On Sept. 9, President Biden announced that he would effect, through OSHA, a COVID-19 vaccine mandate for businesses with 100 employees or more.
As a medical doctor, I give my approval for the COVID vaccine on the counts of its safety and its efficacy. Indeed, I advise all of my patients to get the vaccine as soon as they are able. However, I stand firmly opposed to this broad mandate for COVID vaccination.
Why? This federal mandate is a gross overreach of government and will end up further poisoning the patient-physician relationship. Additionally, such heavy-handedness may actually decrease vaccination rates by unnecessarily polarizing the issue.
Some of my fellow conservatives believe the government has no authority to mandate vaccination. This belief seems to be historically inaccurate. Clearly the government does have this power and has used it in the past — and rightly so. This was notably the case with smallpox vaccine mandates and the affirming 1905 Supreme Court decision Jacobson v. Massachusetts.
However, there are two notable differences between smallpox vaccine mandates of yesteryear and President Biden’s current mandate.
Most important is the vast difference in mortality between these two diseases. The case-fatality rate of smallpox was about 30 percent. For COVID-19 in the United States, it’s hovering around 1.6 percent.
I’m not arguing that 1.6 percent is negligible; even small percentages extrapolated across hundreds of millions of Americans can be terrible. Yet the ancient Greeks called prudence the mother of all virtues for a reason. A disease with a case-fatality rate of 30 percent poses an existential threat to a society, whereas a case-fatality rate of 1.6 percent, though tragic, simply does not.
We should ask ourselves if it is prudent to mandate vaccines for a virus with such a mortality rate.
The second difference between the smallpox vaccinations and the current mandate is a legal and political one.
Do you think Biden’s vaccine mandate is bad policy?
The smallpox vaccine mandates were passed by state and municipal legislative bodies with representatives accountable to the governed. The president’s proposed mandate is to be done entirely through the bureaucracy of OSHA.
If Americans are displeased by the bureaucrats working at OSHA, they have no means by which to replace them or even appeal to them in a tangible way. This is not a small difference between the two approaches but one that strikes at the heart of self-government and representative democracy.
Vaccine requirements make sense for those who work in hospitals taking care of the sick and most vulnerable. Even before COVID, hospitals required their employees to have a whole host of vaccines. But do requirements for vaccines make as much sense for a tech company whose employees work from home? Hardly.
Moreover, do these non-clinical entities have adequate liability measures in place to deal with the few but inevitable forced-vaccine complications?
Hospitals are backed by millions of dollars, and these hospitals have systems in place to assist employees with medical bills and lost wages that may result from an adverse reaction to any mandated vaccine. It’s highly unlikely that every company with 100 employees or more has the financial resources to offer the same.
On its face, Biden’s proposed COVID vaccine mandate seems to raise more questions rather than provide solutions.
Why does the mandate target businesses with more than 100 employees? Anyone can contract and spread COVID regardless of the size of the business they work for.
Why are there no exceptions for those previously infected with COVID-19? There is good data coming out of Israel that suggests natural immunity to the delta variant is more protective than the vaccine.
Why is the mandate targeted towards the workforce, a population that is younger and healthier? Couldn’t the administration use the same police power of the state to enforce vaccination in the elderly who are at greater risk?
I suspect denying Medicare and social security to the unvaccinated wouldn’t play as well on the evening news; indeed, most of us would recoil at the injustice. But theoretical injustice to the elderly is not worse than actual injustice to the young.
To tell a man that if he does not comply you will deprive him of his ability to feed his wife and children is an ignominious coercion.
Based on the available evidence, I believe the vaccines are safe and effective. All eligible Americans, save a select few with serious medical problems, ought to be encouraged to get the COVID vaccine. But persuaded only, not coerced.
Public health experts and my colleagues should remember our purpose as physicians: to not merely fight disease but, more importantly, to promote human flourishing.
To forget that all individuals have reason and free will, to treat them as cogs in a machine, to cynically manipulate them to a desired end, undermines the dignity of the human person. Our elected leaders would do well to remember this.
At the heart of the patient-physician relationship is the element at the root of all fruitful human interactions: trust. If the inoculation of Americans against the coronavirus is achieved at the point of the sword rather than the physician’s powers of persuasion, the trust so vital to the practice of medicine will be undermined.
It is those who distrust the medical field already who are often those who need a physician the most. How can patients trust physicians if we are advocating to have their free will abrogated?
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