Is it Time to Mandate Vaccines?

Huge pockets of the U.S. remain at risk

I have been loudly complaining for some time about the dismal Covid vaccination rates in my home county, in rural Arkansas. Our full vaccination rate is at 29.6 percent, a share of the population that has barely budged since late April. We have a small population with fewer than 17,000 people, but the counties around us are just as bad. That includes Faulkner County to the south, where a small city and college town, Conway, could become the site of a breakout when students return in August. The vaccination rate in Faulkner County is only 32.7 percent. Statewide, cases, hospitalizations, and deaths are trending upward again.

With the highly contagious delta variant raging, the risk to unvaccinated people of getting very sick and dying from Covid is as high as it has ever been. What we’re seeing is a diverging path for two very different Americas: the mostly white, wealthy, well-educated states with active governments, lots of information, and outreach are doing better. The pandemic is almost over for those areas. Other states are stuck.

This situation is untenable. The risk for breakthrough infections among fully vaccinated people is small, but they are most likely to happen in conditions like these, with large unvaccinated populations through which the virus can travel unabated. It is also small comfort to tell the very tiny minority of vaccinated people who get very sick from Covid despite doing everything right that they’re rare, freaky cases: that’s why herd immunity remains such an important goal.

Low vaccination areas also create the conditions for the virus to continue mutating and, God forbid, could cause a variation that is vaccine resistant. Arkansas is part of a cluster of states where high populations of unvaccinated people continue to put the nation as a whole at risk. It is not a risk that should keep you up at night, but it is worth paying attention to. How much fun would it be to do all of this again? Not fun at all, which is why these states are important to care about even if you don’t live in them.

And yet, our governor, Asa Hutchinson, dropped mask mandates in the spring. On June 26, the pandemic unemployment programs ended, because, he said, it “interferes with employers to fill over 40,000 job vacancies in Arkansas.” Other than urge people to get vaccinated, he hasn’t done anything more policy-wise to push vaccination rates higher. He is launching a tour to see what is stopping the vaccine hesitant. I’m sure he’ll listen, but I don’t know what he’ll say.

Why aren’t people getting vaccinated? Early on, availability in poor neighborhoods around the country, especially poor neighborhoods of color, was limited, and it was keeping people who wanted the vaccine from getting it. There is still an important issue of access, and, overall, rates of vaccination are lower for Black and Latino populations, even though they’ve been hit harder by Covid. (This situation is improving, and more recent vaccinations are reaching a higher share of these populations.) Yet, vaccine hesitancy, that is, people who say they won’t get the vaccine, is highest for white evangelicals, and the states that are lagging furthest behind are states like Arkansas with high proportions of white evangelicals.

Vaccine hesitancy takes many forms. I spoke to one young clerk at a local store I frequent (ok, it’s my pet food store) who told me she was waiting for two days off work in a row to get the vaccine. She’d heard it could make you sick, and so she wanted the time off to recover. (Being down with a fever for a day is no joke, and there’s no reason to pretend that it is, even if it’s obviously better than Covid.) As a shift worker, she isn’t normally scheduled for two consecutive days off and is reluctant to ask for them. Also, with the state is acting as though the pandemic is over, getting vaccinated feels less like an urgent emergency than it should. For someone like her, two paid days off in a row from her employer specifically for getting vaccinated would make a difference. Why aren’t the states and federal governments encouraging or requiring employers to provide those?

Most of the very vocal anti-vaccine people, however, believe the vaccines are dangerous. “It been proven covid vaccination has caused heart problems in young people and heart issues run in my family. Wearing a mask is also out of question because it causes me to have dizzy spells if not full blown panic attacks. So I'll take my chances with the proven 99% survival rate,” someone told me. This shows a huge misunderstanding both of viruses and of vaccines, and of what Covid itself does to bodies. People have heard a bit about the extremely rare blood clots caused by Johnson & Johnson’s vaccine, but they somehow discount the harm caused by the virus itself, which includes risks of blood clots, heart problems, and other long-term effects at rates that are orders of magnitude higher than what the vaccines might pose.

It seems suspicious to people that the vaccine was approved on an emergency basis, and that you can’t sue the makers of the vaccines if you’re harmed by them. These people still insist that Covid is not that deadly, and believe the recent reports of cases going up are scare tactics by the media. In general, too, there’s a false distinction between the “natural” world that God made versus a shot of medicine in the arm, part of which is fueled by a completely understandable distrust of pharmaceutical companies. Still, it’s frustrating to try to have these conversations.

It seems a no-brainer that we should require proof of vaccination before people are allowed to go to any indoor event or even inside a store, but the states with the lowest vaccination rates are also the most hostile to more regulations. We should have reached a specified community vaccination threshold before we dropped mask mandates and forced people back to work, but we didn’t. Throughout this entire pandemic, our governments have focused less on saving lives and more on keeping the amount of death at any one time manageable enough that there isn’t a panic, or an economic crash. The focus has been, almost from the beginning, on keeping businesses running at all costs.

There’s a general philosophy that people are free to choose for themselves, and that includes the local leadership here. “I believe life, even covid life, is about personal responsibility and choices,” our county judge, Dale James, said in a Facebook post from Wednesday. He also noted that our county is back up to 30 active cases, which was about where we were at some of the highest points of the pandemic.

The problem is, infectious diseases are a matter of collective responsibility, not personal choice. Our choices affect those around us. This is particularly true of Covid—a disease with high transmission rates from asymptomatic spreaders who didn’t know they were sick—but is true in many other points of everyday life as well. The United States has treated Covid by focusing on individuals rather than on the collective good. Wear a mask or don’t, get vaccinated or don’t—if you kill your neighbor, it must have just been her time. This is a failure of individuals that is allowed and encouraged by failures in policy. Our hyper-individualized society could bring us all down.

What I’m Reading:

This Wall Street Journal piece about high-price master’s degrees that, um, don’t pay off, has really hit close to home. I could say a lot about this, but what I will do instead is echo Kevin Carey, the higher education expert at New America, and say that this is a problem the government created and perpetuates. As Claire Potter, historian and editor of Public Seminar, pointed out, it’s only a problem the government can solve.

Cute Animal Pic of the Week:

A second dose of kitty cuteness: this is Jacks.