[originally posted at National Review]
The debate over vaccine mandates has fuzzy boundaries. One can support mandating vaccinations for certain populations at risk of certain diseases without automatically supporting all such mandates. When it comes to Covid-19, we can argue the marginal cases, such as workers at hospitals and nursing homes. However, there is little justification for broad-based mandates that treat all unvaccinated people as second-class citizens. The unvaccinated should not be denied livelihoods, barred from public accommodations, forced to mask when others aren’t, or otherwise banned from normal participation in society.
Unfortunately, public health officials have increasingly conflated opposition to mandated Covid vaccination with opposition to voluntary Covid vaccination. If the vaccines are so safe and effective, they reason, what could be wrong with mandating them for everyone?
A lot. People experience a genuine welfare loss when forced to do something against their will. In the case of the Covid vaccines, there are some people whose reluctance stems from deeply-held convictions about bodily integrity and autonomy. Giving them a no-jab-no-job ultimatum causes them psychological distress. It sows resentment, distrust, and alienation. It stokes fears of a slippery slope. It causes real harm.
Supporters claim that vaccine mandates overcome that harm by providing major benefits for both individual holdouts and for the broader society. For some vaccines in some situations, this may be true. But are the benefits of Covid vaccination really compelling enough to justify widespread coercion?
Let’s consider individuals first. The argument made by mandate proponents goes like this: Although we generally shouldn’t micromanage people’s health choices, recipients experience such a tremendous benefit from the Covid vaccine that a mandate is justified for individuals’ own good. This argument fails because it applies to only a small proportion of the people who will actually be coerced. Take the elderly. They are by far the most vulnerable group, and if anyone should be forced to get vaccinated for their own good, it’s them. Well, nearly all Americans age 65+ have had at least one dose of the vaccine already, so they cannot be the primary targets of any mandate.
Among non-elderly adults, it appears that about one quarter have not had any shots, but a large proportion of those holdouts are not in major risk groups. For one thing, some holdouts were previously infected with Covid and therefore already have strong immunity. We don’t know what that proportion is exactly, but the CDC estimates that about half of non-elderly adults (not specifically vaccine holdouts) have already been infected.
Furthermore, another subset of holdouts are young, healthy individuals at little risk of a severe case. It may still be a good idea for fit people under 30 to get vaccinated, but their refusal is not exactly an act of self-immolation. In short, the number of holdouts who are in dire need of the vaccine is small, and a mandate will force people at much less risk to bear the brunt of the coercion.
The second argument advanced by mandate proponents is that the population as a whole benefits greatly from mass Covid vaccination even if the individual benefit is small. When the vaccines were first rolled out, there was hope that they could produce the sterilizing immunity needed to block Covid transmission. But now we know they do not. Even high rates of vaccination cannot stop waves of Covid infections from washing over countries on a largely seasonal basis. Israel was one of the first countries to experience a post-vaccination wave, and other countries have followed suit. In the U.S., high-vaccination northern states thought they might be immune to the misleadingly-named “pandemic of the unvaccinated” in the south, but now their winter wave is arriving right on schedule, causing some of their worst infection rates since Covid began. “Herd immunity may well be impossible even if every single American gets a shot,” The Atlantic recently acknowledged.
Although mandates will not stop the spread, proponents say they will still preserve hospital capacity by reducing severe cases. But early fears that Covid patients would lay dying outside of overflowing ERs never came to pass, even before vaccines and antibody treatments were developed to make it even less likely. In addition, we have already seen that most vaccine holdouts are not in the high-risk groups that produce the bulk of severe cases.
Since the case for a broad-based Covid vaccine mandate is so weak, why do the calls for it persist? The illusion of control has biased the thinking of public health officials since the beginning of the pandemic. These officials are searching for something -- anything – to be the next button to press or lever to pull to control the virus. We might admire their quixotic project, except that all those buttons and levers have caused severe social disruptions. Their coercive mandates are yet another escalation.