Commentary: The vax of life

Losing patience with the unvaccinated.

July 7, 2021 5:00 am
Metro Public Healthy Molly Shine preps a vaccine while sister Maya and Sara Gana wait at a recent Nashville mobile vaccine clinic. (Photo: John Partipilo)

Metro Public Healthy Molly Shine preps a vaccine while sisters Maya and Sara Gana wait at a recent Nashville mobile vaccine clinic. (Photo: John Partipilo)

Bringing her vaxo-enthusiasm tour of the south to a Nashville distillery last month, Jill Biden told the assembled dozens that the COVID-19 vaccine “offers almost perfect protection,” plus “it’s just absolutely free so why not?” It’s a fair question, Madame First Spousal Unit, if you assume your intended audience of the unvaccinated can rationally evaluate a public health appeal based on super complex criteria like “does it work?” and “what does it cost?” Alas, if it were as simple as that we’d have vaccination rates as high as daytime July temperatures. 

But it isn’t and we don’t. Vaccines are readily available, but well over half of Tennesseans are still avoiding it, landing us (naturally) in the bottom ten states in rates of vaccination. And for those who might think “well that’s just rural Tennessee conservatives bringing down the numbers; we’re smarter than that in blue Nashville,” think again. At the end of June federal tracking data had 34.8% of Tennesseans fully vaccinated, and 43.7% of people in Davidson County. Sure, 43 beats 34, but it’s still a lousy number, and four in ten humans over 12 years of age in Davidson still haven’t even had one dose. 

With vaccines easy to get and yet rates of getting them leveling off, I’m thinking it’s time to shift our view of those who refuse to partake. For months we’ve packaged the various sentiments of those avoiding the jab into the polite and inoffensive notion of vaccine “hesitancy.” The dictionary defines hesitancy as “slowness in acting or deciding due to doubt or uncertainty.” Uncertainty I can grasp, but notice it doesn’t mention ignorance. Let’s face it: hesitancy rooted in ignorance isn’t hesitancy; it’s ignorance. 

It’s fair to pause the rant here and speak briefly to the legitimate reasons some avoid the vaccine. The biggies that get mentioned a lot are health and religion, but it turns out they aren’t very big at all.

On the health side, a person with a severe allergy to an ingredient in the vaccine shouldn’t get it, and apparently that’s about it. Even those with autoimmune conditions are advised to get it. It turns out that the number of people who can’t do the vaccine for medical reasons is extremely small.

On the faith side, a handy page pulled together by Vanderbilt Medical Center inventories religious views on vaccines. It shows that theological objections to vaccination are found among Christian Scientists, some Dutch Reformed congregations, and a handful of small faith-healing denominations. Some quick skimming around on Google reveals that these add up to perhaps one-tenth of one percent of the population. If that. 

At some point vax skeptics have to grasp that nearly all serious COVID cases and deaths now involve the unvaccinated. At some point, irrational fears give way to sensible decisions.

For vaccination requirements involving kids in schools, some states allow philosophical exceptions when parents have moral objections beyond religion. Tennessee is not one of those states. Tennessee law requires parents with an objection to sign a statement under penalty of perjury about conflict with parents’ “religious tenets and practices.” 

All of which is to say that while medical grounds and religious objections may be valid exemptions in the eyes of the law and in work or school or recreational settings where vaccines might be required, they actually apply to a vanishingly small number of people, and don’t begin to explain the vast numbers of our fellow citizens who just don’t wanna. 

There’s been plenty of analysis and punditry on the psychology of so-called hesitancy. And let’s face it – It’s mostly nonsense.

One common trope: I already had and recovered from COVID, so I don’t want the vaccine because I’m naturally immune. This is partially accurate but even a shallow dive into the science reveals you’d be stupid to shun the vaccine because you think natural immunity affords equivalent protection.

Another: I’m young and healthy and if I catch it no big deal because I’m not at risk. Partially accurate but even a quick glance at the risks of Long COVID should make any rational person choose a demonstrably safe and effective vaccine. If you’re playing this “if I catch it, I catch it” gambit, you are selfishly and callously choosing to help perpetuate the pandemic as variants emerge and circulate. You are a bad person.

Another: I’m concerned it’s not safe so I’m waiting for full rather than emergency FDA approval. This at least bears a shred of plausible rationality, albeit masked by a shallow appreciation for how clinical trials and statistics work. If this is your take, fine, but you should go home and quarantine yourself until you decide you’re ready. 

Another: I’m a Republican populist who bristles at “elite condescension toward ordinary citizens.” Translation: I don’t like doing things that educated people who are subject matter experts advise me to do for my own and my community’s benefit. If you want to live your life that way, have at it, but in the meantime please go home and stay home until you change your mind.

Another: I don’t trust government, and I don’t trust science. Fine. Stay off the roads, stay out of hospitals, go live in the woods. 

Summing up: Medical and religious grounds for avoiding vaccination affect a miniscule number of people. Preferring natural immunity over vaccinated immunity sounds charming but makes little sense if you look at the science. Waiting for full CDC approval is an option you are welcome to pursue in the privacy of your own home. Same goes for those who see refusing vaccination as a way to live out their hatred of coastal liberals and educated elites. 

I’m not denying the legitimacy of wariness early on about vaccines with complicated names based on unfamiliar technology—and suddenly there’s a smiling person in a mask offering to stick you with a sharp instrument. But at some point reasonable humans with minds of their own confront their apprehensions. They listen to reason, weigh evidence, and make choices. At some point vax skeptics have to grasp that nearly all serious COVID cases and deaths now involve the unvaccinated. At some point, irrational fears give way to sensible decisions. At some point, vaccine hesitancy becomes vaccine idiocy. Are we there yet?

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Bruce Barry
Bruce Barry

Bruce Barry is a professor of management at Vanderbilt University who teaches and writes about ethics, conflict, rights, politics, policy, and other things that pop into his head.