Where do we draw the line between vaccines and personal freedoms?

OPINION: One of the most common arguments raised by dissenters of vaccine mandates is that requiring the shot infringes upon an unvaccinated person’s human rights and civil liberties.

The push for more vaccine mandates has intensified as vaccination rates in many places plateau. Cities like San Francisco and New York now require vaccinations to enter restaurants and gyms, to the ire of the unvaccinated, who argue that mandating the COVID-19 vaccine is a violation of their human rights.

On the contrary, some of the nation’s most prominent human rights experts are saying that people have a fundamental right to be protected from COVID-19, particularly as the Delta variant proliferates among the unvaccinated.

So where do we draw the line between citizenry duty, especially during a public health crisis like a global pandemic, and personal freedom under the constitution?

Human rights vs Civil liberties

One of the most common arguments raised by dissenters of vaccine mandates is that requiring the shot infringes upon an unvaccinated person’s human rights and civil liberties; but the two are not the same and knowing the difference is central to the discussion of whether or not vaccine mandates are ethical.

The term human rights and civil liberties are often used interchangeably, but using one in place of the other undermines the vaccine mandate debate.

Let’s start with civil liberties. Protecting one’s civil liberties can be thought of as placing limitations on government power, such that the government cannot legally intrude on one’s personal freedoms. In other words, it’s the freedom to do what you want to do, when you want to do it. These civil liberties are protected under The U.S. Constitution — in particular, the first ten amendments that form the Bill of Rights that protect the freedoms and rights of individuals.

Human rights, on the other hand, are standards that recognize and protect the dignity of all human beings. Human rights are similar to civil liberties in that both arise simply by being a human being, but differ in that human rights also include the right to protect and be protected from harm. Human rights govern how individual human beings live in society and with each other, as well as their relationship with the State and the obligations that the State has towards them. The core essence of human rights is that no government, group or individual person has the right to do anything that violates another person’s rights.

This is where the human rights portion of the anti-vaccine argument starts to fall apart. COVID-19 is a major public health risk — quite possibly the greatest global threat of our livelihood in the 21st century. The virus poses a risk to not only those who are unvaccinated by choice, but also children under 12 who are not yet eligible to get the vaccine and members of vaccine-inaccessible communities including those who live in areas of the world where there is not yet a sufficient supply of vaccines. Because vaccines do not prevent infection, unvaccinated individuals can also pass on the virus to vaccinated individuals who become new vectors of the disease.

The refusal of the COVID-19 vaccine by those who are eligible violates our human right to be and feel safe. Despite mounting research that has shown the vaccine to be safe and effective, questions about the vaccine’s safety have been used as a counter argument to mandates, with some saying that being forced or coerced into taking a perceptually unsafe vaccine is a violation of their human rights. To boost confidence, millions of dollars have been spent on research and pro-vaccine ad campaigns to convince nonbelievers of the vaccine’s quality and safety, but skepticism remains.

Anti-vaccine sentiment isn’t new but it’s coming to a head

In 2018 the World Health Organization reported that measles cases jumped by 50% worldwide. In Madagascar, one of the poorest and least connected countries in the world, nearly a thousand children died after a measles outbreak occurred in the countryside. While the epidemic was quickly contained it served as a reminder of how devastating disease can be against unprepared populations. Meanwhile, in high resource areas like the United States previously prepared populations are having their defences dismantled from the inside.

The rise of carefully targeted anti-vaccine ad campaigns on Facebook, Instagram, Reddit, YouTube/Google and Twitter is worrying. Vaccine misinformation undermines the COVID-19 response and highlights how the widespread availability of sophisticated advertising techniques gives considerable power to people who previously had no way of reaching such large numbers of people.

Social media, which wields powerful influence as a health tool, is made stronger when the heads of these companies put public health before profit. These spaces can encourage citizen participation, optimize health systems, be an interactive space for science dissemination, support health policies, and promote healthy behaviors. When this falls short, due in part to unregulated anti-health messaging, these companies should take some responsibility for the consequences of their profit-seeking algorithms, which promote divisive and potentially harmful messages that go against the ‘community-building’ spirit on which these platforms were created.

