Do Vaccine Mandates Make Sense?

The time is now to question if vaccine mandates are worth it and I don’t think the arguments are very strong. The traditional narrative is that every additional vaccinated person is a clear-cut victory. 60.01% is greater than 60% and therefore we have potentially saved a life. But frankly, people have the right to commit suicide. Forcing people into doing the right thing™ is a dangerous game with real consequences. People can become blinded by righteousness of the correct decision without taking into account behavioral economics or externalities. These mandates are a card that society should play only in the most extreme of circumstance. Is COVID-19 really worth it?

I’m skeptical.

Before we get into this, consider the COVID timeline so we can level set what we are talking about.

  • Jan 9 2020: WHO Announces COVID related pneumonia case in Wuhan, China
  • Jan 20: CDC says 3 US airports will start ‘screening’ for Coronavirus
  • Jan 21: First COVID-19 case confirmed by CDC in USA
  • Jan 23: Wuhan, China now under quarantine
  • Jan 31,: WHO issues Global Health Emergency (the games begin)
  • Feb 1 – May: Shutdowns, rising infections, deaths, etc.
  • May 21: USA and AstraZeneca form vaccine deal.
  • May 28: US Covid-19 deaths surpass 100,000
  • June 10: US Covid-19 cases reach 2,000,000
  • July 14: Early Moderna Vaccine trial shows promise
  • July 21: AstraZeneca, CanSino also appear promising
  • July 22: HHS/DOD announce Vaccine distribution agreement with Pfizer/BioNTech. The USA floods big pharma with money on the condition that we get first dibs. As we know this gamble does pay off big for the USA (thanks Team Trump) with a provision for the USA to get a delivery of 100m doses with the possibility of expanding it to 600m. The only other country which is able to get such early access to Pfizer is Israel, and they do so by turning the entire nation into a clinical trial.
  • July 27: Moderna Vaccine begins phase 3 trials, $472M is given from the Trump Administration (we should mention, the US gets 200m of these doses on the first agreement).
  • September 16: Trump administration releases vaccine distribution plan to have vaccines available for general public in January 2021
  • October 2: Trump gets COVID and becomes the dumbest kid in the room
  • October 19: Global COVID cases reaches 40m
  • November 4: The ‘peak’ of the crisis as US reports 100,000 new COVID cases in a day
  • November 20: Pfizer/BioNTech submits vaccine for FDA approval
  • December 10: Approval granted. Vaccines become available to Americans but with strict rationing
  • December 23: Trump Administration announces it will buy 100m more doses of Pfizer vaccine.
  • Jan 11, 2021: Biden administration reverses Trump admin policy of holding vaccine doses (to ensure people can get 2nd dose) and releases the whole stock gambling on future supply (this gamble, like the Trump one, pays off big). States face rollout hurdles because the logistics of the vaccines.
  • Jan 31, approximately 2.2% of the US population is fully vaccinated
  • Aug 31, 53.5% of US population fully vaccinated
  • Sep 30, 56.4% of US population fully vaccinated, 65.4% have at least one dose.

Source 2020

Source 2021

Let’s stop here, vaccine mandates begin to become effective October and November of 2021, but at this point we have 56% of the US population fully vaccinated and 65.4% of the population with at least one dose. Now the question of vaccine mandates is this, can we get the remaining 35% to get the shot (and the ~10% to get the last shot)?

Full vaccination from September to October 31 went from 56.4%→ 58.2%. As of this writing (November 9 data) that number is at 58.6%. However, note that by November 10th, 50% of 12-17 year olds are fully vaccinated (12.4 million). So we should be seeing a surge in vaccination for the US population as 6-11 gets their shot (24.4 million people).

Therefore, people will make a lot about the success of vaccine mandates to justify a political point, that they work in boosting vaccination anecdotally. But the fact remains that we can expect roughly 50%-60% of these 6-11 year olds to get their shot on their own as a requirement for entering public school (separate from the vaccine mandate for, say, delta airlines or the department of defense). These new vaccinations roughly approximate 3-4% of the entire U.S. population, boosting our numbers of 56% fully vaccinated to 60%, and one shotters from 65.4% probably to something like 70% without any need for a vaccine mandate.

Realistically, a vaccine mandate is really only destined to boost this number to, say 75% or (in a very optimistic scenario) 85%. What societal benefit do we achieve through this marginal 5% or 15% increase in vaccination?

The Curve Will not Flatten Further

The fact is that vaccine mandates are kicking in precisely when the worst of the pandemic has sunset. Some may turn to the possibility of a new COVID strain hitting us and causing another wave, but this is a weak argument. If this new strain can be vaccinated against (i.e. the original COVID vaccine works against it) then the wave will not materialize as strongly as the original or delta variant did because people were not vaccinated during these waves. If our hospitals did not ‘fail’ during the delta surge or during the original COVID surge, then why would they fail when 60% of the population is vaccinated?

(We can quickly dismiss the last case, where vaccines are not effective against this new strain. In this situation we are obviously screwed but it has nothing to do with the decision to mandate or not mandate a vaccine.)

