By Paul Krugman [November 1, 2021]
The Delta surge in Covid-19 seems to be receding. That’s good news, and not just because fewer people are dying. Fear of infection was one reason the economic recovery hit an air pocket in the third quarter. Resuming normal life will be a huge relief.
But the U.S. right is, in effect, trying to keep the pandemic going. We talk a lot about misinformation on social media, some of which — surprise! — appears to be the product of Russian disinformation. However, the role of the right-wing establishment has surely been far more important. Fox News serves up anti-vaccine messages almost every day. Republican governors have tried to ban vaccine mandates not just by local governments and school districts but by private businesses. Multiple Republican attorneys general have filed suit to stop federal vaccine mandates.
The expressed rationale for all this activity is that it’s about protecting freedom. In reality, while there are several reasons for vaccine resistance, politics is a significant driver of the agitation. A successful vaccination campaign could mean a successful Biden administration, and the right is determined to prevent that, no matter how many avoidable deaths result from vaccine sabotage. It’s noteworthy that Fox has a very strict vaccination policy for its own employees.
Still, the case against vaccine mandates, however disingenuous, needs to be answered on the merits. Yet I at least have rarely seen the case against a right to refuse vaccination fully explained, even though you could hardly come up with a better example than Covid-19 vaccination if you wanted to design a hypothetical situation in which arguments for freedom of choice don’t apply. And I think it’s worth spelling out exactly why.
First, personal choice is fine — as long as your personal choices don’t hurt other people. I may deplore the quality of your housekeeping, but it’s your own business; on the other hand, freedom doesn’t include the right to dump garbage in the street.
And going unvaccinated during a pandemic does hurt other people — which is why schools, in particular, have required vaccination against many diseases for generations. The unvaccinated are much more likely to contract the coronavirus, and hence potentially infect others, than those who’ve had their shots; there’s also some evidence that even when vaccinated individuals become infected, they’re less likely to infect others than the unvaccinated.
Incidentally, the fact that breakthrough infections happen — that some people get the virus despite being vaccinated — actually strengthens the case for mandates, because it means that even those who’ve gotten their shots face some danger from those who refuse to follow suit.
And the harm done to others by rejecting vaccines goes beyond an increased risk of disease. The unvaccinated are far more likely than the vaccinated to require hospitalization, which means that they place stress on the health care system. They also impose financial costs on the general public, because given the prevalence of insurance both public and private, their hospital bills end up being largely covered by the rest of us.
Vaccination, then, should be considered a public duty, not a personal choice. But there would be a strong argument for public promotion of vaccines even if we were to somehow ignore the harm the unvaccinated impose on others and look only at the personal choice aspect. For this isn’t an area in which individuals can be relied on to choose well.
Medicine, in case you haven’t noticed, is a complex and difficult subject. As a result, it’s an area where it’s a bad idea to leave people entirely to their own devices. The clamor for unproven treatments like taking hydroxychloroquine or ivermectin reminds us why we require that physicians be licensed and drugs be approved, rather than leaving it up to the public to decide who’s qualified and which medication is safe and effective.
So you have to wonder why anyone would consider it a good idea when Florida’s surgeon general urged people to downplay medical advice on vaccines and rely on their “intuition and sensibilities.”
Finally, the most contentious area in this whole argument involves vaccine and mask requirements for schools. And in this area, opponents of mandates aren’t making decisions for themselves — they’re making decisions for their children, who have rights of their own and aren’t simply their parents’ property.
Now, U.S. law and tradition give parents a great deal of leeway, especially when religious beliefs are involved, but not absolute power over their children’s lives. Adults can’t choose to deny their children basic education; they can’t turn down lifesaving medical treatment. That’s why we have longstanding vaccine mandates for many childhood diseases. And the same logic applies to Covid-19.
Again, I don’t know how many people really believe that vaccine requirements are an attack on freedom. But in any case, it’s important to understand that freedom is no reason to block a potential medical miracle.
Paul Krugman has been an Opinion columnist since 2000 and is also a Distinguished Professor at the City University of New York Graduate Center. He won the 2008 Nobel Memorial Prize in Economic Sciences for his work on international trade and economic geography.