Ostracize and Punish the Unvaccinated

As Alice Cooper sang, “No more Mr. Nice Guy/He said, ‘You’re sick, you’re obscene.’”

The title of this article is politically incorrect — and make no mistake, political correctness constitutes a phenomenon of the right as well as the left, of conservatives as well as liberals. Different constituencies carry their own excessive sensitivities, and today it is fashionable in polite society to pander to most, if not all, of them. “Don’t Shame Young People Into Getting Vaccines,” blared the headline of a recent column in the New York Times (August 6, 2021). Perhaps the authors are correct, but if “shaming” is not the answer to the unvaccinated throngs helping to prolong the pandemic in this country, harsher measures would nonetheless enhance a path toward normalcy.

To be sure, no one should be physically forced to receive any vaccine — doing so would be the sign of an autocratic state. (And, for the moment, never mind the irony of how anti-vaxxers largely overlap with Trump supporters seeking to rig elections, dissolve democracy, and turn everything over to the whims of a bigoted buffoon.) If one wants to live (and possibly work from) home, homeschool one’s children, and spend time in the outdoors isolated from strangers and casual acquaintances, one should not be required to receive a COVID vaccine. If one wants to live as a subsistence or small-time commercial farmer who barely interacts with any non-relatives, and only does so outdoors, one should not be required to receive a COVID vaccine. If one wants one’s “freedom” — the “freedom” to not receive a vaccine — there it is. However, if one wants to function in society by interacting with others, vaccination should be required.

Increasingly, steps in this direction are occurring. In late July, President Biden announced that federal workers must be vaccinated against COVID or else endure a regimen of masking, distancing, and weekly testing (https://apnews.com/article/lifestyle-joe-biden-business-health-travel-a1670ffa08f1f2eab42c675d99f1d9ad). A vast slew of colleges and universities are requiring COVID vaccinations, a policy just affirmed by the conservative, Trump-appointed Supreme Court justice Amy Coney Barrett (https://apnews.com/article/health-courts-coronavirus-pandemic-us-supreme-court-c10f02b467c86e2b61c6743aedd4fc69, https://universitybusiness.com/state-by-state-look-at-colleges-requiring-vaccines/). (One might note that nearly all such colleges and universities are allowing for medical and religious exemptions to COVID vaccination. Medical exemptions are certainly proper for the rare individual who figures to be allergic to the vaccine or otherwise predisposed to some sort of complication. Religious exemptions speak to First Amendment concerns yet otherwise prove dubious, given that religion basically predates the history of vaccination and modern science in general.) In San Francisco and New Orleans (and to some extent New York), proof of vaccination (or, in the case of the Big Easy, proof of a negative COVID test) must be produced in order to enter indoor businesses such as restaurants, cafés, bars, entertainment venues, and gyms (https://www.travelandleisure.com/travel-news/san-francisco-new-orleans-indoor-dining-vaccine-mandate, https://www.reuters.com/world/us/houston-join-schools-rebelling-against-state-bans-mask-mandates-2021-08-12/). As a result, fans attending New Orleans Saints football games in the Superdome must be able to prove that they have either been vaccinated or have tested negative for COVID within the past seventy-two hours (https://www.espn.com/nfl/story/_/id/32010920/proof-covid-19-vaccination-negative-test-result-required-attend-new-orleans-saints-games). And many major American companies are now requiring that office workers provide proof of vaccination (https://www.cnn.com/2021/07/28/business/companies-vaccine-mandate/index.html). Major sports leagues and franchises, too, are moving toward vaccination mandates for nonunionized workers (https://www.espn.com/nba/story/_/id/32096719/nba-calls-covid-19-vaccination-most-staff-2021-22-season, https://www.espn.com/mlb/story/_/id/32097575/sources-houston-astros-washington-nationals-first-mlb-teams-mandate-vaccine-non-playing-employees).

