Freedom in a Pandemic Society
Scott Montgomery discusses the difficult links between anti-vax positions and ongoing democratic backslides in the USA and elsewhere.
As of this writing, covid-19 defines the deadliest epidemic in U.S. history. More than 735,000 have died at the time of this writing, with more than 1,200 dying every day. The overwhelming reason for these numbers is the refusal of vaccine protection by more than 70 million people. Despite recent success of mandated immunization for many government and private company workers, there remain 50 million or more who are hardened against any kind of vaccination. America’s worst epidemic has been transformed into the largest event of mass suicide in modern history.
Since vaccines became widely available in April of 2021, at least 180,000 deaths have occurred in unvaccinated people, including those in their 20s, 30s, and 40s. The U.S. has roughly 4% of the world’s population but 15% of covid-19 related fatalities, well beyond that of any other country.
The two graphs below from the U.S. Centers for Disease Control (CDC) tell a profoundly disturbing story. The upper graph visually narrates cases per week, while the lower one shows vaccination doses given. The covid surge of late 2021 is a direct result from the collapse in vaccination rates. Had such rates continued at even half their peak in mid-April, the pandemic would have essentially ended in the U.S. by August.
Meantime, under President Biden’s orders more than 200 million doses of covid-19 vaccine have been sent to the rest of the world, the most of any nation. Hundreds of millions more doses of the Pfizer-BioNTech vaccine are to be donated worldwide, reaching a total of one billion or more. At the same time, the White House has continued an Americans first policy overall and stopped states like California from sending unused vaccines to other nations. Still, if the U.S. government does greatly increase the number of shots donated to countries with very low vaccination rates, the Biden Administration—despite a slower than hoped-for response—would save enormous numbers of lives, even while fear and distrust of this same government remains ferric in the homeland.
Who are They?
Who are the Americans refusing the life-saving shots? This huge population, if a country, would rank among the world’s top 20. Not a single group, it includes a range of people, whites and those of color, and a variety of anti-vax positions, some in raving conflict with one another.
Whites makeup at least 64% of the unvaccinated at this writing. The makeup of this group has changed over the past three months. It first included many people who were skeptical of vaccines for different reasons--whether they work, are really needed, have dangerous or unexpected side-effects, can produce sterility, or might be spiked with microchips or other secret surveillance technology. Those not ideologically opposed have increasingly chosen to get vaccinated, due to the surge in cases and deaths related to the delta variant and the more recent vaccination mandates by schools, companies, city and state governments. This has meant that a growing percentage of the unvaccinated white population consists of conservative Republicans, a relatively small portion of whom (still likely in the millions) do not even believe covid-19 is real. This white contingent makes up around 70% of those who have said they will never be vaccinated.
It is, however, an error to believe that only the poor, ignorant, and dispossessed are among the never-vaxers. Roughly half have some college or more; over 20% have an undergraduate or graduate degree, with a third earning over $90k per year. Nearly 60% live in suburbs. A fair number are women worried about their children, swayed by online “experts,” “health coaches,” and other “motivators” who promise to clear up any confusion and “deliver choice” back to followers. The demographic is therefore far from homogeneous. It also includes high-tech workers, police and firefighters, members of the military, town and city officials, construction workers, and also—not a little disturbing—health care workers, among other professions.
According to data from the Kaiser Family Foundation (KFF), the percentage of Black people and Latinx (“Hispanic” is the term KFF uses) who still say they will never be vaccinated has fallen considerably, to 10% and 12%, respectively. Their reasons are dominated by worries about side effects, fertility impacts, and doubts about claims the vaccine is safe. Anxiety is often tied to online mis/disinformation (also true for whites), supported by a small number of same-ethnicity anti-vax physicians and individual stories asserted to be representative. But some hesitancy has also come from the history of racist institutions. This includes online emphasis about the Tuskegee Syphilis Study conducted by the U.S. Public Health Service and CDC from 1932 to 1972 (400 Black men with latent syphilis were told they’d be treated for “bad blood” but, in fact, were given placebos so researchers could observe the full course of syphilis to death). It is a tragic irony that this “experiment” persuades people 50 years later to avoid life-saving vaccines.
