An Earnest Question: Is it ethical to mandate something upon which the science is not settled?
Irrespective of your stance on the COVID-19 vaccine itself, or your personal vaccine status...here's why the current mandates are deeply unethical.
The onslaught of vaccine mandates around the country have come with the explanation that “the science” justifies them. But we’ve seen the data update in real-time for 19+ months in ways that have shifted conclusions. And we’ve seen policies and directives change, sometimes doing complete one-eighties. So why would we hardwire rules and policies into the American fabric based on shifting sands?
In addition to not having longer-term data on the vaccines, we simply do not know how long the vaccine confers strong and durable immunity. In other words, WE CANNOT REACH A RELIABLE SCIENTIFIC CONCLUSION. Thus, we should not be developing policies that impact livelihoods around the country.
You might be saying, “But Sarah, THE SCIENCE IS CHANGING!” To which I reply, “No, the data is changing. The science hasn’t made up its mind yet. And THAT is precisely why it’s batsh*t bananas to mandate something that is still relatively fluid. Moreover, it’s deeply unethical to do so.
Let me be VERY clear. In this post, I am not arguing for or against vaccines. I am, generally speaking, pro-vaccine. They are an important part of modern medicine and have saved countless lives. I am not even arguing for or against the COVID-19 vaccines in particular in this post. Rather, I am simply asking if it is ethical (or moral, or LOGICAL) to mandate a vaccine that we are still learning about in terms of efficacy and longevity in real-time.
I’m also not even arguing about freedom versus the public good right now, or if vaccines mandates as a general matter make sense.
I simply want to know….how is it not completely illogical, immoral, and unethical to mandate something based on information we don’t fully understand?
Most people who are pro-mandate for these vaccines may think we know *enough* and use some combination of the following arguments to justify their support for these draconian, livelihood-destroying mandates. So let’s talk about those arguments…
“It’s not new to mandate vaccines. There is precedent for vaccine mandates….”
There have been vaccine mandates before, yes. But how many of those mandated vaccines were so new and novel that they were developed, tested, deployed and then mandated all within less than 24 months? The answer is zero. NO VACCINE has ever been mandated within its infancy like this, so THIS IS NEW. There is no precedent for this kind of vaccine mandate in particular. Every mandated vaccine in this country was around long enough for us to understand whether it conferred complete and sterilizing immunity or not, what a multiple year safety profile looked like, and how long the inoculation would last (and thus how many boosters may become necessary over time). None of that applies to the COVID-19 vaccines. So…yeah…this is absolutely new. And there is no precedent for something like this.
So even if you’re generally pro-mandate, consider the real-world implications and the actual differences between a vaccine that’s been around for years -- decades even -- and a brand new one, and how treating them like they are the same might not make complete logical sense. (Or any logical sense at all, really).
“If you’re vaccinated, you’re far less likely to get sick or spread the disease.”
We cannot actually know that, because we simply do not have that data. As of May 2021, well before the rise of the delta variant, the CDC stopped collecting broad-level data on breakthrough infections. (Check for yourself here.) At that point, they decided they only needed to monitor breakthrough cases that resulted in hospitalization and/or death.
So let’s break down just what that means.
First, it means that there’s no mechanism deployed to count total breakthrough infections, thus, no official count of all breakthrough infections exists. But we do know that if you get a breakthrough case, you can spread the virus. That’s been a stated reality by the CDC and the NIH.
We also know that a breakthrough infection is likely to be less severe, perhaps to the point that the infected person may be asymptomatic or simply believes they have a cold or similar. Many of these people, then, are unlikely to get a test. So even where there are counts of breakthrough infections available, they are likely incredibly undercounted.
So, that means that it’s entirely possible, and likely probable, that there are many vaccinated people out there who may be asymptomatic or mildly symptomatic who are spreading COVID. Some will never test and know they’re COVID positive and will contribute to transmission, spread (and perhaps mutation) of the virus. And yet these mandates operate as if this is not true. These mandates operate as if only the unvaccinated spread the virus.
Thus, they are not scientifically sound at all, and they are serving to create a deeper political rift, and threatening to put many working class people out of work, even though those are the same people that propped up the economy last year while many of us got to hide inside, work from home, and order contactless groceries and take-out.
“If you’ve already recovered from COVID-19, you should still get vaccinated because it makes your immune system even stronger. Plus we don’t know how long immunity from a prior infection lasts, so get vaccinated.”
It’s true that many of the studies that explore the strength of natural immunity include the finding that a single dose of the vaccine gives COVID-recovered people a bump in immunity. HOWEVER, those studies also say that even without the vaccine, COVID-recovered individuals have AT LEAST AS MUCH, and LIKELY MORE of a strong immune response than people who were vaccinated but never infected. So, if your goal is protective immunity levels in the population, and THE CURRENT SCIENCE OVERWHELMINGLY SAYS that COVID-recovered individuals are enjoying levels of immunity that are just as good and perhaps BETTER than those who have been vaccinated, why are the mandates treating vaccination as the only standard?
Furthermore, these studies have indicated varying ranges for durability, from about 8 months in some studies, and others showing lasting immunity beyond a year. Thus, more data is needed for THE SCIENCE to settle on exactly how long and strong natural immunity is, but remember, that’s ALSO TRUE for the vaccines. We are seeing in real-time how short lived the immunity conferred by the current vaccines actually is. So again, the science isn’t settled on either end here, but we’re mandating the end of the equation that actually seems to indicate shorter duration. HOW? WHY?
So to recap:
We have reliable data that show a waning efficacy of the vaccines.
We have a strong, and growing set of reliable data that shows immunity from prior infection is at least, and likely stronger, than vaccination.
And we know that it is not just unvaccinated people who can catch and spread the virus. (And among those who are COVID-recovered, we know they are LESS likely to spread the virus than the vaccinated).
We do not have a complete data set on breakthrough infections, and thus it’s very possible (and arguably likely) that breakthrough cases from vaccinated people are driving and contributing to the spread of the virus in ways that are well undercounted.
And yet, we have mandates that ignore ALL of this taken together. They ignore the science while offering it lip-service. The rhetoric they are built upon is ripping apart relationships between families, friends, and loved ones. And it is forcing people into a corner, demanding they take a medical intervention upon which the science is not truly settled or face job loss. They threaten the livelihoods of people around the country, many of whom worked through the pandemic at great personal risk, many of whom already contracted COVID, some of whom had to quarantine from their families to keep working in areas of high exposure and serve the public interest. These mandates hurt the people that served us the most during the bulk of this pandemic.
Excellent piece. I agree these mandates are not moral, ethical or logical. And the economic impact is and will be huge. Shortages of police, firefighters, teachers, nurses and doctors, pilots, ferry operators, etc. People fighting for their right about what to put in their body. Folks, Covid is NOTHING LIKE SMALLPOX! About a 0.3% infection fatality rate vs. about 30% for smallpox. C’mon. I am at much greater risk of dying from something else. And since I take good care of my health, my risk is even lower. Mandates = coercion. Wrong approach!!
Hear hear re: mandates. A most bewildering decision across the world.
Regarding: "mandate a vaccine that we are still learning about in terms of 1. efficacy and 2. longevity in real-time."
I would add:
3. direct harms / adverse effects including death
4. indirect harms via depressed or rewired immnunity, OAS and ADE
5. long-term evolution pressure leading to ongoing breakthroughs / variant chasing boosters