Some of these requirements are not as absolute as one might like — a simple “vaccinated-or-fired,” “vaccinated-or-banned” approach would be best, yet may be complicated by the prerogatives of unions and the potential for fake vaccination paperwork. And they represent just the beginning of an approach that ideally would become nearly universal, embraced by virtually all companies (big and small) for virtually all workers in virtually all towns, cities, and states in the land. And, frankly, this beginning is belated — it should have been embraced weeks earlier. But it provides a roadmap for where society must go, and it is hardly unprecedented. After all, all manner of vaccines have long been mandated for public school children on a state level, helping squelch such longtime viral adversaries as smallpox, polio, measles, and mumps. (Unfortunately, the last two have recently staged something of a comeback, due in part to the anti-vax movement.)

The point is that one’s right to “freedom” ends when it starts impinging on the freedom of others. If one wants to refrain from receiving a COVID vaccine and simply stay in one’s home or exist apart from nonrelatives in general, then one should enjoy that right. But if one wants to function and interact in society, either as an employee sharing a workplace or as a customer patronizing a store or an entertainment venue, then one should be required to produce proof of vaccination. Without being vaccinated, a person seeking to partake in societal functionalities and commonalities is akin to a drunk driver or someone smoking in a public indoor space. Yes, anyone twenty-one or older has the legal right to guzzle alcohol and potentially destroy his or her liver, but once that person sits behind the wheel or controls of a vehicle, he or she is risking the lives and freedoms of others. Yes, anyone eighteen or older has the right to smoke tobacco, but if he or she does so in the presence of others, they have to battle the potentially cancer-causing secondhand smoke of the puffer. And for that reason, in recent decades, American society has barred people from smoking in indoor public spaces. The “freedom” of the drinker and the smoker have their limits, because their behavior can wreck the lives and liberties of others. As a society, America has increasingly rendered that recognition.

Analogously, the person who refuses COVID vaccination without a valid medical reason risks the health and freedom of others. The willfully unvaccinated are socially irresponsible, even reckless — potential carriers of a devastating, even lethal disease that also imperils society and the economy. They constitute dangers to liberty and to people’s health, and thus they must be restricted. They can live their own lives in their own personal spaces and private places, but they must not be allowed to mingle freely with any and everyone, lest they communicate the virus to others. Again, they represent the equivalent of drunk drivers and smokers in indoor public spaces.

Even as state and local governments in big cities, along with big businesses and the federal government, begin to move in this direction, society can go further to punish the reckless and ignorant behavior of the willingly unvaccinated. Some commentators have argued that people eligible for the vaccine who nonetheless decline it should pay higher health insurance premiums, creating a financial “stick” to compel vaccination and dissuade costly behavior. But Natalie Shure, a Boston-based writer and researcher, compellingly argues that higher premiums for the unvaccinated will make such people less likely to access a primary care doctor, who could persuade them to become vaccinated. She also indicates that charging different premiums based on vaccination status could risk unraveling one of the Affordable Care Act’s greatest achievements, the ban on discrimination for preexisting conditions (https://newrepublic.com/article/163276/unvaccinated-pay-higher-insurance-premiums).

By the same token, the willingly unvaccinated are exacting a massive toll on society. Not only are they spreading a brutal and sometimes fatal disease that could be controlled — even stamped out — with vaccines, but they are taxing doctors and health care workers and filling up hospitals and intensive care units. The result is that people who require hospitalization for other reasons may be out of luck, threatening their health and their lives (https://denver.cbslocal.com/2021/08/16/hospital-beds-shortage-colorado-surgery-pandemic/). In fact, a Tampa hospital recently rejected a patient requiring emergency cancer treatment because unvaccinated COVID patients were using up all the beds (https://www.cnn.com/2021/08/26/us/covid-florida-doctor-cancer-patient/index.html). And in late August in Texas, a Purple Heart recipient named Daniel Wilkinson, who served two tours of duty in Afghanistan, perished from gallstone pancreatitis. The condition is eminently treatable, but hospitals in that state and others nearby — Colorado and Kansas, Oklahoma and Arkansas— have been flooded with unvaccinated COVID sufferers and he could not find an available ICU bed in time (https://thehill.com/homenews/state-watch/569834-veteran-dies-of-treatable-illness-after-waiting-hours-for-icu-bed). “I’ve never lost a patient from this diagnosis, ever,” said the emergency room physician, Dr. Hasan Kakli, who initially treated him and frantically tried to relocate him to an appropriate hospital. “We know what needs to be done and we know how to treat it, and we get them to where they need to go. I’m scared that the next patient that I see is someone that I can’t get to where they need to get to go. We are playing musical chairs, with 100 people and 10 chairs,” he said. “When the music stops, what happens?” (https://www.cbsnews.com/news/covid-us-hospital-icu-bed-shortage-veteran-dies-treatable-illness/).

