A July 29 blog by former New York Times columnist Frank Bruni criticized anti-vaccination people succinctly – they have “elevated superstition over science,” have a “cracked version of personal freedom,” and they do not “live in some epidemiological Wild West of their own.” They are largely responsible for the current surge in cases.

That said Mr. Bruni continues: “… blame them if you like – but in a quiet voice purged of cruelty and contempt.” We don’t want “… these vaccine holdouts (to) feel pushed around and condescended to … hectoring them could … cement their resolve not to do what they’re being urged to (do).”

Give me a break – 615,000 Americans have died from COVID-19. We have vaccines that are over 90 percent effective, but on July 30, only 49.3 percent of the eligible population is fully vaccinated. The highly transmissible delta variant is spreading rapidly and causing an alarming rise in cases. Unvaccinated people constitute a very high percentage of these new cases, but these facts have not generated a rush to vaccination.

Yes, we’ve seen an upward bump in vaccinations, but nothing to compare with the early 2021 vaccination surge and nothing that comes close to meeting the unmet vaccination needs of the country as a whole, and not enough to slow (much less stop) the spread of the delta variant and newer variants spawned by the delta variant.

The sad reality that Mr. Bruni and many state and national leaders ignore is that vaccination has become a political football. Anti-vaccine people are seldom amenable to reasoned discussion, the advice of family physicians, the growing body of scientific evidence that vaccines work or pleas to get vaccinated by family and/or political leaders. They are more often moved by disinformation spread largely by Trump apologists, and a value system that puts opening the economy ahead of saving lives (even as the number of lives lost reaches unparalleled highs).

It’s time we moved to a harder edged set of strategies – strategies that have their roots in governmental “police powers,” i.e., government’s duty to protect the public’s health, safety and general welfare. In hundreds of areas of social concern, we don’t hesitate to adopt laws/regulations that require workplace safety, control potentially unsafe air and water emissions, prevent the random disposal of hazardous wastes, prevent unsafe vehicles and/or drivers from being on the road, inspect food supplies to assure safety. The list is endless.

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We don’t ask those subject to these socially necessary constraints how they feel about it. We don’t tolerate opting out. We don’t tolerate disinformation – we rely on facts and promulgate laws/regulations that protect the larger social good. If you break a law/regulation there are sanctions/ consequences, often meaningful and swift.

We need to approach anti-vaccination people in much the same way. Stop worrying about their hurt feelings; whether they’ll feel “hectored.” Their view that they can do whatever they want to do is mistaken. They are not a law unto themselves – they are a part of a larger society that is threatened by a unique virus that can rapidly change its characteristics and that has killed a significant number of people. That said, vaccination to the point of achieving “herd” immunity is essential – it serves the nation as a whole, including the unvaccinated.

In short, we need to stop coddling those who refuse to be vaccinated. I’d begin at the federal level by immediately requiring all employees (full or part-time), military personnel and employees of those who contract with the federal government to be vaccinated. I’d immediately require all employees and users of federally supported hospitals, health care facilities, schools and modes of transportation (air, rail, bus) to be vaccinated. I’d incentivize all state and local governments to put similar vaccination mandates in place. At the same time, states should be incentivized to follow all CDC guidelines with respect to masks, social distancing and superspreader events. I’d incentivize large (above 1,000 employees) private employers to put similar vaccination requirements in place.

Bottom line: no vaccination, no job, no access to public schools and other desired services, limited travel. People are dying. The virus has the upper hand. Laws and regulations are needed – vaccination refusal, except for medical reasons, should not be accepted.


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