Vaccines and Masks:
On Coercion: Vaccine Mandates Are No Different Than Other Rules Imposed To Protect Public Safety
We are living through a public health emergency. There is no other way to describe the last 20 months. As I write this, the news that we have surpassed 700,000 deaths from Covid-19, a virus that has killed 4.8 million worldwide. Two of every 15 people have contracted it in the United States, with one of every 61 person infected dying. The disease has wrought significant damage to our economy, to our politics, and our collective psyche — and we remain far from out of the woods.
We have had three vaccines available in the United States for much of 2021. They are proving to be very effective both at slowing the spread among vaccinated people and at minimizing the ill effects of the virus, which include damage to lungs and organs that can be long-lasting, along with a hodgepodge of other disorders. Still, just 55 percent of Americans are fully vaccinated (two hots of the Moderna or Pfizer vaccines, or one shot of the Johnson & Johnson), a figure that is unconscionably low given what we know about Covid, the vaccines, and vaccination in general.
Our low vaccination rate is part of a web of failures that includes a withered public health infrastructure and a dysfunctional economy creates greater and greater economic and social inequality, as Ed Yong writes in The Atlantic. It’s not just that the Affordable Care Act was never up to the task — yes, it expanded access to health insurance, but it did not create a standard of universal care — it is that many rural areas no longer have functioning health clinics or even hospitals, that we consign immigrants to substandard health care, that we have have a massive problem with homelessness and food insecurity. Economic and social inequality undermine public health systems, Yong points out, by creating large pockets of vulnerability.
“Infectious diseases can spread,” Yong writes, emphasis in the original, “from the vulnerable to the privileged,” which would require us to refocus the “spotlight away from pathogens themselves and onto the living and working conditions that allow pathogens to flourish.” Stemming the spread of a virus like Covid “means measuring preparedness not just in terms of syringes, sequencers, and supply chains but also in terms of paid sick leave, safe public housing, eviction moratoriums, decarceration, food assistance, and universal health care."
It means accompanying mandates for social distancing and the like with financial assistance for those who might lose work, or free accommodation where exposed people can quarantine from their family. It means rebuilding the health policies that Ronald Reagan began shredding in the 1980s and that later administrations further frayed. It means restoring trust in government and community through public services.
But, dear reader, I suspect you know all of this. I offer this summary of where we are as context, to make clear that we are living through extraordinary times. We face an existential threat, but it is one we can fight, and one we must.
Perhaps, it is a symptom of our time that public health recommendations that we wear masks, social distance, limit our interactions with others when we can, are met with political backlash, that the arrival of a vaccine based on long-used scientific methods and efforts to get the public vaccinated should be seen as a tyrannical effort by an autocratic government — responses so out of step with reality that it is difficult to know how to respond.
But that is where we are. Barely more than half of all Americans are vaccinated, even though the scientific community believes we need to reach somewhere between 75 and 90 percent for the vaccines to be fully effective, and we need to maintain a regimen of social distancing that includes, at a minimum, widespread mask use.
State and local governments are attempting to address this issue. New York City has imposed a series of vaccine requirements that are designed to force city employees and consumers to get their vaccines. San Francisco has a similar requirement in place, and the state of California is looking to do the same. Most of those who are covered by these requirements are following through, though there are hold outs and challenges, most offering a version of the argument made by a small group of New York teachers who challenged the city’s rules in federal court. They claimed the “mandate interferes with their freedom to pursue their chosen profession and discriminates against them because other municipal workers can opt out by taking weekly COVID-19 tests,” an argument dismissed by Supreme Court Justice Sonia Sotamayor.
The teachers’ argument is an attractive one. The United States is a nation founded on notions of personal and political liberty, many would argue, one forged in a revolution tossing off the coercive power of the British Empire and codified in a Bill of Rights that enumerates our respective individual freedoms. State coercion, the argument goes, is prohibited, except in the narrowest of circumstances, except in cases when competing rights conflict. This is how John Stuart Mills might view it, as Colin Heydt of the University of South Florida points out in his entry on Mills on the Internet Encyclopedia of Philosophy.
Heydt describes Mills’ argument in On Liberty, the 1859 book that sums up his views on “civil and social liberty.” In the book, Mills considers “the nature and limits of the power that can legitimately be exercised by society over the individual,” ultimately siding with the individual as the entity best able to govern himself. However, he does make a distinction between “the enforcement of rules of conduct that are both arbitrary and strongly adhered to” and the notion of a public good. Mills says there is only one reason for “interfering with the liberty of action” of any individual: “self-protection.”
That the only purpose for which power can be rightfully exercised over any member of a civilized community, against his will, is to prevent harm to others. His own good, either physical or moral, is not a sufficient warrant. He cannot rightfully be compelled to do or forbear because it will be better for him to do so, because it will make him happier, because, in the opinion of others, to do so would be wise, or even right. These are good reasons for remonstrating with him, or reasoning with him, or persuading him, or entreating him, but not for compelling him, or visiting him with any evil in case he do otherwise. (OL, 51-2)
Mills, Heydt says, leaves undefined “what counts as ‘harm to others.’”
