“Your right to individual medical freedom, your right to hold a fist and punch, ends when you start hurting someone else. And that’s what we are dealing with. We are not dealing with someone’s individual choice of whether they want to do something. We are dealing with them coming into the workplace with a communicable, spreadable disease and hurting other people.”
– Sarah Jodka, who testified for the Ohio Chamber of Commerce against the bill to ban mandatory vaccines
The Ohio House Health committee heard more than four hours of testimony from both opponents and supporters of a bill, which could ban all mandatory vaccines such as those against childhood diseases and meningitis.
A bill to ban vaccines that don't have full FDA approval goes into effect in October, aimed at COVID shots. But if this bill pass, the Pfizer COVID shot would be included in the ban on all vaccines, since it’s been given full FDA approval and can now be required in Ohio. Mainstream medical groups oppose the bill.
(Jo Ingles. “Marathon Hearing On Ohio Bill To Ban Mandatory Vaccines Brings Out Hundreds.” The Statehouse News Bureau. August 25, 2021.)
The Question
To what extent can a state legitimately restrict the liberties of its citizens in order to serve the common good? Furthermore, to what extent has the protection of the public's welfare been a pretext for governments to curtail or erode fundamental rights?
The COVID-19 pandemic has brought the tension between individual rights and the public good to the forefront of the national discourse. Many pandemic response measures – such as stay-at-home orders, mandatory business closures or restrictions, and mask mandates – have evoked vocal opposition by individuals who feel these measures infringe on their freedom.
Mandating the Vaccine
Federal guidance issued in December 2020 allows employers to require that their workers get COVID-19 vaccines, although they must accommodate employees' religious objections and also make sure vaccine requirements don't discriminate against employees with disabilities.
Accommodating a religious objection could involve changing an unvaccinated worker's job duties to maintain a safe workplace. For instance, employers could ask workers who refuse immunization to work remotely or wear protective gear.
Before the pandemic, most businesses didn’t require workers to get immunized. The exceptions included some hospitals and health care settings that serve people with weak immune systems – such as newborns, cancer patients or older adults – for whom an infection could be fatal.
(Sophie Quinton. “Bills to Block Mandatory Worker Vaccines Falter in the States.” Stateline Article. Pew. February 23, 2021.)
With the emergence and spread of the Delta variant, it is clear that we are in a long-term coronavirus war with no quick victories.
Unfortunately, when it comes to COVID-19 vaccination rates, health care workers seem to reflect the country. Vaccination rates vary greatly, with 96% of physicians but 55% of nursing home staff, fewer than 50% of nurses, and just 26% of home health aides being fully vaccinated.
(Ezekiel J. Emanuel, MD, PhD abd David J. Skorton, MD. “Mandating COVID-19 Vaccination for Health Care Workers.” Annals of Internal Medicine. July 30, 2021.)
To prevent the ravages of COVID-19, many more people living in the United States need to be vaccinated. The facts are clear: The U.S. Food and Drug Administration (FDA) – authorized vaccines have been administered to hundreds of millions of people and have been found to prevent severe disease and death. It is imperative that all 17 million health care workers in the United States be vaccinated
To induce employers to require vaccines, health care professional societies and organizations endorse this requirement. As of July 29, 2021, 88 organizations had signed, representing all facets of health care: physicians, nurses, pharmacists, physician assistants, nurse practitioners, epidemiologists, public health workers, and long-term care workers.
The rationale for requiring vaccines for health care workers is 3-fold:
“First, like any person, health care workers have a general ethical duty to protect others, especially when there is minimal threat to their own well-being, and the vaccines have so few adverse effects that there is little risk to a vaccinated person's health.
“Second, beyond this general ethical duty, health care workers have a special ethical and professional responsibility to protect others. The objective of the health care professions is to promote the health and well-being of patients and their families, residents of long-term care facilities, and the broader community. Getting vaccinated is one way to achieve this professional objective and protect the health of all of these parties.
“This responsibility holds not only for physicians, nurses, respiratory therapists, and other health care professionals who take professional oaths or pledges but also for the dietitians, environmental workers, safety officers, clerks, and other support staff at health care facilities. All who choose to work in health care settings—hospitals, urgent care settings, long-term care facilities, physicians' offices—must be committed to putting patients first. During their usual activities, health care workers are likely to interact with patients who are vulnerable to COVID-19, namely elderly adults, children younger than 12 years, and immunocompromised persons. Their work setting confers a special responsibility to not endanger the health of other people.
“Third, requiring COVID-19 vaccines for health care workers is not new but is merely an extension of well-established practices and policies. Many health care facilities have long required their workers to be vaccinated against influenza, hepatitis B, and other infectious diseases. As a result, health care workers have historically been role models of good health behaviors, particularly vaccination. All of us working shoulder-to-shoulder in health care can embody health practices for the public. Part of our opportunity to have a positive effect is to show the importance of receiving the COVID-19 vaccine—and, indeed, all vaccines.”
(Ezekiel J. Emanuel, MD, PhD abd David J. Skorton, MD. “Mandating COVID-19 Vaccination for Health Care Workers.” Annals of Internal Medicine. July 30, 2021.)
The Bottom Line
I get it. The opposition to mandatory vaccinations for health care workers is primarily based on the fact that U.S. citizens don’t want the government dictating their behavior. Many Americans feel betrayed – by the government, by the marketplace, and by all whom they consider to be political opponents bent on limiting their rights.
There is now a never-ending culture war. The non-vaxxers have grown to distrust everything and everybody, so they reject authorities and even science. They see the world with moral outrage, and they fear disconnection with public institutions in which they once held a sacred trust.
Never before has so much doubt led to such widespread fear. And, with this fear comes an honest horror and accompanying agitation of losing control. Thus, many people want so much to believe in a return to something they once knew as normalcy that they grasp onto any idea that offers an escape to happier days of the past – to times less bridled with responsibility and thoughtful consideration.
Nevertheless, during the pandemic, we live in a time in which it is of prime importance to help bear one another's burdens. That charge includes the accountability of health care workers to take every measure to stop the spread of the disease. Unvaccinated individuals are more susceptible to infection and more likely to spread the virus. Getting shots saves lives and prevents the mutation of more virulent coronavirus strains.
Lawmakers and courts will likely continue to argue the constitutionality of mandating vaccines. Still, precedent exists for the government, public-private entities, and private businesses to impose all sorts of socially beneficial restrictions – including basic public health and safety measures – before people access institutions or avail themselves of services. Consider airlines, public schools, and even restaurants – “No shirt, no shoes, no service.”
And, hey, consider that service members in the U.S. Armed Forces will be required to get vaccinated against the coronavirus by mid-September. Uncle Sam says, “It's the right thing to do.”
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