Missouri, et al. v. Biden, et al., No. 4:21-cv-01329 (E.D. Mo.)  Order and Opinion entered November 29, 2021.

Missouri, et al. v. Biden, et al., No. 4:21-cv-01329 (E.D. Mo.) Defendants’ Notice of Appeal filed November 30, 2021.


The United States District Court for the Eastern District of Missouri has enjoined the federal government from implementing mandated COVID-19 vaccination for healthcare providers and other workers associated with facilities receiving Medicare or Medicaid support.  The United States has filed a notice of appeal from the injunction ordered on November 29th.

The federal trial court observes that the Department of Health and Human Services, Centers for Medicare and Medicaid Services (CMS), lacks Congressional authority for the actions it has taken, which because of its sweep would require explicit and clear authority if it authority could be delegated at all in light of the federalism question that the federal intrusion on private citizens’ health care decisions and the disruption of federal-state balance that the vaccine mandate present.  

Moreover, CMS erred in abandoning notice and requirement provisions, as no excuse for having done so, including any alleged emergency, can be found.

Of particular significance to the court is not merely the shift from encouraging to demanding vaccination of healthcare workers and the application of a one-size-fits-all policy without respect to the institution involved but also the threat to access to care that the mandate provides.

Provider institutions already face a shortage in workers that began before but has been compounded by the COVID-19 pandemic. As mandated vaccination may precipitate additional worker shortages, which in turn will impact access to care, the court agrees that the threat of harm to the public because of mandated vaccination merits injunctive relief.

Missouri, et al. v. Biden, et al., No. 4:21-cv-01329 (E.D. Mo.) Order and Opinion November 29, 2021

Missouri, et al. v. Biden, et al., No. 4:21-cv-01329 (E.D. Mo.) Notice of Appeal filed November 30, 2021

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