Of course, it is obvious that any additional person protected against such a strain will have benefits socially, but this quickly leads into a zero-risk fallacy.

People have the right to play Russian roulette with their lives

We can resolve the above situation by introducing an axiom that people seem to simultaneously accept but then behave contrary to: COVID-19 is so infectious and face masks that people use are so inadequate that it is almost certain that most (80%+) of the U.S. population is going to be exposed to COVID-19 and the delta variant at some point in their life, if they haven’t been already.

No matter what we do everyone will have to cross the COVID-19 albatross. Some will survive, some will be maimed forever, others will die. The only question is if they can be vaccinated before that happens. Under this guise ‘flattening the curve’ made sense. We were buying time to save a large quantity of human life. However, that choice is already behind us, we looking to the future now.

As of the writing of this post, (excluding ages 0-11) all people who want the vaccine could already have gotten it. Do those who remain have the right to take risk? I think the answer is yes so long as that risk isn’t a substantial risk to others (at this point I believe that is true). We will pick up the comment on ages 0-11 later.

Now we must ask ourselves what are the social costs are to achieve an additional 5% vaccination? 10%? And what are the real, social benefits to this? Again, we play this game for any other spreadable illness (flu, measles, mumps, rhubella, etc). I think the fact remains that we wish society would have elected to take the shot in bigger numbers (getting to 80% without prodding) but that was not the case. This is a reality we have to live with.

If COVID-19 is going to become endemic then hospitals are going to have to deal with these COVID-19 cases just like they deal with flu cases (even if COVID is more severe and dangerous). There is a motivated portion of the population who is willing to enter themselves into poverty (lose their jobs) to do this. So ask yourself if you are okay with the externalities of ostracizing this person all so that 1 more person can get vaccinated. We live in a democracy, this person has a single vote, by forcing them into something they don’t want to do you are directly radicalizing them with serious consequences. So even those who feel forced to get the vaccine and take it, will organize and enact political revenge later. Local election participation rates are very low, 20% or less in some instances. motivated minorities can have big impacts in our every day lives. Are you okay with these people taking over school boards? Becoming mayors? Running your state legislature? Is a 5% increase in vaccination worth this cost? Is the vaccinated population willing to ‘stand vigil’ to block these motivated voters come next cycle? I think no, they are split politically and don’t (because of that) constitute a majority.

But let’s talk about the children for a second now.

The people who couldn’t get the vaccine are exactly those who are least at risk

It’s worth saying, that as of now all reasonable ages can get the vaccine. But we can run the thought experiment anyway and pretend that young people cannot to entertain the ‘think of the children’ argument. Let’s look at COVID death rates for these teens and compare them with historical flu deaths. We will find that COVID-19 is approximately equal to the flu in terms of death risk for ages 0-18 (less dangerous than the flu for 0-4, slightly more dangerous for late teens).

2017-2018 Flu Season

0-4: 115 Deaths

5-17: 528 Deaths

2018-2019 Flu Season

0-4: 216 Deaths

5-17: 156 Deaths

COVID Deaths For Children/Teens (1/4/2020-11/10/2021)

0-4: 210 Deaths

5-18: 490 Deaths

These numbers speak for themselves. COVID is dangerous, yes. Is it bad to have basically 2 versions of the flu around to kill children? Of course. Would I prefer it wasn’t the case? Yes. But what are the probabilities we are talking about here? The 0-4 age cohort is roughly 20 million. That’s 0.00105% death rate or 1 in 95,238.

Let’s see what that compares to . Something like the 1 year probability of death by riding a motor cycle, it is 1/3rd the probability of death by firearm in a given year, and half the probability of dying as a pedestrian walking along the road. Zero risk tolerance is a fallacy, we cannot exist in a society that restricts essential activities (i.e. going to school) in order to hedge every basis point of risk. At some point we have to drive on a freeway, we have to live our lives. There is a cost to economic shut down and the people who are impacted most are the poor and venerable.

Policies to mitigate COVID risk impact the poorest most

Poor whites and poor minorities are those who get hurt the most by shut downs and policies which discourage people from utilizing services in the public market (concerts, bars, restaurants, etc.). This may seem like a separate argument to forced vaccination but, the argument for forcing vaccines (reduce the risk of covid) is similar to a host of other covid risk mitigation strategies (some of which make no sense at all). Rich, wealthy tech workers (i.e. neo-liberals) are those who benefit the most from these restrictions as they can remote in to work (their lives actually improve because they don’t have to commute any longer) and are paid well. Meanwhile we close parks, shut down pools, force mask wearing in restaurants (only to take them off when we sit), and burn stupid amounts of political capital to maybe, kinda-sorta reduce –some– covid risk when you go to a grocery store. When will the insanity end?

This is the calculus health professionals refuse to entertain but it is something society must answer. We are not given the luxury of the concrete palace that is a virologist, economics absolutely comes into play when making these decisions.

Conclusion

Is there a point can we just look at this objectively and say that this probably isn’t going to be effective? And even if we do get to our 80% or 85% vaccination rate, what do we have to pay to get there? Sometimes the broader conversation gets drowned out by zero-risk madness.