Where should we mark the boundary between conduct that is principally self-regarding versus conduct that involves others? Does drug-use cause harm to others sufficient to be prevented? Does prostitution? Pornography? Should polygamy be allowed? How about public nudity? Though these are difficult questions, Mill provides the reader with a principled way of deliberating about them.
It is a useful paradigm for consider the current debates over vaccines and placing these debates alongside other arguments over drug legalization, abortion, immigration, and other issues.
I don’t know where Mills would come down on vaccine mandates, but I think his framework is important in that it places the notion of coercion within a context of public good and the impact that our decisions have on others. The liberty argument, as pressed by anti-vaxxers and anti-maskers, is based on lawed premises, based on a mythologized reading of American history and a misreading of the science of vaccines and virus spread. The mythology of liberty is distorting in that it assumes a conflict between government and the people, even though, in our republican form of governing, the government and the people are one. Government can and does overreach and do bad things, especially in foreign affairs where secrecy often rules, but its legitimacy is directly tied to our consent. There is a commonweal, a social compact that ties us together, that links our individual actions to those around us. This is important in setting the parameters of this debate, because one of the main premises underpinning opposition to vaccine and mask mandates is a notion that our actions are more important than the actions of others and that the impact of our action on others does not matter.
Not getting vaccinated will have direct, personal impact, of course, but it also affects everyone else. Vaccines work by “train(ing) our immune systems to create proteins that fight disease, known as ‘antibodies,’ just as would happen when we are exposed to a disease,” according to the World Health Organization (https://www.who.int/news-room/q-a-detail/herd-immunity-lockdowns-and-covid-19#:~:text=Vaccines%20train%20our%20immune%20systems,without%20making%20us%20sick.). Those who are vaccinated are less likely to get a disease against which they are vaccinated, and are even less likely to pass along the virus, “breaking any chains of transmission.” This creates “herd immunity,” or the “indirect protection from an infectious disease that happens when a population is immune either through vaccination or immunity developed through previous infection.” The more people who have immunity, the fewer hosts will be available for the virus to embed itself in, which then results in a weakening of the virus, and a diminishing likelihood of dangerous variants developing and spreading.
In this way, vaccines offer broad social protection as much as — and, perhaps, even more so than — they offer individual protection. The dangers posed by the spread and mutation of Covid are what legitimize the use of coercive authority, what permits the seeming violation of individual liberty by the state. You lose your right to avoid vaccination, because doing so endangers others.
Vaccines are like other parts of the regulatory state, which have been empowered by the government with the consent of the governed to protect our water, air, farmland, banking system, etc. We employ restaurant inspectors, meat inspectors, building inspectors, all tasked with the same basic mission: Protect the safety of the public. This massive regulatory apparatus exists despite theories of personal liberty and property rights, because across our history we have time and again reinforced the notion that there exists a commonweal, a common good.
This is the rationale being used by local and state governments, along with the Biden administration and many in the business community to move ahead with requirements that workers, students, and consumers be vaccinated before they enter their workplaces, their schools, restaurants, and other public places. I teach at Rutgers University, which has such a requirement for students and a somewhat less stringent one for staff, and my union has endorsed such a mandate, providing there are strong due process protections for employees. I am vaccinated, and knowing my students are is comforting, but we are still wearing masks — university requirement — and doing what we can as a community to keep each other safe.
The county colleges at which I teach also require masks indoors, and have differing vaccine rules, and at all three of my schools I can prevent a student from attending my class if they refuse to mask up.
Critics of mandates, however, continue to paint it as a question of individual liberty. Eric Brakey of Young Americans for Liberty told Fox News that “individuals should be free to make their own healthcare decisions with their doctors.”
Fox (citing an NJ.com story) also pointed to a 22-year-old Rutgers student who refuses to get vaccinated and says he had been locked out of his campus email and digital accounts as a result.
"I’m not in an at-risk age group. I’m healthy and I work out. I don’t find COVID to be scary," Hollar told NJ.com. "If someone wants to be vaccinated, that’s fine with me, but I don’t think they should be pushed."
These responses continue to frame vaccination as a personal choice, ignoring the impact that the unvaccinated have on others and on the spread of Covid and other illnesses. They privilege an individual over the collective, ignoring how the two are linked.
We live in a country that conflates concepts of self-indulgence and freedom, and in which coercion and control are only viewed as acceptable when they are applied to others. The same people who bristle at being asked to wear masks or get vaccinated are the ones who most loudly demand drug testing for recipients of federal and state benefits; the ones who proclaim their rights to manage their businesses their way, regardless of how it impacts their neighbors, or to have their kids educated in school regardless of whether it endangers staff or other students are the same one’s who are passing laws designed to control women’s bodies, who want to constrain the freedoms of trans youth and gay couples. Their hypocrisies undermine their declarations of liberty, make it clear that what they really are seeking to maintain is selfishness and privilege.