There is another truth of terrible consequence. Deepened fears of government action against people of color are an inevitable result of the Trump Administration. The violent anti-immigration policies and overt white supremacism pushed consistently over four years by Trump and his inner circle--as well as the mixed messages his administration put out regarding the virus—have had their impacts.
Give Me Liberty, Or
The overwhelming majority of those who have refused vaccinations in the U.S. have done so out of mistrust, particularly aimed at government. Such is widespread in contemporary democratic societies, a truth much discussed in recent years. But it is particularly advanced in America. Here, it’s been a core principle of the Republican Party for four decades and has spread more widely for complex reasons, affecting non-conservatives. As an existential “illness” of its own, deep institutional distrust has merged with the covid pandemic to yield illness for millions and deaths for well over a hundred thousand people. Again, the actual numbers continue to grow by the day and the hour.
White anti-vax conservatives appear moved by two ideas. One involves refusal of a medicine produced and pushed by the left, by a medical science ruled by these types, who care more for their grants, careers, and influence than for ordinary Americans and are willing to lie about vaccine safety. This view has found high caliber when aimed at government spokesperson, Anthony Fauci, head of the National Institute of Allergy and Infectious Diseases.
There are subsurface aspects to this idea. Science cannot be relied upon when it is in the hands of those with other motives than people’s health and nothing but their health. People are being asked, urged, and now (in a growing number of cases) forced to accept into their body a needled fluid that embodies the work of dishonest, deceitful others. At worst, it may bear in some symbolic or even physical way the Pandora evils of a corrupt, arrogant, and dependent society. That the vaccine comes through a needle (versus a pill), thus a penetrating violation that forestalls all freedom to choose, only adds to the sensibility of submission and loss of self-determination. It is in this frame that concepts like “medical tyranny” make the most sense.
The second idea, and by far the most articulated in private and public settings, is that of an assault on personal freedom. "It is very important that we say, unequivocally, no to lockdowns, no to school closures, no to restrictions and no to mandates," says Florida’s governor, Ron DeSantis, speaking for a sizeable portion of Republican true-hearts. The reason given is “overreach” of government power into areas that must be left to personal choice. This includes businesses, schools, factories, indeed any workplace of any kind. It does not seem to matter if state governors impose their own mandates, prohibiting any of these entities from choosing on their own to require vaccinations.
In truth, there are more than a few contradictions like this in the outrage that has been expressed, not least by Republican lawmakers. Their political cynicism becomes apparent in claims that the Biden Administration “failed to shut down the virus” yet has “no right” to mandate vaccinations. Some have even claimed that covid isn’t serious enough, as polio was, to abridge liberty by obliging people to get vaccinated. Those who impose vaccine mandates, from local school boards to the White House, are thus posed as the next worst thing to tyrants, Stalinists, totalitarians, and, worst of all, “socialists.”
Over and above the rhetorical fray are the two facts: mandates have been effective, and people continue to reject them as an attack on personal “choice” and “freedom.” Online anti-vax sites exploit such appeals aggressively, emotionally, and effectively, just as they have worries over side effects. An often expressed sentiment runs: “It is not anybody’s business whether you have had the vaccine or not; only you, not the government, should decide what goes into your body.” Those who created the United States, the Founders, would strongly disagree. This includes George Washington, who, in the first year of the Revolution, saw 90% of the deaths in his army caused by disease, above all smallpox. In February of 1777, he ordered the mass inoculation of his army—a mandate countering a proclamation by the Continental Congress against any such action, based on ill-informed fears of infection (British forces were themselves already inoculated).
