MOORE And BORIO: Universal Vaccination Is The Most Important Component To Defeating COVID

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Editor’s note: We endeavor to bring you the top voices on current events representing a range of perspectives. Below is a column arguing that universal vaccination, including mandates, are the most effective way of ending the pandemic. You can read a counterpoint here, where Dr. Roger Klein argues that vaccine mandates will not be enough to defeat the virus.

All the world’s governments embrace COVID-19 vaccines as their central strategy to overcome the economic and social damage the pandemic has caused to their populations. Although vaccination works best when combined with other public health measures, it is the single most effective and least disruptive tool available to contain the pandemic.

The United States has enough safe and highly protective doses for everyone, but over 50 million Americans have refused vaccination. That’s not only harmful to individual health, it damages businesses, large and small, trying to remain viable during the pandemic. Boosting America’s competitiveness in the global economy should matter to everyone, however we vote. Why, then, are so many people refusing to protect themselves and their families, friends and co-workers? The reasons include how rampant disinformation, national politics and anti-government attitudes intersect with the concept of personal freedom – “my body, my choice.” America has forgotten the national joy, and relief, that greeted the polio vaccines in the 1950s.

Let’s be clear: COVID-19 vaccines work. Large studies, here and in other countries, consistently prove that vaccination markedly and meaningfully reduces the risk for COVID-19 infections, re-infections, severe illness and death. The clear and reliable worldwide statistics don’t depend on the political lean of national governments. The unvaccinated are now our greatest reservoir of COVID-19 infections, and they dominate the statistics on COVID-19 deaths. The data determine why vaccination is being encouraged everywhere on Earth.

Mandates are understandably unpopular. Before this pandemic, public health advocates generally opposed vaccine mandates, even during a public health emergency. But persuasion and education have not worked well enough, while mandates help increase the vaccination rate.

A mandate is not a legal requirement to be vaccinated. An individual can still refuse vaccines, but must accept that doing so creates certain constraints. Restaurants and gyms in New York city require proof of vaccination for entry to reduce infection risks in otherwise problematic indoor settings. Our Canadian neighbors cannot fly domestically or take inter-city trains unless they are vaccinated. In one of the most restrictive policies to date, unvaccinated Germans soon won’t even be able to go shopping for non-essential goods. Nations never take such steps lightly.

A virus pandemic is not a “me thing” — it’s a “we thing.” Vaccines benefit individuals, but more important is that by curbing virus spread they protect populations and save societies. By protecting yourself, you’re actually helping all those other people you come into contact with. You might be a healthy 25-year old man, but your grandparents may be old and frail. And there are millions of Americans with impaired immune systems who deserve our protection as they go to work and shop for groceries.

Americans accept all sorts of health-based restrictions. We are free to smoke cigarettes, but it’s been decades since we were allowed to light up in bars, restaurants, near schools, on planes. Tobacco and alcohol advertising is tightly regulated for the sake of young people. Most of us don’t object to these impositions on unrestricted freedom because we realize that common sense public health measures are important in a complex society — where others also have the right to a healthy life. If we aren’t permitted to breathe secondhand smoke over nearby people, then what’s wrong with protecting them from a nasty virus that could be lurking in our breath without us even knowing it? Vaccines and masks do that.

Vaccination works best when combined with other common sense public health measures, including mask-wearing and avoiding large indoor gatherings (particularly when many participants are unvaccinated). The past 18 months have taught us how to avoid catastrophic super-spreader events that amplify virus spread within a local community. These survive-and-thrive strategies shouldn’t be controversial. If you have to wear a shirt and shoes to enter a restaurant, then what’s the freedom restriction involved in also donning a mask? Sure, masks can be uncomfortable and inconvenient, but what’s really and truly a hassle is being hooked to a ventilator in an ICU.

Relying on “natural immunity” caused by a prior virus infection is a mistake. It’s true that infections induce immune responses that confer some protection against a second virus exposure. But almost all studies show that antibody responses (and overall protection) are quite variable and significantly weaker after infection than what mRNA vaccines provide. And vaccinating people who recovered from an infection rapidly and strongly increases their immune responses from what are often worryingly low levels. Americans generally want “the best,” and the best protection available is conferred by the vaccines. Why not be the best you can be? If the new Omicron variant spreads widely here, as looks likely, be aware that it’s particularly prone to penetrate the protection prior infection provides.

Lies about the COVID-19 vaccines being dangerous are spread by people who all too often have personal agendas. No medical intervention is perfectly safe for everyone, but these vaccines have an incredibly good safety record on a population basis. In contrast, the utterly ineffective Ivermectin triggered 21 calls to a poison control center in a single state in a single month (Oregon; August 2021), with 6 poisoned people ending up in hospital and 3 in the ICU. Vaccine technology is life-saving and game-changing. It should be embraced by all Americans as the best route back to the normality we all yearn for. By reducing the nation’s economic competitiveness with countries that have far better controlled their pandemics, the unvaccinated are being unpatriotic – and that’s un-American.

This winter will be grim as virus spread continues — now probably including Omicron. A reasonable projection from what we are seeing in national statistics is that over 100,000 more Americans will die in the next few months, and around 90-95% of them will be folks who rejected vaccination. What’s the point of living free when living free means you die prematurely?

John P. Moore is a professor of microbiology and immunobiology at Weill Cornell Medicine. Luciana Borio is a senior fellow for global health at the Council on Foreign Relations.