Ultimately, it was not the Taliban, or al-Qaeda, or ISIS, that killed Daniel Wilkinson, but his fellow Americans — the willingly unvaccinated ones, to be specific. Through their selfishness and ignorance — facilitated by sociopathic corporate clowns such as Mark Zuckerberg, who allow disinformation to proliferate on their platforms — they threaten the lives of their fellow citizens. Indeed, the willingly unvaccinated represent the real terrorist threat to the US “homeland.”

So rather than charging higher health insurance premiums for the unvaccinated, here is a different idea. If someone who was eligible for vaccination yet declined it for a nonmedical reason ends up in the hospital with COVID, he or she has to pay the entire cost, irrespective of his or her health insurance status. Premiums would be unchanged, and thus there would not be the same disincentive to obtain health insurance, visit a primary care provider, and address myriad health concerns. But if one is so irresponsible as to reject a free, safe, and readily available COVID vaccination, thus stressing the nation’s hospital system and denying access to other potential patients, there should be a price to pay. For, again, the willingly unvaccinated are not simply endangering themselves. They are endangering the health and lives of others, in part by needlessly and disproportionately swamping the nation’s hospitals.

As Ms. Shure notes, “structural forces” play some role in who has received a COVID vaccine and who has not, but so too does personal responsibility. The prospect of private health insurers (and, much less likely, Medicare and Medicaid) exempting COVID-induced hospital costs from their coverage could at least induce many vaccine-hesitant folks (if not the virulent anti-vaxxers) to take some initiative, learn the factual information, and actually receive the vaccine. If their health is not enough to motivate them, perhaps the prospect of drowning in debt for decades to come could provide the necessary inducement.

Of course, in order to work (and to be fair and transparent), such a policy would need to be advertised frequently, boldly, and clearly by the insurer, not buried in fine print in the manner of a credit card footnote. But while there is a role for kind coaxing on a “micro” level, in the manner of Dorothy Oliver in Panola, Alabama (https://www.newyorker.com/culture/the-new-yorker-documentary/an-alabama-womans-neighborly-vaccination-campaign), society at large cannot simply coddle the willingly unvaccinated. For in a digitized world, the tendency toward bias confirmation and “alternative facts” is simply too strong. A case in point is a recent Newsweek column authored by a woman named Suri Kinzbrunner. Her opinion piece is titled “No, the Unvaccinated Aren’t Selfish or Ignorant. Here’s Why I’m Not Vaxxed” (https://www.newsweek.com/no-unvaccinated-arent-selfish-ignorant-heres-why-im-not-vaxxed-opinion-1617993). She then proceeds to echo ignorant fears and dubious or unsubstantiated assertions that supposedly justify her decision to not receive a COVID vaccination.

For instance, she writes, “Cardiac issues, blood clotting, stroke, and autoimmune disorders are all acknowledged adverse events that can occur as a result of the COVID-19 vaccine.” But while Ms. Kinzbrunner acknowledges that such adverse reactions are “rare,” she mitigates this point by failing to provide the context. Billions of people around the world have been vaccinated, and the percentage who have suffered any kind of serious negative reaction is microscopic. One’s chances of being struck by lightning at some point in life are far greater than one’s chances of suffering a notable negative reaction to a COVID vaccine. For instance, according to the National Weather Service, if one lives for eighty years, one has a 1-in-15,300 chance of being struck by lightning (https://www.weather.gov/safety/lightning-odds). Conversely, in the article that she links to regarding “blood clotting,” the reporter notes that the risk is nearly 1-in-1,000,000,000 regarding the Johnson & Johnson vaccine and 1-in-100,000 for the Vaxzevria (or University of Oxford/AstraZeneca) vaccine, which has never been approved in the US, anyway. Indeed, by Ms. Kinzbrunner’s logic, one should never venture outside, or perhaps never take an Advil, because a microscopic number of people will suffer a serious adverse effect to a common and generally safe medicine.

