The Volokh Conspiracy
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Mandatory Vaccination Plans Seem Premature, Until All Willing Recipients Are Vaccinated
Josh posted below about whether a law requiring vaccinations—perhaps even physically coercing people to get vaccinated—would be constitutional. This is an interesting legal question.
But the question, and the New York bill he's discussing, seems a bit premature. First, if there aren't enough vaccine doses to go around at first, it seems odd to take time and effort coercing vaccinations of those who say "No, thanks" when there are others who are saying, "Hey, I'll take that!" (And it likely would take time and effort; at least so long as there is any medical or religious exemption available, each such exemption request—including the ones that are doomed to lose—will have to be litigated.)
I realize there might be some unusual twists in some situations; for instance, perhaps the person saying no is someone who, if infected, will likely come into contact with lots of other people he could infect, but the would-be substitute wouldn't provide as much social value in getting immunized. But on balance, I expect the vaccine resister problem won't be a real problem, if at all, until after there's enough for everyone.
Second, say enough vaccine doses can quickly be made; there may still be lines to get them for other reasons, such as limited personnel capable of administering them. There too it seems better to focus on the willing recipients, rather than taking time and effort to go after the unwilling.
Third, say that everyone who wants to get the vaccine (and is medically safe to get it) does get it. Maybe at that point we'll get the much-talked-about "herd immunity," where enough of the population is immunized that the existing virus will largely stop spreading; again, we might avoid the need to go through the huge problems involved in coerced vaccination. Or maybe at that point we'll learn that the vaccine does have some serious side effects, at least for some categories of people, so perhaps the justifications for refusing vaccination are stronger. Or maybe by then we'll have learned something else; scientists have been learning more about this illness every month, and I expect they'll learn more by then.
Now perhaps at some point we will need to physically force people to get vaccinated—or, short of that, threaten them with fines or even jail to coerce them into getting vaccinated. But that seems like a decision for legislatures to make then, with more information about availability, herd immunity, side effects, and more. It seems premature to make it now.
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My thoughts generally line up with yours.
In regard to past and current stay-at-home orders, I have supported them, since your selfish actions (e.g., refusal to wear masks, refusal to keep 6 feet apart when interacting in public with strangers, etc) can directly harm me, or my loved ones. But (assuming vaccines are widely available), as long as I, my family, etc, can get the vaccine and be safe, I care much less about your (dumb? uninformed??) choice to refuse the vax. Now, your bad choices affect only yourself and those 'refusers' like you.
My assumption is that what will happen is: 1. The vaccine becomes available. 2. Many people will refuse. (Science deniers, a segment of black Americans who look to history for reasons not to trust US governmental attempts to give them vax, etc) 3. Those groups will then suffer far more deaths and serious illnesses than the population at large. 4. And at some point, they will say to themselves, "Wow, we're really hurting ourselves. I'm changing my mind about this."
If my kids are safe, and my parents are safe, and my friends are safe, and they can't be hurt by poor life choices made by other people, then I'm all for giving people that freedom to make dumb or poor choices. It's why I support the right of an adult to smoke cigarettes, or drink alcohol, or own 30 guns, or eat only junk food. And why adults should be free to ignore seat belt laws and helmet laws. (As long as they sign a waiver giving up the rights to health care for resulting injuries and illnesses.)
Hear, hear !
Just curious. Anyone know if military vaccination programs are specifically authorized by Congress, or are they enforced as a matter of executive necessity, or what? If someone is in the military, and doesn't want a vaccination, is there any elaborate legal process which has to be completed before he gets it? Does any of that have any relevance to what might happen in a contagion emergency, under a proclamation of marshal law?
If you enlist, the military owns you. They can force you to take vaccines, drugs, whatever. See the infamous anthrax vaccine which was forced on us, despite never getting FDA approval. No waivers allowed.
Now, your bad choices affect only yourself and those ‘refusers’ like you.
I doubt that situation will ever be available. Won't there will always be folks who for medical reasons cannot be exposed to certain vaccines?