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2 comments

  1. Thank you thank you thank you. Generally I am against vaccine mandates in principle, but of course situations will arise which make us consider our principles in light of a cost-benefit analysis. I like how you show here that on any sensible reading of the situation, the costs of mandates are just too high, economically and politically, and the benefits are just too low, especially when it comes to vaccinating children. It makes no sense to take an absolutist approach to the vaccine. I think I may have commented before on your site that I am more on the conservative side of things than you are, but I appreciate the way you take a ‘step back’ from partisan politics and refuse to place the blame solely on one side or the other. In this case, I thought it was interesting that you warned your readers about radicalizing those who don’t want to get the vaccine because this will have adverse political consequences. I think you are right to make that connection. I have been a mom for 23 years and for the first time in my life I am speaking at school board meetings and considering taking my kids out of school on designated ‘protest days’. I don’t think this is a bad thing that I am getting more involved, or that conservatives are getting more ‘mobilized’. On the other hand, the ‘politics of protest’, as anyone on the left will know, is not a politics of dialogue and debate and good will; it is a politics of zero compromise, surely the breeding ground for more desperate kinds of thinking and acting. When people are coerced into something through a ‘zero tolerance’ kind of approach, this is, sadly, what we should expect.

    1. Hi Holly, thanks for your comment. You bring up some interesting points, on one hand your observation that I am more liberal than you are is almost certainly correct; personally I think i’ve started to identify as a reluctant liberal. But you never know with these things. As I get older I find myself willing to dip my toes in any pond if it says something I think makes sense. Vaccine mandates was one such deep dive that didn’t make any sense. But i’m boring, let’s talk about your interesting situation where vaccines has pushed you into protest; in particular for children.

      The issue with kids is pretty fascinating because the State seems to feel a moral obligation to intervene very strongly in their lives and in the interaction between a parent/child. On one hand conservatives seem to be very pro-intervention (child abuse, neglect) and in this instance of vaccines have started to become very resistant. The only argument string that makes sense (to me) for this resistance is the claim that vaccines are dangerous to the child’s health. If that’s the sincere belief then I understand that, as an axiom, it would need to be resisted. Arguments about the child’s freedom haven’t yet convinced me but I’m always open for the counter (we would start by addressing the issue that we are forcing children into schools in the first place and progress from there, children have very few actual claims to freedom it seems).

      However, and maybe this is your pitch, there is this third take that my post walks through. The risk/reward element of this mandate is either being completely ignored or it’s being presented to the public by the government in a, frankly, disingenuous way and they refuse to back-peddle on this which is eroding their credibility (very dangerous, credibility is so precious right now). But an outsider can see this nuanced argument to be very strange, like it’s attempting to white wash a deeper, more radical opinion (something about ‘the company you keep’ rings here).

      But what is this all for if we aren’t going to highlight contradictions. The risk/reward of a vaccine is very much in favor of vaccines however, the risk/reward of vaccine mandates in the same guise becomes very questionable so long as the number of people who voluntarily get the vaccine crosses some minimum threshold (let’s pretend that’s 50%). In my view, the actual risk to kids right now appears to be at levels of the flu PRIOR to them being vaccinated (and I’m certain at least 50-60% would get it on their own volition). So my post took a very conservative view here (COVID is actually less dangerous for school-age children than the flu, assuming 50% get vaccinated). Yet we don’t mandate flu vaccines. One way around this is to say the flu vaccines are a lot less effective and so we decide collectively to swallow this risk. Just so! But why? What reason is there for taking this risk and accepting it? I don’t see how that logic doesn’t doubly apply in the COVID situation.

      Engaging children in political protest is also very interesting to me but maybe that’s too much of a tangent.

      In some ways what i’m doing here (and maybe you are doing? not sure) can be a strange line to walk. I’d be curious to hear more on why you have became more politically involved in this sense (is it because vaccines are poison? is it because children have freedom which is being infringed upon? is it because the vaccine mandate itself is contradictory to societies existing risk-tolerance?). And to be clear, not super interested in convince anyone that vaccines are actually god’s gift as that’s 1. not in my realm of competency but 2. not worth while for anyone involved.

      On your last comment with respect to conservatives becoming more mobilized and how protest is a dialogue of no-compromise; I agree on both points. Protest is the option people must take when the normal venue (say, voting) fails. But blame can be landed on both ends. On a personal level i’m an aggressive conformist, but protest is healthy for a democracy. Liberals just don’t like it when its for conservative issues.

      Maybe to provide some final detail here: on one end, people protested police treatment of minorities because they are unable to enact political reform the normal way. Why? Because we have (as a society) created a ‘techne’ of law enforcement so entrenched and isolated from political interference that they’ve spawned their own sub-culture. This sub-culture has been great for the USA (we have never been safer in this country than we are today), but it has also spawned really bad outcomes which, thanks to smart phones, can no longer be hidden. We solved one problem from the 1800s and created another.

      Schools, thankfully (for conservatives), are not as isolated as police departments so I suspect protests will be far more effective at the local level in that instance than they were for BLM. just my 2 cents

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