Notably, Ms. Kinzbrunner fails to acknowledge that even for “healthy, young” individuals, the threat of contracting COVID and suffering a serious adverse response to the disease is vastly greater than the risk of the vaccine. Indeed, another one of the articles that she links to, published by the UCL Queen Square Institute of Neurology, details the (minute) risk of stroke from the Oxford AstraZeneca vaccine (which, again, has never been approved in the US) while concluding with the following quotation from a University of Cambridge neurology professor: “It is important to remember that these side-effects are rare, and much less common than both cerebral venous thrombosis and ischaemic stroke associated with Covid-19 infection itself.” In other words, contracting COVID is far more likely than the vaccine to induce a stroke.

Ms. Kinzbrunner also repeats the conservative canard that “healthy, young” people are at little risk from serious COVID consequences, misunderstanding (or willfully distorting) the actual point. “Healthy, young” people are at less risk than older people, or those with comorbidities, from suffering badly courtesy of COVID, but the risk is still significant. Indeed, during this past NBA season, two members of the Boston Celtics, Jayson Tatum and Evan Fournier, saw their health and performance decline notably after contracting COVID (at a time when they were not eligible for vaccination). Tatum, a two-time All-Star and one of the best young players in the NBA, tested positive for COVID in early January 2021 — when he was twenty-two. After missing more than two weeks’ worth of games, he returned, but his performance sagged in the weeks ahead — it was noticeable both visually and statistically. Eventually, Tatum acknowledged that he was sometimes struggling with his breathing on the court, over a month after contracting COVID (https://www.espn.com/nba/story/_/id/30912183/boston-celtics-jayson-tatum-says-feeling-effects-covid-19). Later in the season, Tatum’s performance picked back up, but he stated that he was using an inhaler before games, something that he had never done before (https://nba.nbcsports.com/2021/04/14/post-covid-19-jayson-tatum-says-he-uses-inhaler-to-open-lungs-up-before-games/).

His teammate, the twenty-eight-year old Fournier, reported that he was dealing with concussion-like symptoms, including blurry vision, for weeks after contracting COVID (https://www.cnn.com/2021/05/04/sport/evan-fournier-covid-effects-spt-intl/index.html). Unsurprisingly, then, Fournier — a skilled shooter — missed his first ten field goal attempts after returning from the illness and shot sixteen percent from the field, and less than twelve percent on three-pointers, in his first four games back, averaging all of 3.8 points in 27.2 minutes per contest (https://www.basketball-reference.com/players/f/fournev01/gamelog/2021#554-557-sum:pgl_basic).

Then there was Boston Red Sox starting pitcher Eduardo Rodriguez, a premier performer in 2019, when he won 19 games and finished sixth in American League Cy Young Award balloting. In July 2020, at twenty-seven, Rodriguez contracted COVID before the start of the truncated Major League Baseball season, developed myocarditis as a result, and sat out the entire campaign. This spring, he stated, “Now that I’m recovered, I can be an example to others to take care of themselves. This isn’t something like: ‘Oh, this is the flu — it’s not much’” (https://www.nytimes.com/2021/05/19/sports/baseball/eduardo-rodriguez-red-sox-myocarditis.html). (And while myocarditis — inflammation of the heart muscle — constitutes the only statistically significant and serious side effect that can result from a COVID vaccine available in the US, it represents a very rare, mild side effect, mainly in young men. The chances of developing myocarditis are far greater — almost ten thousand times more likely — from contracting COVID itself, and in that case, the myocarditis is also more likely to be severe [https://www.news9.com/story/612ffa036918130beb2feedb/ou-health-doctor-explains-risk-of-myocarditis-with-covid19-vaccine-versus-covid19-virus, https://medicalxpress.com/news/2021-09-myocarditis-higher-covid-vaccines.html]. Conversely, most of the patients who have contracted myocarditis from a COVID vaccine have recovered quickly [https://www.webmd.com/lung/covid-19-vaccine-myocarditis#1, , https://medicalxpress.com/news/2021-09-myocarditis-higher-covid-vaccines.html].)