For the sake of argument, assume new Covid vaccines work great for everyone with a typical immune system. But assume also that for folks predisposed to autoimmune disease, the new vaccines sometimes (maybe fairly often) activate the immune system as they are supposed to, but with autoimmune attacks as a side effect, and cytokine storms which can permanently injure them, or kill them. What then?
I don't know if that could even happen, but it worries me because if it can happen I might be one of those people. I am looking forward to hearing far more detailed information about how many folks with autoimmune diseases, and which diseases, have been included in the safety trials.
Assume that some immune-compromised people have been included, without ill effects. What is the right legal posture if that number is not sufficient to furnish a statistically reliable result proving safety for that population?
Won’t there will always be folks who for medical reasons cannot be exposed to certain vaccines?
Only the few live vaccines have some very limited contraindications; no MMR in folks undergoing chemo, or a few rare congenital immunocompromised diseases.
The biggest one is the polio vaccine. Vaccine-associated paralytic poliomyelitis (IE, getting Polio from the vacccine itself) is a real issue
Gasman and Armchair, those are not the kind of contraindications I am talking about. These new vaccines apparently do not use the virus at all, but only snippets of RNA engineered to trigger antibodies to the virus. If I have understood that, it seems reasonable to suppose getting Covid from the vaccine because of immune incompetence is not a risk.
The problem I am talking about involves autoimmune diseases, including fairly common ones such as rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis, and others less common. Those diseases manifest when the immune system is activated, but do so by triggering immune attacks on the body itself. I speculate that it could be that diseases of that sort at least partly explain the so-called cytokine storm which sometimes accompanies Covid infection.
Perhaps in some patients Covid activates the immune system in a particularly provocative way, and in patients with autoimmune disorders, a hyper-activated immune system goes on to kill the patient. With that as a premise, the risk would be that in susceptible people the Covid vaccine might trigger the same malign autoimmune response without ever giving the patient Covid.
I am not a medical professional, let alone a researcher, and this is pure speculation. It's on my mind because I have one such disease (it's an unlucky genetic endowment). I have been along for the ride for many decades, as my cranky immune system—often after being challenged by a virus or bacteria—picked out some random-seeming target—skin, joint, eyeball, gums, cartilage, lung tissue, whatever—and went after it, sometimes for weeks, sometimes for years.
Several times—a week or two after apparently recovering completely from typical respiratory infections like bronchitis—I developed unexpected pneumonia symptoms, with x-ray findings that later put me in mind of the distinctive Covid x-rays that were in the news at the outset of the pandemic.
On the basis of that experience, I plan to be cautious about taking the vaccine. I will wait until I get word from my rheumatologist that sufficiently extensive clinical trials have ruled out any link between the vaccine and cytokine attacks in patients who share my medical history.
lathrop....I spoke to my rheum at length regarding the Pfizer/Moderna vaccine. I am aware of the different vaccines out with their MOA, and did some self-directed research on them. I too have an autoimmune disorder (very overactive immune system). I completely understand your reticence.
I am running, not walking to get that Pfizer vaccine. You cannot contract covid-19 from the mRNA vaccine. I want my old life back.
(Disclaimer, I'm pro-vaccine)
That being said, this is the first time mRNA vaccines have really been used. They are a new technology, and there may be "hiccups" which are unforeseen in the general population.
I'll take my chances, AL. Like I said, I want my old life back.
" If my kids are safe, and my parents are safe, and my friends are safe, and they can’t be hurt by poor life choices made by other people, then I’m all for giving people that freedom to make dumb or poor choices. "
No doctors, nurses, orderlies, paramedics, etc. in your family?
Someone would have to be an UNVACCINATED medical professional. There probably won't be many of those. Admittedly there will be people who cannot be vaccinated for medical reasons.
This logic wouldn't apply if the vaccine were only 70% effective or so, but at 95% effectiveness you really can protect yourself without unvaccinated people in your vicinity endangering you too much.
-dk
Dick King, not if only 70% of the people in your vicinity get the 95% vaccine.
Nothing worse than attacking a bad argument with an even stupider one. Aren't you supposed to be smart or something?
