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Federal Register / Vol. 86, No. 116 / Monday, June 21, 2021 / Rules and Regulations NGA, March 19, 2020; NGA, December 4, 2020; Ayanian, June 3, 2020.
The U.S. Food and Drug Administration FDA issued or expanded emergency use authorizations EUAs for three COVID19 vaccines between December 2020 and May 2021.
Currently, everyone in the United States age 12 and older is eligible to receive a COVID19 vaccine. As of May 24, 2021, the CDC reported that 163,907,827
people had received at least one dose of vaccine and 130,615,797 people were fully vaccinated, representing 45
percent and 32.8 percent of the total U.S. population, respectively CDC, May 24, 2021e. Vaccination rates are higher among people ages 65 and older than among the rest of the population.
Despite the relatively rapid distribution of vaccines in many areas of the U.S., a substantial proportion of the working age population remains unvaccinated and susceptible to COVID19 infection, including approximately a quarter of all healthcare and healthcare support workers King et al., April 24, 2021. And, as discussed in more detail in Grave Danger Section IV.A. of this preamble, because workers in healthcare settings where COVID19
patients are treated continue to have regular exposure to SARSCoV2 and any variants that develop, they remain at an elevated risk of contracting COVID19 regardless of vaccination status. Therefore, OSHA has determined that a grave danger to healthcare and healthcare support workers remains, despite the fully-vaccinated status of some workers, and that an ETS is necessary to address this danger see Grave Danger and Need for the ETS
Sections IV.A. and IV.B. of this preamble.

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References Ayanian, JZ. 2020, June 3. Taking shelter from the COVID storm. JAMA Health Forum. https jamanetwork.com/
channels/health-forum/fullarticle/
2766931. Ayanian, June 3, 2020.
Centers for Disease Control and Prevention CDC. 2020, January 21. First travelrelated case of 2019 novel coronavirus detected in United States. https
www.cdc.gov/media/releases/2020/
p0121-novel-coronavirus-travelcase.html. CDC, January 21, 2020.
Centers for Disease Control and Prevention CDC. 2021a, May 24. COVID data tracker. Trends in number of COVID19
cases and deaths in the US reported to CDC, by state/territory: Trends in Total COVID19 Deaths in the United States Reported to CDC. https covid.cdc.gov/
covid-data-tracker/trends_
dailytrendscases. CDC, May 24, 2021a Centers for Disease Control and Prevention CDC. 2021b, May 24. Cases & Deaths among Healthcare Personnel. https

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covid.cdc.gov/covid-data-tracker/
health-care-personnel. CDC, May 24, 2021b Centers for Disease Control and Prevention CDC. 2021c, May 24. COVID data tracker. Trends in number of COVID19
cases and deaths in the US reported to CDC, by state/territory: Trends in Total COVID19 Cases in the United States Reported to CDC. https covid.cdc.gov/
covid-data-tracker/trends_
dailytrendscases. CDC, May 24, 2021c.
Centers for Disease Control and Prevention CDC. 2021d, May 24. COVID data tracker. Trends in number of COVID19
cases and deaths in the US reported to CDC, by state/territory: Daily Trends in Number of COVID19 Cases in the United States Reported to CDC. https
covid.cdc.gov/covid-data-tracker/
trends_dailytrendscases. CDC, May 24, 2021d.
Centers for Disease Control and Prevention CDC. 2021e, May 24. COVID19
Vaccinations in the United States.
https covid.cdc.gov/covid-data-tracker/
vaccinations. CDC, May 24, 2021e.
Chen, Y.-T, et al., 2020, August 6. An examination on the transmission of COVID19 and the effect of response strategies: A comparative analysis.
International Journal of Environmental Research and Public Health 1716:5687.
https www.mdpi.com/1660-4601/17/
16/5687. Chen et al., August 6, 2020.
King, WC, et al., 2021, April 24. COVID19
vaccine hesitancy January-March 2021
among 1864 year old US adults by employment and occupation. medRxiv;
https www.medrxiv.org/content/
10.1101/2021.04.20.21255821v3. King et al., April 24, 2021.
National Governors Association NGA.
2020, March 19. Coronavirus:what you need to know. https www.nga.org/
coronavirus/. NGA, March 19, 2020.
National Governors Association NGA.
2020, December 4. Summary of state pandemic mitigation actions. https
www.nga.org/coronavirus-mitigationactions/. NGA, December 4, 2020.
The White House. 2020, March 13.
Proclamation on declaring a national emergency concerning the novel coronavirus disease COVID19
outbreak. https web.archive.org/web/
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www.whitehouse.gov/presidentialactions/proclamation-declaringnational-emergency-concerning-novelcoronavirus-disease-covid-19-outbreak/.
The White House, March 13, 2020.
United States Department of Health and Human Services US DHHS. 2020, January 31. Determination that a public health emergency exists. https
www.phe.gov/emergency/news/
healthactions/phe/Pages/2019nCoV.aspx. US DHHS, January 31, 2020.
World Health Organization WHO. 2020, January 5. Emergencies preparedness, responsePneumonia of unknown causeChina. Disease outbreak news.
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III. Pertinent Legal Authority The purpose of the Occupational Safety and Health Act of 1970 OSH
Act, 29 U.S.C. 651 et seq., is to assure so far as possible every working man and woman in the Nation safe and healthful working conditions and to preserve our human resources. 29
U.S.C. 651b. To this end, Congress authorized the Secretary of Labor Secretary to promulgate and enforce occupational safety and health standards under sections 6b and c of the OSH Act.1 29 U.S.C. 655b. These provisions provide bases for issuing occupational safety and health standards under the Act. Once OSHA
has established as a threshold matter that a health standard is necessary under section 6b or ci.e., to reduce a significant risk of material health impairment, or a grave danger to employee healththe Act gives the Secretary almost unlimited discretion to devise means to achieve the congressionally mandated goal of protecting employee health, subject to the constraints of feasibility. See United Steelworkers of Am. v. Marshall, 647
F.2d 1189, 1230 D.C. Cir. 1981. A
standards individual requirements need only be reasonably related to the purpose of ensuring a safe and healthful working environment. Id. at 1237, 1241;
see also Forging Industry Assn v. Secy of Labor, 773 F.2d 1436, 1447 4th Cir.
1985. OSHAs authority to regulate employers is hedged by constitutional considerations and, pursuant to section 4b1 of the OSH Act, the regulations and enforcement policies of other 1 The Secretary has delegated most of his duties under the OSH Act to the Assistant Secretary of Labor for Occupational Safety and Health.
Secretarys Order 082020, 85 FR 58393 Sept. 18, 2020. This section uses the terms Secretary and OSHA interchangeably.

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