Today, as in most advanced and an increasing number of emerging nations, Americans have been vaccinated repeatedly as children (by mandate), to prevent polio, chickenpox, mumps, measles, rubella, diphtheria, pertussis, and tetanus. This has been required for half-a-century to attend any public or a huge majority of private schools. Within the walls of these institutions, they learn that vaccination has been the most effective public health advance in history. They learn of Edward Jenner and smallpox, worst modern killer of human beings, ending 300 million lives in the 20th century alone, more than all wars, purges, and genocides combined, before being eradicated by systematic, nationally mandated immunizations. In 1990, nearly 13 million children under five were killed by disease; by 2015, this number had fallen to 6 million, and today it is closer to 5 million, with immunizations a key reason. This will be extended further by malaria vaccines, the first of which has only just been approved by the World Health Organization after more than three decades of research. The live-saving powers of these medicines are the reason so many of the world’s governments have moved over the past half-century to make them readily available to as many families as possible without cost.
Nonetheless, many political and influencer careers today are made by stirring confusion, inspiring fear, and promising liberty. To rephrase a famous line, “They would prefer liberty to death, but death if liberty be denied.” And, indeed, the claim made against mask and vaccine mandates in the U.S. very often invokes such a war cry.
Freedom’s Forgotten Requirement
Time to take account in a more honest tone. The anti-vax position in the midst of a global pandemic is irresponsible, dangerous, and suicidal. In the midst of sickness and death, such resistance qualifies as a disregard for moral principles regarding one’s relation to other people. It embodies a solipsistic worldview (“I matter, and no one else does”), thus contempt for public welfare. At an objective level—that of the virus and its biology—fear or intention have no relevance. Vaccine refusal simply offers more bodies for infection and proliferation. It qualifies as working on behalf of the virus itself, thus the opportunity for it to be more lethal and injurious for a longer period of time to a greater number of people—mothers and fathers, brothers, sisters, children. In this context, anxiety over side effects becomes self-fulfilling (often via someone else), religious objections (serious or not) turn into secular endangerment, and the idea of vaccines as a weapon translates into a paranoid attack on the body social.
This leaves the matter of personal freedom. The problem here is worse. For 350 years, liberal and conservative thinkers have agreed that liberty does not and cannot exist without responsibility. Hobbes, Locke, Spinoza, Burke, Mill, and other gargantua of modern political thought all insist that one person’s freedom can extend only to where it begins infringing on another’s. Liberty must have limits if people are to live communally—they cannot simply do as they please in every case, above all when it comes to the physical endangerment of others. In Mill’s words: “doing as we like…without impediment from our fellow creatures, so long as what we do does not harm them…[and also having] freedom to unite, for any purpose not involving harm to others.” In any functioning society, liberty does not exist without obligation to others.
The past year has clarified that the world now has the scientific capability to defeat a new plague. What it lacks is the organizational, political, and ethical sensibility to carry this through. Conflicting information about many aspects of the disease, as well as about vaccine effectiveness, has continued since early 2020, adding to anxiety and suspicion. Meanwhile, if a mercantilist approach to vaccine production and use made sense at the earliest stages, the arrival of new variants soon proved this to be a deadly overall strategy. The best course would clearly have been massive, cooperative vaccine production on a multinational basis, with continuous global distribution to reduce the total spread and, especially dangerous in the longer term, the appearance of new variants. Yet, as weapons of national prestige, vaccines were wielded against one another, in some cases rushed into circulation without proven effectiveness. The losers, of course, have been the enormous numbers of people who have yet to receive a single dose.
Blame, though popular, may be beside the point. The pandemic has fallen like a thick shadow on a historical period of intensified conflict, broken cooperation, rising autocracy, and fractured democratic norms. The tens of millions in the U.S. opposed to vaccines out of distrust and fear place it in a similar category to Russia, whose government has done a great deal more to earn the suspicions and misgivings of its people. That these two rival states, with their opposing political systems, share such a problem in the face of a pandemic has much to say about the current state of the world and the challenge that the covid-19 virus may continue to present.