scientists conducted clinical trials. FDA, CDC, and their advisory
committees conducted rigorous reviews of the data.16 CDC and FDA
continue to monitor the safety of COVID-19 vaccines through both
passive and active safety surveillance systems. 17 A study of over six
million people who received the Pfizer or Moderna vaccines found that
serious side effects are very rare. 18 Another study concluded that there is
no increased risk for mortality among recipients of any of the COVID-19
vaccines, and that vaccine recipients in fact had lower non-COVID-19
mortality risks than did unvaccinated people.19
16 Benefits of Getting a COVID-19 Vaccine, CDC (Nov. 5, 2021), https://bit.ly/3H6BsiF.
17 Nicola P. Klein et al., Surveillance for Adverse Events After COVID-19 mRNA
Vaccination, 326 J. Am. Med. Ass’n 1390, (Sep. 3, 2021), https://bit.ly/3F1XQYM;
COVID-19 vaccine safety surveillance, FDA (Jul. 12, 2021), https://bit.ly/3wxPlB.
18 Klein et al., supra n. 17.
19 Stanley Xu et al., COVID-19 Vaccination and Non–COVID-19 Mortality Risk —
Seven Integrated Health Care Organizations, United States, December 14, 2020–July
31, 2021, 70 Morbidity & Mortality Weekly Rpt. 1520 (Oct, 29, 2021),
https://bit.ly/3D1ZRn4.
6
COVID-19 vaccines are also effective. First, each of the three
vaccines greatly reduces the likelihood of contracting infection. The
Pfizer, Moderna, and J&J/Janssen vaccines are 91.3%, 90%, and 72%
effective against infection, respectively.20 Although the vaccines’ efficacy
wanes over time, initial data on Pfizer booster shots show that they may
boost the vaccine efficacy to over 95%. 21 For comparison, the flu
vaccination reduces the risk of flu illness by between forty and sixty
percent. 22
Second, each of the three vaccines is even more effective against
serious illness and death. Studies have estimated the Pfizer, Moderna,
and J&J/Janssen vaccines as 95.3–97%, 95%, and 86% effective against
severe disease, respectively. 23 The vaccines are likewise highly effective
against hospital admissions, “even in the face of widespread circulation
of the delta variant.”24 According to one analysis, between March 11 and
20 Kathy Katella, Comparing the COVID-19 Vaccines: How Are They Different?, Yale
Med. (Nov. 3, 2021), https://bit.ly/307jEU5.
21 Pfizer and BioNTech Announce Phase 3 Trial Data Showing High Efficacy of a
Booster Dose of Their COVID-19 Vaccine, Pfizer (Oct. 21, 2021),
https://bit.ly/3EXQa9K.
22 How Well Flu Vaccines Work: Questions & Answers, CDC (last visited Nov. 9, 2021),
https://bit.ly/3HifLMP.
23 Katella, supra n. 20.
24 Sara Y. Tartof et al., Effectiveness of mRNA BNT162b2 COVID-19 Vaccine Up to 6
Months, 398 Lancet 1407, 1407 (Oct. 16, 2021).
7
August 15, 2021, unvaccinated people accounted for 84.2% of patients
hospitalized for COVID-19, including those infected with the Delta
variant.25 As of August 28, 2021, the age-adjusted rate of COVID-19
associated hospitalizations in unvaccinated adults was more than 18
times that of fully vaccinated adults.26
The initial rollout of COVID-19 vaccines in the United States “was
associated with reductions in COVID-19 cases, emergency department
visits, and hospital admissions among older adults.”27 In August 2021,
unvaccinated people had a 6.1 times greater risk of testing positive for
COVID-19, and an 11.3 times greater risk of dying from COVID-19, than
fully vaccinated people.28
Third, evidence suggests that those who are fully vaccinated are
contagious for shorter periods than unvaccinated people. 29 Most
25 Mark W. Tenforde, Association Between mRNA Vaccination and COVID-19
Hospitalization and Disease Severity, J. Am. Med. Ass’n (Nov. 4, 2021),
https://bit.ly/3bZBHhb.
26 See Rates of laboratory-confirmed COVID-19 hospitalizations by vaccination status,
CDC (last updated Aug. 28, 2021), https://bit.ly/3oIwsZ4.
