(Warning: Long Rant with Minimal Editing)
When we talk about vaccine mandates, what are we talking about?
A local event venue has, after a year, resumed in-person events. They require proof of vaccination before entry, but they are flexible about what counts as ‘proof.’ A photo of a vaccination card suffices for them. It’s not just this venue–bars, restaurants, etc. are taking similar measures.
Meanwhile, the city government now requires all employees to be vaccinated (perhaps there are exemptions, I don’t know the details).
Some places accept recent/frequent covid tests in lieu of proof of vaccination, but the systems are set up to make things much more difficult for people who try to gain admission through negative covid tests than vaccination.
I’ve also encountered talk of forcing people to get vaccination–not just denying them admission or causing them to lose their jobs, but imposing legal penalties, perhaps even physical force–though no government agency or private business has suggested that, as far as I know.
So much to unpack…
What is the purpose of the mandates? Is it to stop people from being a risk to others? Is it to stop people from being a risk to themselves? Is it a reward/punishment for compliance? My assumption is that the purpose is to stop people from being a risk to others.
VACCINATED PEOPLE CAN STILL TRANSMIT THE VIRUS
Do the vaccines stop people from spreading the virus to others? The answer is… partially.
Immunity to measles is sterilizing. That means that someone immune to measles will not get infected with measles even if they are exposed. This applies to both measles survivors and people vaccinated against measles. People immune to measles can’t be asymptomatic carriers.
Immunity to pertussis is non-sterilizing. I know from firsthand experience: I’ve been infected with pertussis at least twice. My second case of pertussis was much milder, which indicates that I had some immunity… but not sterilizing immunity. Despite the prevalence of vaccination against pertussis, pertussis has been spreading exponentially in the United States for over a decade (until the covid pandemic… maybe it’s stopped because some measures which limit the spread of covid also work against pertussis). It’s spread too much to be explained merely by anti-vaxxers (though they are contributing to the spread). Either the bacteria evolved to spread more effectively (possible) and/or the vaccine had a problem (probable). This is difficult to track due to a lack of testing for pertussis, but some evidence suggests that a) pertussis infections are often asymptomatic and b) immunity to pertussis only prevents symptoms; people immune to pertussis can still be asymptomatic carriers who infect others.
Evidence makes it clear that coronavirus immunity (whether by vaccine or natural infection) is much more like pertussis immunity than measles immunity. To what degree?
This study says:
Based on these data, the researchers estimate that fully vaccinated people in this testing round had between around 50% to 60% reduced risk of infection, including asymptomatic infection, compared to unvaccinated people.
In addition, double vaccinated people were less likely than unvaccinated people to test positive after coming into contact with someone who had COVID-19 (3.84% vs 7.23%).
This data was collected in the UK before ‘Freedom Day.’ It reflects how covid spread when they had the mid-June restrictions. 100% of the positive covid tests in this study were caused by the Delta variant. Based on this data, let’s say that vaccinated people are 60% less likely to get infected with covid (including asymptomatic infections) than unvaccinated people.
Are vaccinated!infected people equally likely to spread covid as unvaccinated!infected people? I don’t know. However, this article says, “The new data, published in the U.S. agency’s Morbidity and Mortality Weekly Report, also found that fully vaccinated people who get infected carry as much of the virus in their nose as unvaccinated people, and could spread it to other individuals.” Therefore, I’m assuming that vaccinated!infected people can spread the virus as much as unvaccinated!infected people.
How does this compare with masks? Data on masks is all over the place because different masks are different, some people don’t wear masks properly, etc. However, this meta-analysis found that, in lay people, masks reduce the spread of covid-19 by about 60%. (This twitter thread provides context to the meta-analysis).
According to the data I’m using, vaccination is about as effective at stopping someone from spreading covid-19 to other people as wearing a mask. If someone is vaccinated AND masked, the protective effects stack. Otherwise, a vaccinated unmasked person (of unknown infection status) presents about as much risk to others as a masked unvaccinated person.
If these numbers are valid (and they may not be, all kinds of things may be wrong with these numbers)… I’m suspicious of anyone who advocates a vaccine mandate yet thinks it’s fine for vaccinated people to congregate without masks. Why privilege unmasked!vaccinated people over masked!unvaccinated people? (I understand the argument for privileging masked!vaccinated people over masked!vaccinated people.)
Bars and restaurants… shouldn’t let customers indoors while the delta variant is on the rise. They can’t impose indoor masking mandates because people can’t eat and drink with masks on.