Since society shares medical costs (through private insurance, publicly funded Medicaid, health insurance premium subsidies, CHIP, and Medicare) there may be an argument that someone else not getting a vaccination does impact the rest of us in our pocketbooks.
One would need to know the cost of treating the average COVID-19 patient (both short term and, if the person survives, additional costs associated with long term impacts of COVID-19) and the odds of an unvaccinated person getting COVID-19 after all willing individuals have been vaccinated to make a determination on this. I suspect the average cost of COVID-19 medical care far exceeds the cost of a vaccination, but if herd immunity gets high enough that the risk of infection drops very low the 'no-vax' alternative might conceivably be cheaper.
I would think that insurance companies/employers should be allowed to charge higher premiums for those who choose not to get vaccinated w/o a valid medical reason -- just as they can charge smokers more. Both are lifestyle choices by others that I shouldn't be bearing the cost of.
"And why adults should be free to ignore seat belt laws and helmet laws. (As long as they sign a waiver giving up the rights to health care for resulting injuries and illnesses."
Out of curiosity, should people who engage in sexually risky behavior be required to sign waivers as well?
In the existential sense; sure, that would be consistent. In the actual, real-world sense; no, that would be too intrusive. Also, driving is a public activity, while sex (generally-speaking) is an inherently private activity, and society probably does not want to micro-manage sex.
But I get your point.
Your assumptions seems pretty simplistic to me. My mother is 92 she says she won’t get the vaccine because she has reacted badly to vaccines in the past. I’ll get it to help keep her safe, but I’m not to worried about Covid myself. I’m not sure my youngest son will get it either since he reacted badly to the HPV vaccine after the first shot and didn’t complete the others.
Interesting that you make the following two statements:
1. “I have supported them, since your selfish actions (e.g., refusal to wear masks, refusal to keep 6 feet apart when interacting in public with strangers, etc) can directly harm me, or my loved ones...”
2. “It’s why I support the right of an adult to smoke cigarettes, or drink alcohol...”
You are aware that secondhand smoke damages an innocent bystander’s lungs and many innocent people die in drunk driving accidents?
1. Fair points. Here in California, I really do feel safe from secondhand smoke. It's not allowed in govt buildings, restaurants, bars, etc etc. The only time I am exposed to smoke is when I go to a friend's private home...and, of course, I can choose to not do this. But for children living in a home where a parent smokes, it absolutely is an exception, and there are lots of studies showing the harmful effects to children raised in smoke-filled homes.
2. I did not discuss the difference between me drinking and me drinking and driving, since I assumed such a difference was so self-evident that it did not need to be actually stated. I don't care if my surgeon or my airline pilot drinks. I care very much if she has 6 drinks an hour before she operates on me or before she steps/staggers into the cockpit. Again, self-evident, methinks. 🙂
I guess my point is, allowing for the freedom to consume alcohol also opens the door for one’s poor choice to inadvertently harm others. In order to shut that door, we should ban alcohol all together.
Isn’t that the way the current mandates operate? People no longer have the freedom to breathe fresh air or congregate with whomever they choose, whenever they choose, because they *might* get someone sick... even though it is far more likely that a person is not sick and, therefore, poses no danger to others whatsoever.
"In regard to past and current stay-at-home orders, I have supported them, since your selfish actions (e.g., refusal to wear masks, refusal to keep 6 feet apart when interacting in public with strangers, etc) can directly harm me, or my loved ones."
And, what about the selfish actions (refusing to let people decide their own risk level) which have caused massive damage to the economy, business closures, massive deficit spending, and probably millions more deaths long term? I don't fault you, or anyone, for the calculus that "my family is more important to me than those outside of my family". It's rational. But, our reaction to covid has not been rational. The rational thing to do would be to take extra precautions with the at-risk population, and generally leave everyone else alone.
Well, England has just announced that people with allergic reactions should NOT have the vaccine -- two serious (potentially fatal) reactions on the first day. Anaphylactic shock if I am not mistaken.
I predict an attempt to make it mandatory relatively early.
