Should Covid Vaccines Be Mandatory?

The toll of the Covid-19 pandemic has been devastating: Worldwide, about 2 million people have died from it, as of mid-January. That includes more than 380,000 people in the United States. But the one bright spot in pandemic news has been the development of vaccines. The United States approved two Covid vaccines in December and began giving them to vulnerable health care workers immediately. Additional vaccines are being tested and reviewed. These vaccines have the potential to end the pandemic—if enough people take them to stop the spread of the disease.

An epidemiologist and a health care policy researcher at a libertarian* think tank face off about whether the government should require vaccination.

February 15, 2021

How will the Covid-19 pandemic end? The answer is surprisingly straightforward: when 60 to 80 percent of the population is immune. Globally, that’s more than 4 billion people, including up to 262 million Americans. How do we get there? By making Covid-19 vaccination mandatory.

We have a powerful tool to achieve immunity: safe and effective vaccines. The vaccines now available have gone through clinical trials in tens of thousands of volunteers before approval by the Food and Drug Administration and the U.S. Centers for Disease Control. To control the spread of Covid-19, we need the majority of Americans to take a vaccine. This might not happen if vaccination is optional, like wearing masks was earlier in the pandemic.

Some argue that we should allow more and more people to become infected and acquire “natural” immunity. This is a terrible idea. Not only would that cause many more deaths and increased economic damage, but there is no proof that survivors will have lasting immunity.

We have a powerful tool to achieve immunity: safe and effective vaccines.

There is a legal precedent for mandating vaccination. In the early 1900s, Cambridge, Massachusetts, required public vaccination to control a devastating smallpox outbreak. One individual protested that vaccination was “a violation of liberty.” The case went all the way to the Supreme Court, which ruled in 1905, in Jacobson v. Massachusetts, that “government is instituted for the common good, for the protection, safety, prosperity and happiness of the people” and that the state could intervene when “the safety of the general public may demand.”

This principle applies to the current pandemic. Anyone who is not immune to Covid-19 is a threat to us all. There are rare individuals who cannot take vaccines for health reasons and should be exempt. However, for the rest of us, vaccination is a civic duty, and the government should make it mandatory. Let’s roll up our sleeves and stop this pandemic together.

—W. IAN LIPKIN

Director, Center for Infection and Immunity, Columbia Univ. Mailman School of Public Health

With a dangerous disease circulating in the population, government’s goal should be to reduce the amount of harm people do to each other. Vaccination can reduce such harms, but making Covid-19 vaccination mandatory would do more harm than good.

The United States can achieve “herd immunity” without resorting to mandates. There has already been a substantial uptick of trust in the vaccines. A recent poll by the Kaiser Family Foundation found the share of American adults willing to be vaccinated rose from 63 percent in September to 71 percent in December. That’s close to the 75 to 85 percent that Dr. Anthony Fauci, the government’s top infectious disease expert, estimates we would need to achieve herd immunity. That increase was the result of persuasion—greater public awareness of the dangers of Covid-19 and more evidence about the vaccines’ safety and efficacy—not mandates.

Making vaccination mandatory would do more harm than good.

That same poll suggests most of the holdouts are also open to persuasion. Of the 27 percent who say they are not currently willing to be vaccinated, only 37 percent say they don’t trust vaccines in general. The most prevalent concerns among the unwilling relate to side effects and a desire to collect more data. That means that the best way to achieve herd immunity in the U.S. is to treat vaccine skeptics like adults, give them truthful information, and let them decide.

In today’s politically charged environment, a mandate could ironically make skeptics less willing to be vaccinated—or to comply with other pandemic-control measures. More than half of the vaccine holdouts already say they don’t trust the government. A mandate would make them even less trusting. It would also fuel the broader movement against vaccines by allowing activists to argue that the government knows it can’t win the vaccine debate with persuasion alone. Ultimately, a vaccine mandate could inadvertently delay population immunity and increase the death toll from Covid-19.

—MICHAEL F. CANNON

Director of Health Policy Studies, the Cato Institute

_{*A political philosophy advocating as little government intervention as possible in the lives of citizens}

VACCINES By the Numbers

75%

Minimum percentage of Americans that must be vaccinated in order to achieve herd immunity.

_{SOURCE: Dr. Anthony Fauci}

2

Number of Covid-19 vaccines approved in the U.S. by mid-January.

13

Number of vaccines the CDC recommends American children take by age 18 (not including annual flu vaccines).