If a small venue has indoor gatherings for activities which can be done while masked and imposes BOTH a vaccine and a mask mandate, and there’s a compelling reason to be indoors rather than outdoors… I’m fine with that. I’m even open to bars and restaurants to imposing vaccine mandates on customers who drink/dine outdoors on the bar/restaurant’s premises. Even if the vaccine mandate is too sloppy to limit the spread of covid-19, it might make customers/employees feel better, and potential customers who dislike it can just not go to those bars/restaurants/gatherings.
HOW DO WE KNOW WHO IS VACCINATED?
A huge advantage of mask mandates is that it’s easy to tell who is masked. Since some places fail to enforce even mask mandates, I don’t trust them to be good at enforcing vaccine mandates.
The vaccination cards used in the United States are so, so easy to forge. They are so easy to forge that any vaccine mandate based on checking vaccination cards is a joke. Yet stricter methods for checking vaccination status will wrongfully mark people as unvaccinated. Including me.
The guy who filled out my vaccination card made mistakes. I corrected the mistakes in my own handwriting. As long as the vaccination card is only used for my personal records, that’s fine. But anyone who uses my vaccination card to check if I’m vaccinated or not should be suspicious. If I use my vaccination card as proof, and they accept it, then they probably accept a lot of forged vaccination cards. If they don’t accept my vaccination card as proof, they might be good at catching forgeries, but I’m going to be excluded despite being fully vaccinated. So many people are in situations like this (improperly filled vaccination cards, vaccinations outside the United States, vaccination by vaccines not approved for use in the United States, etc.) that I don’t see how any small organization can do this competently.
France, at least, developed a HealthyPass which allows small businesses to check whether someone is vaccinated/has recently tested negative/is immune by prior infection. (More on that later).
However, in the United States, the only fair ways to separate the immune from the non-immune are antibody tests and/or frequent covid tests. Lab test results are much harder to forge than vaccination cards. If a vaccinated person fails an antibody test, they probably should not be treated like a vaccinated person. Frequently covid tests screen out vaccinated people with breakthrough infections (an infected vaccinated person is definitely more dangerous than an uninfected unvaccinated person). However, requiring antibody tests and/or frequent covid tests for all customers/guests aren’t workable for many small organizations.
WHAT ABOUT THREATENING TO FIRE PEOPLE WHO REFUSE THE VACCINE?
Employers, such as local governments, hospitals, etc. which impose vaccine mandates operate at a higher level. They can use antibody tests and/or frequent covid tests instead of vaccination cards. Should a city worker who does 100% of their job at home lose their job just because they refuse vaccination? I say no. What about outdoor litter collectors? They perform 100% of their job outdoors and can keep physical distance from other people. I wouldn’t make them lose their job over vaccine refusal either. The only group of employees who I would consider a vaccine mandate for are those who, as part of their job duties, must interact with people at close distance indoors. (I also want them to be masked on the job).
The prime example are healthcare workers. Yes, I want all healthcare workers to be vaccinated. However… imposing a vaccine mandate on them could backfire. I’ve seen anecdotes from doctors who are vaccinated themselves who oppose a vaccine mandate because they believe some colleagues they depend on will quit rather than take the vaccine. News stories like this corroborate these anecdotes. So many healthcare workers have quit due to the stress of the pandemic that, if a large number of healthcare workers quit, they cannot be replaced in the short term. (If administrators hadn’t treated healthcare workers so badly in the past year and a half, more qualified healthcare workers would be willing to continue healthcare work, which would make it easier to find healthcare workers who are willing to take the vaccine.) These doctors are afraid that a vaccine mandate will cut the healthcare workforce so deep that it will cause more deaths than it prevents.
I wish we didn’t have to choose between ‘ensure all healthcare workers are vaccinated’ and ‘retain enough healthcare workers to keep the healthcare system functional (or at least more functional than it would be otherwise).’ But the healthcare workers who are willing to withhold their labor control the options available, not me. Given the sacrifices healthcare workers have made during the pandemic, I’m not going to shame them with moralizing sermons. The healthcare workers who refuse the vaccine may know something relevant which I don’t.
If a vaccine mandate will cause 10% of healthcare workers to quit, and those healthcare workers can’t be replaced in the short term, I’m opposed to putting a vaccine mandate on them.
Since I’ve come out against vaccine mandates against healthcare workers, I can’t in good conscience advocate vaccine mandates for other categories of workers, even in professions where I really want everyone to be vaccinated.
(Also, healthcare workers can forge vaccination records more easily than most people. Administrators may even help them to make the numbers look good. I’d rather have a system where people honestly report how many healthcare workers are vaccinated than a system which encourages fake vaccination records.)
DO VACCINE MANDATES INCREASE VACCINATION RATES?