So if elite professional athletes in their twenties, making millions of dollars per year and enjoying access to the best health advice and conditioning programs, can develop substantial, long-lasting symptoms from COVID, the generic “healthy, young” person is at even greater risk. Consider Cody Lyster, a twenty-one-year old college student and club baseball player at Colorado Mesa University, who perished from COVID in April 2020, becoming the youngest victim in the state at that time (https://www.9news.com/article/news/health/coronavirus/colorado-mesa-university-student-dies-covid-19/73-156870a3-ed07-4570-a917-c9926cfb39f5). Or contemplate the unvaccinated people in their twenties who have undergone lung transplants — in some cases double-lung transplants — after contracting COVID (https://www.nbcnews.com/health/health-news/horrific-2-unvaccinated-covid-patients-require-lung-transplant-partial-lung-n1274102, https://www.nm.org/about-us/northwestern-medicine-newsroom/press-releases/2020/meet-the-two-covid19-double-lung-transplant-patients, https://www.nm.org/healthbeat/covid-19/advances-in-care/double-lung-transplant-saves-patient-after-covid-19). And there was forty-one-year old Republican Luke Letlow, just elected to the US House of Representatives from Louisiana in November 2020. Less than two months after winning his seat, Letlow contracted COVID and died. According to G.E. Ghali, the chancellor of LSU Health Shreveport, “He had no underlying conditions. It was just COVID” (https://heavy.com/news/luke-letlow-wife-julia-barnhill/). And on August 11, a healthy thirty-six-year old husband and father named Josh Tidmore died in Alabama after refusing to receive a COVID vaccine, imagining that his age and health provided protection. “Josh was completely healthy, active, not a smoker,” says his widow, Christina, now remorseful about their decision to avoid vaccination (https://www.beaumontenterprise.com/news/article/Nobody-should-go-through-this-Delta-variant-16402503.php). Eight days later in Texas, a nineteen-year old incoming college student named Breanna Gray, who had no underlying health conditions and had declined the vaccine, perished from COVID. Her mother, Tabitha, now regretful that she had not insisted on vaccination, could not help her dying daughter as Breanna screamed through her mask (https://www.msn.com/en-us/health/medical/the-mother-of-a-college-student-who-died-screaming-through-the-mask-wished-she-had-made-her-get-the-covid-19-vaccine/ar-AAO5ExX?li=BBorjTa&ocid=mailsignout). So, again, being “healthy” and “young” just means that one’s risk level is lower than that of an older person or one with compromising health conditions, not that the risk is insignificant. But if one is “healthy” and “young” and also fully vaccinated, one’s chances of being hospitalized due to COVID, let alone requiring a double-lung transplant or dying, is virtually nonexistent.

Ms. Kinzbrunner’s article if full of other fallacies, spawned by her ignorance of science and the history of vaccination. For instance, she writes, “But even while the experts push the vaccine, they have undermined it by arguing that vaccinated individuals spread the virus as effectively as unvaccinated individuals. It begs the question: If everyone now has to wear a mask because everyone is now back to being suspected asymptomatic carriers, why get the vaccine at all?” She conveniently (or ignorantly) fails to mention that just a few months ago, transmission by vaccinated people proved extremely rare, hence the CDC’s decision in May to drop the mask recommendation for vaccinated people. But since then, the notorious Delta variant has become the dominant COVID strain in America. Delta is far more transmissible, hence the new scientific data and revised mask guidance recommending that in areas of high transmission, vaccinated people again don masks indoors.

In other words, a virus evolves, and with it so does the science. Keeping up to date with the scientific evolution in a fluid situation is not about “undermining” a vaccine that “experts” are “pushing” — it is about honesty, nuance, facts, and truth, all elements that the willingly unvaccinated eagerly ignore. The Delta variant is not the same as the earlier COVID strains that provided the foundation for the vaccines — it is a sequel to the original movie. Either Ms. Kinzbrunner is deliberately ignoring these realities, or she is intellectually incompetent.