There's a whole culture of toxic narcissists who look for any opportunity to try to force others to be like themselves in whatever way. If people resist being forced, that gives the narcissists exactly what they love most: a chance to look down on and name-call the proles and to proclaim themselves even more virtuous by comparison.
Lethally reckless
jerks' mantra: 'nobody can
tell me what to do'
Better people should
disregard preferences
of sl@ck-j@wed losers
How do these yahoos
abide stop signs, center lines,
drunken driving laws?
So virtuous...
It is not difficult to be your betters.
Now do BLM protests.
Attempts to make it mandatory won't go far. The WAPO reports that polling on the vaccine shows that < 50% of Blacks plan to get vaccinated, 61% of Latinos, and 63% of whites.
You can imagine the people pushing mandatory vaccination folding like cheap suit at the first assertion that mandatory vaccination will disproportionately affect communities of color.
Kaz,
Can you explain? This first assertion would be, I expect, that the vaccination would disproportionately benefit communities of color, right? Since those communities are currently being hit very hard by Covid, the vaccine would help them more than the average demographic group, yes? I'm not understanding why people pushing mandatory vaxx would fold at the above assertion.
Sure, here you go.
1. The people pushing hardest for mandatory vaccinations tend to be Democrats. Many of these depend on minority support.
2. The country has an, ahem, "history" of trying to "do the right thing" to minority groups, often over the minority groups quite heated objections.
3. Pointing this out may lead to some Democratic leaders questioning the wisdom of "doing the right thing" to a minority group over their objections...again.
No they won't. They'll go into full Science!! Science!! Science!!! tantrum mode and they'll create racial exemptions to the mandate. And they'll push that for a year or three until courts tell them they can't.
You assume the purpose of the bill is the rational distribution of resources. That's not the purpose of the bill. The purpose of the bill, like many such bills, is grandstanding and the hopes of a brief mention that the politician was "doing something" on a local news station.
Mandatory Vaccination Plans Seem Premature, Until All Willing Recipients Are Vaccinated
World-wide? In my nation? In my state? In my city or town? In my workplace? In my school? Does it matter?
I’d say worldwide.
Let’s face it if the covid has given us any lessons it should be that the virus knows no borders.
If the goal were to get people vaccinated, sure.
If the goal is just to hammer home that we're not living in a free society, and you'd better remember it? Which appears to be the goal of a lot of the lockdown orders?
Then you'd go straight to mandatory, even if you had to leave volunteers in the lurch.
Brett continues to find that the obvious intent is cover for a secret liberal agenda.
"It seems premature to make it now."
Yes. Exactly right.
But in recent years, I think Americans have been going out of their way to pick fights with each other. We fight over big issues, small ones, and stupid ones. I think this proposed NY bill just reflects that. It is an attempt to provoke a fight.
None of this reasoning prevented flu vaccine mandates throughout the country. Where there is a political will, the Constitution is just a speed bump.
We should not make the vaccine mandatory. But there should be consequences if someone refuses to take it. So I would propose this.
1. Anyone who refuses to take the vaccine would have their health insurance cancelled with respect to covering Covid. The person would have to pay for all of their care out of their own pocket. If they cannot afford it, too bad.
2. A person unvaccinated after having the opportunity to get vaccinated and causes another person to get the Covid would be financially responsible for that person's health care with respect to treatment for Covid.
In short, let's do the market based solution. If you don't want to take it, no problem. But don't expect anyone else to pay for your consequences and expect to pay for the damage you cause.
That works!
“2. A person unvaccinated after having the opportunity to get vaccinated and causes another person to get the Covid would be financially responsible for that person’s health care with respect to treatment for Covid.”
How many degrees of separation between breath leaving a person’s body and infecting someone else is a person responsible for? If I give it to my son and he gives it to a classmate and he gives it to another classmate and that kid gives it to his older brother and that guy gives it to his college roommate and that guy gives it to a cashier at Kroger and he gives it to his girlfriend and she gives it to... her grandma! Who is at fault? Can I trace it back farther to get out from under responsibility? What if grandma’s dying breath then goes to the nurse, who gives it to *his* husband, who gives it to my coworker and it gets back to me?
