As Democrat-run state legislatures consider requiring Covid shots for children to attend school, many parents like me are looking back at how their perspective on vaccine mandates has changed over the past two years.
If you had asked me three years ago why the government should mandate vaccinations like the chickenpox and the measles, mumps, and rubella (MMR) vaccines in order to attend school, I would have argued that vaccine mandates are a valid exercise of government authority to protect the “public health,” since unvaccinated people can spread the disease to others, particularly those too medically fragile to receive vaccinations. I would have appealed to “herd immunity” and called most anti-vaxxers “irresponsible” or “selfish.”
I now believe vaccine uptake should rise and fall based on the merits of the shots, not government pressure or mandates, for two reasons. First, it is wrong to coerce people to inject themselves or their children with a product they do not believe benefits them. To violate someone’s bodily autonomy so they can enjoy the same rights, liberties, and entitlements as others, such as air travel or public education, is in itself a harm. It is tyrannical.
Second, mandates are an attempt to ensure high vaccine uptake, but government coercion feeds into a warped regulatory system that may lead to unsafe or ineffective shots being left on the market while weakening trust in vaccines generally.
The first objection to eliminating mandates is that it will likely lead to outbreaks of previously rare diseases with low vaccination rates. If you don’t vaccinate your child, your child may be vulnerable to diseases such as measles or chickenpox. This could cause children a great deal of suffering, especially in the former case.
Even if your child is vaccinated, however, there’s very small chance he gets infected in an outbreak. We haven’t had a polio outbreak in this country for many decades, which would lead to permanent injury or death in a small subset of victims. Nobody wants an outbreak of a terrible disease like this, and helping neighbors avoid outbreaks is a healthy secondary motivation to maintaining your own child’s health.
But the desire for herd immunity or full eradication of a disease should not override individuals’ right to make serious choices about their own bodies, which some call bodily autonomy. The potential for dangerous outbreaks is an argument for extremely safe and effective vaccines and trustworthy information campaigns, for informative and empathetic discussions between patients and doctors, not top-down mandates.
It’s not at all clear that mandates truly support high vaccine uptake, anyway. A 2017 analysis done by the European Union-funded ASSET Project comparing vaccine recommendations to mandates across European countries didn’t point to “any evident relationship between vaccination coverage and national policies on compulsory vaccinations.” As Gary Finnegan wrote for Vaccines Today, “ASSET experts have also argued that while mandatory vaccination might fix a short-term problem, it is not a long-term solution. Better organisation of health systems and strong communication strategies may prove more effective.”
This dynamic of “short-term fix” at risk of long-term gain played out beginning in 2021. Draconian policies like mandating Covid vaccine passports to enter gyms, restaurants, and shops undoubtedly increased uptake of the experimental treatments. But uptake of other childhood immunizations for illnesses that pose a greater risk to most children, and with much safer shots that have longer-proven efficacy, has dropped.
Some of this was due to delays caused by lockdowns, but some of it is due to a rise in vaccine hesitancy. There are no shortcuts to confidence in pharmaceuticals—even vaccines. Treating people like objects of government control reduces their trust in that government and its recommendations.
One might argue this is just a “one-off” case of a truly bad vaccine poisoning the well of vaccination generally, and not representative of “normal” vaccine requirements. It is indeed hard to disentangle the distrust sown by the mandates and that sown by the fast-tracked, emergency-authorized Covid shots that even its proponents now admit failed to mitigate SARS-COV-2 transmission and are now known to be associated with problems, such as heart troubles for some young men and significant disturbances to some women’s menstrual cycles.
Would confidence in other vaccines be dropping, particularly in young adults, had the Covid shots been developed and evaluated exactly as it happened, but government didn’t use shame and coercion to push them on the public? I find it hard to believe the answer is yes. The whole debacle has led people to ask of vaccine mandates generally: if a product is so safe and effective, why is a mandate necessary? If governments and health experts would spread false and misleading information about these shots, what else are they doing it about? Is “misinformation” really so powerful a factor it must be overcome with coercion?
In the end, attempts to coerce people simply drive the hesitant into the arms of the so-called propagators of “misinformation.” Who are you going to trust: the people who say you’re right to be skeptical, it’s your body and your choice, or the ones who’re trying to force you to take a drug you’re not sure you want or definitely don’t want—objections be damned?
The problems aren’t just in perception, they’re systemic. Mandates can lead to monopolies when only one or a handful of companies can provide the product, exacerbating a lack of accountability. How much does a company strive for excellence and responsibility when they’re the only game in town, or one of two? Worse, government depends on the companies producing the product to fulfill the mandate, making it expedient to not examine safety and efficacy too closely when concerns could hold up manufacturing and distribution.
Mandates also strengthen the perceived need for liability shields like that provided by the 1986 National Childhood Vaccine Injury Act. If you’re mandating injections, it follows that you must maintain the liability of vaccine injury and provide compensation to potential victims. This perverts incentives: the incentive for drug makers is not necessarily to provide extremely safe and effective vaccines that can be sold to the public with low risk of expensive litigation and health harms, but to provide whatever vaccines meet the standards that the FDA sets, which may be influenced by politics.
For fast-tracked Covid shots or the now-litigated HPV vaccine Gardasil (HPV shots are mandated for school attendance in some states), ensuring safety appears to have conflicted with political considerations. Safety regulation can be expected to occasionally fail, particularly since trials can’t always “catch” rare adverse effects, but when the same government both regulates and mandates private products, then shields private companies from lawsuits, we’ve created many wrong incentives. How are critically thinking citizens supposed to trust products produced in this regulatory environment?
We’re not at a point at which some states may force children with a general 99.9997 percent survival rate of Covid to bear the health risks of a Covid shot to attend school. Restoring trust in the public health authorities (if indeed we need a public health bureaucracy at all) who overreach so far will take many things, not least of which is cleaning out all the leadership involved in this Covid vaccine scandal.
Congress could also remove the liability shield for immunizations so drug companies can be sued for vaccine injuries or deaths. But trust in vaccines in particular will never be what the public health establishment has always hoped for without eliminating all government mandates, even long-standing requirements for school attendance.
If public officials really want high vaccination rates in schools, they can point parents to independent, non-government-funded resources about the dangers of the diseases they’re intended to protect against and the vaccines’ safety and efficacy data. That data should be publicly available as a matter of course (barring private patient details), so it can be analyzed by a diverse range of non-government experts. Citizens should never be asked to look past a lack of transparency or swallow conclusions funded by those who are likely to politically or financially profit from those same conclusions.
Whether parents want to educate themselves on vaccines or not, vaccination is their decision. The government must fully acknowledge that the power to help keep people from getting seriously ill from vaccine-preventable diseases belongs to the citizens, not the state, and that citizens may or may not choose vaccines as part of their efforts to keep their families healthy. Some people don’t find the risk-benefit profiles of certain vaccines convincing, or of any vaccines at all. Officials must make peace with that, as an aspect of living in a free society.
If confidence in vaccines is the goal, then the state must protect citizens’ freedom to make the choice themselves, without penalty or shame. There is no other way.