Moreover, she misses the point: the CDC’s decision to reverse course this summer regarding indoor masking for the vaccinated is primarily to protect unvaccinated people such as Ms. Kinzbrunner, since they account for nearly all of the COVID hospitalizations and deaths across the country. Although vaccinated folks can transmit the Delta variant at similar rates as unvaccinated people, they are far less likely to become infected by the virus in the first place and they still enjoy overwhelming protection against serious illness. It is the unvaccinated who constitute sitting ducks, playing Russian roulette with their lives.

Of course, if they were only endangering their own lives, we perhaps could prove more patronizing toward people such as Ms. Kinzbrunner, who are obviously looking for excuses to avoid vaccination. But they are endangering the lives and normalcy of their fellow citizens as well — by prolonging the pandemic, by spreading the disease to others (both vaccinated and unvaccinated, including children under the age of twelve, who are not yet eligible for vaccination), and by swamping the nation’s hospital system, stressing doctors and health care workers while denying hospital and ICU access to patients who require non-COVID care. In other words, contrary to Ms. Kinzbrunner’s self-delusions, the willingly unvaccinated are extremely selfish, as well as socially and morally irresponsible. Again, if they end up in the hospital, health insurers should force them to pay the entire cost out of their own pockets. In a digitized universe where huge swaths of people do not believe in science and facts or cannot distinguish between actual information and disinformation, trying to reason with such folks can constitute a futile effort. But money still talks, and the prospect of taking an enormous long-term hit to their finances because they refused to be vaccinated may jar some of these folks into rolling up their sleeves and receiving a pinprick. And contrary to what Ms. Kinzbrunner writes about alternatives to vaccination, only through mass vaccination can society defeat disease, at least without mass carnage.

Again, though, no one should be literally forced into taking the vaccine. If Ms. Kinzbrunner and her ilk seek to subscribe to hysteria, ignorance, and innuendo (contrary to what she suggests, no American deaths have been conclusively linked to COVID vaccination), they should be allowed to do so. But what they should not be allowed to do is participate in society like vaccinated folks — they should not be allowed to serve as the equivalent of drunk drivers and smokers in indoor public spaces, wrecking lives and spreading disease. And that is why businesses and governments should indeed mandate vaccines — for employees and customers, for teachers and students (if eligible).

Ms. Kinzbrunner writes that she is homeschooling her seven children, which is fine. But what about the unvaccinated mother (or father) who is not homeschooling her children and transmits COVID to her kids, who in turn transmit it to classmates, some of whom may suffer from compromised immune systems or other comorbidities? And not only have hundreds of American children perished from COVID since the start of the pandemic, but the Delta variant has emerged as a far more contagious menace to kids (https://www.insider.com/children-are-not-supposed-die-children-us-died-covid-19-2021-7, https://www.cnbc.com/2021/08/25/pediatric-covid-hospitalizations-surge-to-highest-on-record-in-us-as-doctors-brace-for-more.html). Or what about, say, the nursing home worker who refuses vaccination and imperils the elderly residents in that home? Such a situation unfolded this summer in Florida, where eighty-four-year old Clark Allen passed away from COVID despite being fully vaccinated (he suffered from chronic obstructive pulmonary disease). As his daughter, Danielle, wrote in Mr. Allen’s obituary, “He was infected by someone who chose not to get vaccinated and his death was preventable” (https://www.tampabay.com/news/health/2021/08/19/in-obituary-for-a-vaccinated-man-daughters-share-anger-and-a-plea/?fbclid=IwAR0DQcbCCO0yLM1Z0wWHJ9J98l-dB-30BSTlHBJ-kK_an4EnAnZJiXSFLkw).

People such as Ms. Kinzbrunner should possess the right to remain unvaccinated and stay in their homes, work from home if possible, homeschool their children, order deliveries of groceries (or farm their own food), and spend time outdoors when socially distanced from strangers. But their freedom should not be allowed to override and impinge upon the freedom of others, stamping out lives like Clark Allen’s. Indeed, for them to imagine that they should possess that right is sick — it’s obscene.