Those that are vulnerable (in the kill zone) are at the top of the list. If they refuse, they are risking their own lives. Medicos are right behind. Everyone else? ie, those with no co-morbidities, are in no more danger than a tough cold.
90+% of deaths come from a well defined population. We've been nine months refusing to take action to protect the vulnerable. Instead we shut down schools, for no discernible reason.
"Now perhaps at some point we will need to physically force people to get vaccinated—or, short of that, threaten them with fines or even jail to coerce them into getting vaccinated. "
That's a pretty extreme statement if you think about it. You're asserting the government has the "right" to go, hold down and physically inject an innocent person with a substance, against the person's wishes. It's a pretty harsh imposition on the person's personal liberty...amazingly so. Because it's "medically necessary, for the community".
Let's extend this analogy for a moment.
Thousands to tens of thousands of people die every year, due to the lack of a kidney transplant. Can the government assert it's "medically necessary, for the good of the people" to take an innocent person, hold them down, and harvest one of their kidneys against the will of the person? After all, you only need one kidney to live and it's for the good of the nation as a whole? Or is that organ harvesting an imposition on the person's liberty?
When you "force" someone to undergo a medical procedure against their will, whether it be an injection or a harvesting....that's a real imposition on their liberty. And something to consider
Yup, it sure is a slippery slope.
What ever happened to "my body: my choice"?
It's a slippery slope, and it goes to the heart of fundamental liberties and human rights
"Can the government assert it’s “medically necessary, for the good of the people” to take an innocent person, hold them down, and harvest one of their kidneys against the will of the person?"
The answer is it depends. Are they Falun Dafa, Uighur, or other anti-socials?
Or are they religious types in the US who refuse the vaccine....
But it’s more fun to coerce people.
Share the Kiss of Peace. Merry Christmas
Critical Race Theory, the New Intolerance, and Its Grip on America
https://www.heritage.org/sites/default/files/2020-12/BG3567.pdf
Will there be a photo-ID card for people once vaccinated?
How will people prove/disprove who has been vaccinated?
If they prioritize essential workers to get the vaccine early, how will Wallgreen or CVS verify the employment category of people in line at the drug store?
Bureaucratic paperwork could make our species go extinct.
Maybe you'll have to show a vaccination record in order to be able to fly on an airplane. But guess that might create another black market item. Do the Real IDs support information like vaccinations?
Getting back to the point, there is enough (50 million times two doses) of the Pfizer vaccine to juice roughly 20% of the eligible population (328 million minus 80 million children) and additional doses of the concoction will not be available until late June or early July (see https://www.theday.com/article/20201207/NWS13/201209543 ). Subtracting from the eligible population of 248 million the 16 million of African descent, the 29 million of Latinxoxo background, and the 119 million pure white folk [and simply ignoring other perceived "race" groups as we often do] who have no intention of pumping the Kool-Aid into their veins, there are only 84 million Americans who are keen on receiving their share of the available 50 million double-shots: about 34 million people (about 10% of the US population) might be mandated to do that which they wish to do but cannot possibly do.
If politicians mandate that Unicorn piss lovers drink non-existent Unicorn piss, does such a mandate have any practical effect?
Personally, I'm impressed that the government got the purchase just about right: the Trump Administration purchased just about enough concoction to shoot up those who want to be shot up. It is the sort of limited waste that ought to make us all proud... and stands in stark contrast to the Swine Flu vaccination program of the early 1970's [remember that one, complete with Guillain-Barre syndrome?].
Now perhaps at some point we will need to physically force people to get vaccinated—or, short of that, threaten them with fines or even jail to coerce them into getting vaccinated. quoted from EV last paragraph.
Still seems like a marketplace solution will settle most vaccination issues. Employers will wish to protect their businesses from all of the pandemic related losses. Vaccination is a good way to ensure that their employees are well enough to show up, don't spread disease to co-workers, vendors, customers, staunch the flow of money into PPE, and project a sense of safety to the customers of the business.