Do vaccine mandates discriminate against the unvaccinated?

The pro- vs anti-vaccine divide shows how vaccination status has rapidly become a marker of identity. Some Republican lawmakers are even pushing bills that would give unvaccinated people the same protections as those surrounding race, gender and religion, but with the exception of religion, human rights protect something that is inherent to you. Vaccination is a choice, therefore the push for national “anti-discrimination” bills protecting the unvaccinated have fallen short. Still, these movements have made some headway at the state-level. Montana has made it illegal to “discriminate” on the basis of vaccine status, with some exceptions within the health care sector; and Alabama prevents schools and universities from requiring coronavirus vaccines and bans businesses from refusing to serve someone based on their vaccine status.

Vaccination as a public duty

Vaccination stops viral replication, limiting the spawn of mutant viruses that are undetectable to the immune system of all people regardless of vaccination status. It also decreases the likelihood of unknowingly passing the virus to family members and friends. It is the most effective way of building community immunity and ending the pandemic, but getting shots in arms has been a slough.

According to the CDC, 99% of COVID-19 hospitalizations are among the unvaccinated; and the virus has killed nearly 700,000 people with the delta variant lying in wait ready to take many more. These numbers alone should be reason enough to take the vaccine, but sadly, this isn’t the world we live in.

Our social responsibility to protect one another is unquestionable, but trust is earned through a just and transparent process that treats ordinary people as equal partners. Until this is achieved, the expectation of goodwill and solidarity around the vaccine is simply unrealistic.

How do we navigate this dilemma?

According to research conducted by Verywell Health, age, location, and political affiliation are the most influential factors in predicting how people feel about vaccines. Young people and Republicans are consistently less likely to say they’d take the vaccine than other age groups and Democrats; and rural Americans are nearly twice as likely as their suburban and urban counterparts to be vaccine hesitant, so a targeted public health approach is needed to reach these groups.

Public trust in government remains low. The sense that modern life is being dehumanized, and that outside forces are conspiring to squeeze out what little humanity is left by turning us into obedient robots is a powerful influence on those who are jaded by a system that has let us down time and again. When all trust in our leaders is lost, it does not matter that they are getting it mostly right this time. We all pay the consequences. The distrust in government and every field that it touches — healthcare, medical research, and education — fueled by the anti-vaxxer movement, puts not only those who can make choices for themselves at risk but also children and the ill, who cannot.

This is where loving thy neighbor comes in. Pro-vaccine campaigns must walk the delicate line of providing education and encouragement without bullying. This requires that pro-health advocates (that means you) listen to anti-vaccine concerns, speak directly to parents as the gatekeepers to vaccination for their families, and have greater visibility in the actual communities where vaccines are needed most.

Ultimately, increasing vaccination rates will depend on partnerships with various institutions, like schools, community organizations, and employers. Only after these efforts have been maximized do mandates become an attractive option to help stem the spread of disease, especially if credible exemptions are possible and everyone affected has equal access to the vaccine. Still, despite our best efforts, we may be at a critical point in the pandemic where widespread vaccination mandates are necessary, but the only permanent solution is to put forth the effort needed to rebuild trust in science and one another, rendering mandates unnecessary.

Dr. Shamard Charles is an assistant professor of public health and health promotion at St. Francis College and sits on the anti-bias review board of Dot Dash/VeryWell Health. He is also host of the health podcast, Heart Over Hype. He received his medical degree from the Warren Alpert Medical School of Brown University and his Masters of Public Health from Harvard’s T.H. Chan School of Public Health. Previously, he spent three years as senior health journalist for NBC News and served as a Global Press Fellow for the United Nations Foundation. You can follow him on Instagram @askdrcharles or Twitter @DrCharles_NBC.

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