Now, about France’s HealthyPass. They seem to have a system which makes it possible for even small businesses to check customers’ vaccination/covid-testing status with low risk of fraud. More people are choosing the vaccine now in France than last month. The same in happening in California now. Can this be attributed to the announcement of HealthyPass (in France) or increasing numbers of vaccination mandates (in California)? Correlation does not prove causation. HealthyPass and the patchwork in mandates in California probably increase willingness to vaccinate to some degree, but recent news about the Delta variant may be the main driver of increased vaccine requests.
WHAT ABOUT VACCINE WEAR-OFF?
Scientists agree that vaccines against coronaviruses will only provide immunity for years, at most. Some say that these vaccines will only be effective for months.
Do these vaccine mandates take into account vaccine wear-off and potential boosters? How? If not, how can these vaccine mandates work for more than a short time?
WHAT ABOUT THE LAMBDA VARIANT?
Data about the Lambda variant (first detected in Peru) is limited. The data we have suggests that it might have escaped the vaccines. The Lambda variant is currently rare in the United States, but it is here, and like all covid variants, it can spread exponentially.
Even if the Lambda variant hasn’t escaped the vaccines, another variant which already exists might have. And if not yet, then in the future. Is it worth the risk? Do we want to find out whether the Lambda variant has escaped the vaccines by making it easy to spread?
If the Lambda variant, or any other variant, has truly escaped vaccines, then vaccine mandates will do nothing to stop it. Vaccine mandates may even make things worse, by encouraging people to engage in risky activities, such as eating indoors in crowded spaces with people from multiple households.
To make it as difficult as possible for the Lambda variant to become widespread in the United States, we need masking, ventilation, restrictions on air travel, and bans on indoor public dining/drinking.
THE USE OF FORCE
I’ve already encountered talk of forced vaccination. Not just making people lose their jobs (which is already highly coercive), but physically vaccinating people against their will.
So far, I haven’t seen this talk from government officials. But the fact that I’ve encountered this talk at all scares me. I don’t want this to get into the Overton window, let alone be implemented.
I don’t even understand the logistics of forced vaccination. How will you track down unvaccinated people? Who will catch them? Who will use physical force on them as you inject them? What if the targeted people use weapons to resist vaccination? The people who advocate vaccinating people against their will don’t answer these questions, so I suspect they haven’t thought about it.
I also know, in my bones, that this kind of forced vaccination will break social bonds to an extent which will kill far more people than covid-19. That’s why I want to kill this talk with fire.
Maybe these vaccine mandates in restaurants/bars/etc., porous as they are, are increasing vaccine uptake to a small degree, and even that small increase in vaccine uptake will save enough lives to justify the problems these porous vaccine mandates cause. (But will they save more lives than just shutting indoor dining/drinking in restaurants/bars/etc. down?)
However, I’m opposed to vaccine mandates which go beyond that level. Vaccine mandates which go beyond porous mandates for bars/restaurants/cultural events/etc. will do more harm than good.
The most ardent advocates of vaccine mandates are people who refuse to take responsibility for their own failures. People who discouraged mask-wearing in vaccinated people. People who encouraged risky yet frivolous activities because vaccines are magic. People who want to take out their frustrations on unvaccinated people rather than understand why some people are unvaccinated (such as precarious employment which makes it impossible for them to set aside two days to recover from vaccine side effects). People who want their summer vacations in places over a thousand miles away (1600 km) and don’t care that long-distance travel is the main way variants get spread to new regions. People who want indoor dining in restaurants while the pandemic is still out of control.
Those who continued to encourage masking, limiting non-essential travel to local areas, holding gatherings outdoors rather than indoors, etc. in conjunction with vaccines to make the pandemic go down faster have far more credibility with me. They aren’t the loudest voices in favor of vaccine mandates. That tells me something.
The best approach to this pandemic is to use multiple imperfect solutions. Too many people treated vaccines as a magic bullet. Now that vaccines are acting as an imperfect solution, not magic bullet, they are blaming the vaccine refusers rather than admit their own mistakes.
(What about all the people around the globe who can’t get the vaccine even if they want it? What about the people who are obstructing manufacturing doses at lower cost in more countries because patents? If the people who refuse the vaccine are really at fault, aren’t the people who are standing in the way of manufacturing more doses and making them available faster to more people even more at fault? Oh wait a minute, the people who are defending patents and pharmaceutical company price gouging have power, it’s much easier to pick on powerless poor people who can’t afford to lose their jobs because of missing a shift due to side-effects from the vaccine.)
The people who cling to the belief that vaccines are magic bullets want to preserve that belief by telling themselves that if only they mandate vaccination, then everyone will get vaccinated (no, they won’t) and after everyone is vaccinated the pandemic will disappear (no, unless it’s combined with other measures). They haven’t thought through the messy consequences of vaccine mandates.