27 Lucy A. McNamara et al., Estimating the Early Impact of the US COVID-19
Vaccination Programme on COVID-19 Cases, Emergency Department Visits, Hospital
Admissions, and Deaths Among Adults Aged 65 Years and Older: An Ecological
Analysis of National Surveillance Data, Lancet (Nov. 3, 2021), https://bit.ly/31NqTRq.
28 Rates of COVID-19 Cases and Deaths by Vaccination Status, CDC (last visited Nov.
9, 2021), https://bit.ly/3F3YMLV.
29 See COVID-19 Vaccination and Testing; Emergency Temporary Standard, 86 Fed.
Reg. 61,402, 61,419 (Nov. 5, 2021).
8
importantly, “[r]egardless of viral loads in vaccinated and unvaccinated
individuals, the fact remains clear that unvaccinated people pose a
higher risk of transmission to others than vaccinated people, simply
because they are much more likely to get COVID-19 in the first place.” 30
III. The more federal contractor employees who get
vaccinated, the safer the workplace becomes.
The more federal contractor employees who get vaccinated, the
closer we are to slowing the spread of the virus, creating a safer
environment, and preventing employee illness due to COVID-19. As the
AMA has explained, “[t]he only way to truly end this pandemic is to
ensure widespread vaccination.”31 Infectious diseases such as COVID-19
continue to circulate as long as the average infected individual is able to
transmit the disease to one or more uninfected individuals within the
community. 32 Widespread vaccination is the only practical way to push
the effective reproduction rate of the SARS-CoV-2 virus below one, the
rate at which endemic transmission begins to die out.
30 Id.
31 Press Release, Am. Med. Ass’n, AMA, AHA, ANA urge vaccinations as U.S. reaches
750,000 COVID-19 deaths (Nov. 4, 2021) (emphasis added), https://bit.ly/3C07CIS.
32 See generally Paul Fine et al., “Herd Immunity”: A Rough Guide, 52 Clinical
Infectious Diseases 911 (2011).
9
Widespread vaccination reduces the likelihood of infections among
both vaccinated and unvaccinated people. “[S]tates with high vaccination
rates (>70% of the population) are reporting lower numbers of vaccine
breakthrough cases as well as hospitalizations and deaths from COVID-
19.” 33 This is particularly important for people who cannot get vaccinated
due to age or medical condition, as well as immunocompromised people,
who remain particularly susceptible to infection even after vaccination.34
History has shown that vaccine requirements are critical to
achieving the degree of vaccination necessary to curb or eradicate
infectious disease. Countries or states that mandated smallpox
vaccination saw 10 to 30 times fewer smallpox cases than those that
declined to do so.35 Before compulsory school vaccination laws were in
place throughout the United States, states with strict vaccination
requirements had incidence rates of measles less than half those of states
33 Carlos del Rio et al., Confronting the Delta Variant of SARS-CoV-2, Summer 2021,
326 J. Am. Med. Ass’n 1001, 1002 (2021), https://bit.ly/3bVL5Cj.
34 How Effective Are COVID-19 Vaccines in Immunocompromised People?, Am. Soc’y
for Microbiology (Aug. 12, 2021), https://bit.ly/3F24HBh.
35 Rajaie Batniji, Historical Evidence to Inform COVID-19 Vaccine Mandates, 397
Lancet 791 (2021) (citing Frank Fenner, et al., World Health Org., Smallpox and Its
Eradication (1988)).
10
that did not. 36 More recently, in a report by the CDC of measles
occurrences in the United States between January 4 through April 2,
2015, a total of 159 cases were reported, including in Georgia. 37 “Over
80% of the cases occurred among persons who were unvaccinated or had
unknown vaccination status.” 38 The report went on to conclude that the
“continued risk for importation of measles into the United States and
occurrence of measles cases and outbreaks in communities with high
proportions of unvaccinated persons highlight the need for sustained,
high vaccination coverage across the country.”39
COVID-19 spreads in communities with fewer vaccinated
individuals, even if they are within or adjacent to communities with a
higher proportion of vaccinated individuals. The more federal contractor
employees who are vaccinated, the better protected all employees—
vaccinated and unvaccinated alike—will be.
