Monday, August 23, 2021

Vaccinations and the State (Part II)

In a previous post I tried to show that two of the key arguments against requiring vaccinations miss the mark.  The inflamed rhetoric of "freedom" verses vaccination is an abstract debate that has little applicability in the real world. In the real world, we constraint freedom of action all the time in order to enhance people's freedom. We don't allow people to beat up others to get what they want, we require parents to look after their children, and we have rules that prevent you from lying publicly about other people (defamation). What this means is that once we move the issue of vaccinations out of the realm of a first year debating club and consider how requirements actually function in our society, this becomes much less of a yes/no issue. 

Not only that, while we compel people do all manner of things in our society (not drive until a certain age and passing a test, properly store fire arms, drive below a certain speed on the road), we do these things in the name of freedom.  A quick example: I start a business because I know people cannot lie about my product. Imagine the reverse situation. I start a restaurant and people (say, my competitors) are allowed to say I poison my customers ... I'd likely not start my restaurant. The law against libel and defamation enhances my ability to make meaningful choices.  Likewise, preventing people from beating others up to get their way expands freedom allowing us to do the things we want without fear that someone will come by and beat us up and, say, rob us. 

I also tried to show that the slippery slope argument is problematic. It is not a trump card (we don't know what will happen next so ....), but an argument and that argument can, in that case, be subject to reasonable proofs. It is a question of evidence; not of speculation and necessarily needs to be. If speculation was our policy and legal standard, we would be in pretty bad shape. Why? Because speculation is, necessarily, speculative. It is a hypothetical situation that might or might not happen and different people's speculations can lead in different directions. What one person sees as a reasonable speculative probability; another does not.  Because there is little way to determine which speculation is correct we cannot, without recourse to some kind of evidence, make it the basis for policy decisions. Thus, I see little evidence that a vaccine requirement (something we already have had for a range of vaccines and for certain professions) will cause an erosion of democracy. 

Finally, there are other grounds on which we can and do compel behaviour. We compel behaviour because it is fair. The example I've used before is paying taxes. We have people pay taxes because they derive benefits from public policy. I periodically hear people say things like "I should not have to pay tax X if I don't want." This comment is often made, however, from a perspective of ignorance. For instance, some people might not want to pay the percentage of their taxes that go to fire protection because, they might say, they don't intend to use the fire department. This argument sounds reasonable except when you consider the fact that these people have already benefitted from having fire protection.  Having fire protection makes everyone safer whether you use it or not. It stops fires from getting out of control, increases property values, etc. Same thing with public works (water, roads, bridges). Consider this example. Someone might say "I don't drive, why should I pay a gas tax?" Well, you don't. That is levied at the gas station but you do benefit from roads. Do you buy groceries or clothes or heating oil? Did someone hook up your wifi or did you need to use the hospital? Roads are essential for all of our well being, Hence, we have to pay for them because they don't build or maintain themselves. Hence, paying something for the benefit (even while not as much as the person who drives) through indirect costs is fair. If you did not pay, you would be in a situation where others were paying your share and you were benefitting. You were, in effect, off loading costs onto me. 

Vaccinations can be like that. When you have a large population where most people are vaccinated, it is possible that non-vaccinated people can off-load the cost. Because a large enough people are vaccinated a population immunity of sorts is created and you (or, say, your child) can derive a benefit (not getting ill) without paying the cost (getting vaccinated) because others have paid it for you. Sometimes there is serious confusion about this. I have heard people say "well, my kid is not vaccinated against measles and they didn't get sick." There is a real faulty logic here that we won't get into but you can see what has actually happened. The anti-vax parent has, in effect, offloaded their child's safety onto parents who vaccinate their kids. 

The real problem, of course, is that the anti-vax parent has mistaken safety caused by population immunity for safety in general.  The irony is that it is the very efficacy of the vaccine that makes people safe and allows people to think that they don't need to vaccinate. And, yet, you can see what happens when we are unable to get to population immunity. The situation becomes more grave. It starts to strain resources (say, in the health care system), threatens the economy (there is a further irony here that we don't have time to address), and threatens people who have been vaccinated via breakthrough infections. The key thing about these points is that they are not speculative. They are empirically demonstrable. Thus, we can point to hospitals with increased numbers, for instance, in American states well into their next wave. 

From a rights perspective, the issue is this: where does your right begin and my right end?  This is the old "fire in a crowded building" argument. The standard argument is that your right ends when it infringes on my right and vice versa. I don't have any easy answer to this but rephrased the question might be this: do you have a right to engage in behaviour that we know endangers my life?  In terms of speeding on the highway of driving drunk or misusing a fire arm, the answer is no. 

This is not a lock sync argument. It is, however, a way of saying that compelling vaccinations is an argument that is on a continuum. People who believe that they can easily assert their right against it as if calling something an individual right made it immune to any argument is inaccurate. 

In my view, then, the state is within its bounds to require vaccination for certain jobs, particularly but not exclusively those that deal with high risk populations (say, those living in long-term care facilities or those with health problems). In my view, private institutions (say, universities) are also right in so doing -- although for slightly different reasons that I won't get into. Finally, requirements are also legitimate in those instances where there is a risk of passing on infections that can create dangerous situations for third parties (say, people who work in the public schools) or creating situations for widespread infection. 

Does this mean that we say "my way of the highway" to those who oppose vaccination? I don't think so. I think that we can, depending on the circumstance, do our best to accommodate people.  Such accommodations might range from transfers to other departments, working or studying from home, providing timelines, or perhaps other measures.  Said differently, where possible, we should do what can reasonably be done to accommodate differing perspectives on vaccination. But this would not be a relationship of equals, as it were. The anti-vax position would be accommodated where it could be. I don't imagine, for instance, that students would be forced to learn from home because their teacher refuses a vaccination. I do imagine that it might be possible to transfer that teacher into a different job (say, curricular development) that does not involve interaction with unvaccinated minor populations.  In short, I am not looking for a balance of a half-way point but something that can work for most people while underscoring the legitimacy of requiring vaccination. 

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