36 Kevin M. Malone & Alan R. Hinman, Vaccination Mandates: The Public Health
Imperative and Individual Rights, in Law in Public Health Practice 262 (1st ed.,
2003), https://bit.ly/3BUviyg.
37 Nakia S. Clemmons, et al., Measles — United States, January 4–April 2, 2015,
Morbidity and Mortality Weekly Rep., Vol. 64 Issue 14: 373–376 (Apr. 17, 2015),
https://bit.ly/3l3bkvK.
38 Id.
39 Id. (emphasis added).
11
IV. Widespread vaccination is the most effective way to
protect federal contractor employees from COVID-19.
The statistics on COVID-19 vaccine efficacy speak for themselves.
No other measure has been shown to reduce the risk of infection,
hospitalization, and death to the degree that vaccination does. Although
misinformation about the efficacy of vaccines abounds, the science is
clear: no arguments against the need for vaccination are medically valid,
other than instances where an individual has a medical contraindication.
Natural immunity—the immunity against SARS-CoV-2 that
develops following recovery from infection—is not an adequate substitute
for vaccination. 40 Infection carries a significant risk of death or serious
illness; vaccination does not. Moreover, vaccination better protects
previously infected people against reinfection. Studies have shown that
unvaccinated people are at least twice as likely to become reinfected as
40 See Catherine H. Bozio et al., Laboratory-Confirmed COVID-19 Among Adults
Hospitalized with COVID-19-Like Illness with Infection-Induced or mRNA Vaccine-
Induced SARS-CoV-2 Immunity – Nine States, January–September 2021, 70
Morbidity & Mortality Weekly Rpt. 1539 (Nov. 5, 2021), https://bit.ly/3kvoBwR
(finding 5.5 times higher odds of laboratory-confirmed COVID-19 among previously
infected patients than among fully vaccinated patients).
12
are vaccinated people. 41 There is no evidence that vaccination is harmful
to people who were previously infected.
Other mitigation measures, such as mask wearing and social
distancing, remain important. They do not, however, provide the same
level of protection against COVID-19 as does vaccination. Although
wearing a face mask can be highly effective at limiting the transmission
of SARS-CoV-2, many people choose not to wear face masks, even when
encouraged or legally required to do so. Noncontinuous face mask
wearing has been shown to result in the spread of COVID-19 in the
workplace.42
Immediate, widespread vaccination against COVID-19 not only
promotes workplace efficiency and reduces worker absenteeism; but it
also is the surest way to protect federal contractor employees and the
public and to end this costly pandemic.
41 Alyson M. Cavanaugh et al., Reduced Rick of Reinfection with SARS-CoV-2 After
COVID-19 Vaccination — Kentucky, May–June 2021, 70 Morbidity & Mortality
Weekly Rpt. 1081 (2021).
42 Donatella Sarti et al., COVID-19 in Workplaces: Secondary Transmission, 65
Annals Work Exposures & Health 1145 (2021), https://bit.ly/3Cj6oJ3.
13
CONCLUSION
For the reasons stated above and in Defendants’ filings, the
American Medical Association urges this Court to deny Plaintiffs’
amended motion for a preliminary injunction.
Dated: November 29, 2021 Respectfully submitted,
/s/ Jarred Klorfein
Jarred Klorfein (Georgia Bar No.
562965)
Michael A. Caplan (Georgia Bar No.
601039)
CAPLAN COBB
75 Fourteenth St. NE, Suite 2750
Atlanta, Georgia 30309
(404) 596-5611
jklorfein@caplancobb.com
mcaplan@caplancobb.com
Rachel L. Fried (pro hac vice pending)
Jessica Anne Morton (pro hac vice
pending)
Jeffrey B. Dubner (pro hac vice
pending)
DEMOCRACY FORWARD FOUNDATION
P.O. Box 34553
Washington, DC 20043
(202) 843-1642
rfried@democracyforward.org
jmorton@democracyforward.org
jdubner@democracyforward.org
Counsel for Proposed Amicus Curiae
American Medical Association
14
CERTIFICATE OF SERVICE
I hereby certify that on November 29, 2021, a true and accurate
copy of the foregoing motion was electronically filed with the Court
using the CM/ECF system. Service on counsel for all parties will be
accomplished through the Court’s electronic filing system.
/s/ Jarred Klorfein
Date: November 29, 2021
15
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