Dr. Richard Feldman: Vaccination common sense proves elusive

Dr. Richard Feldman

Dr. Richard Feldman
For The Republic

A public health expert recently noted that it is impossible to convince a person thinking illogically using logic. Although COVID vaccines are lifesaving, over 60 million adults remain unvaccinated, some fearful, and worse, some hostile to vaccination and even masking. Politicization regarding the COVID crisis and vaccination is rampant. Millions are willing to believe disinformation from garbage internet and social media sites, politicians, and some in the right-wing media rather than information provided by public health professionals and officials and their own trusted personal health-care providers.

David Leonhardt (New York Times) and Philip Bump (Washington Post) have penned articles explaining that the irrational politicization of COVID, COVID vaccines, and masking created a coronavirus death-rate gap between blue and red America. The gap, once minimal, dramatically and progressively widened since vaccine availability with conservative areas having significantly higher mortality. Forty percent of Republicans remain unvaccinated compared to 10 percent of Democrats. The fight against COVID should be a public health battle, not a cultural one.

There is no substitute for vaccination for the greatest and longest protection. Non-vaccinated individuals will continue to suffer the greatest burden of disease.

Fully immunized status, nationally at 60 percent and in Indiana at 50 percent, falls well short of herd immunity. Indiana owns one of the lowest state rates. As winter sets in, we are again experiencing a new surge of delta infections and the new worrisome variant, omicron, looms before us. Yet the illogical thinking continues. Recently, Governor Holcomb and the legislature, in special session, attempted to end the COVID emergency order prematurely, eviscerate business’s ability to mandate vaccines, and codify disinformation. The legislation, postponed but already filed again for the next session, is a symbolic nod to resisting “government overreach”. What a dreadful message to the public – “Time to move on, the pandemic is over.”

With inadequate immunization rates persisting, vaccine mandates are a rational last-resort public health measure to achieve herd immunity of 85 to 90 percent vaccinated. No one really wants mandates, but it’s the only path forward out of this crisis.

American smallpox immunization mandates go back over 200 years. School mandates are responsible for our high childhood immunization rates. Nonetheless, many conservative states have enacted laws that prevent local and state government from mandating COVID vaccination in various ways, including Indiana. With the proliferation of businesses requiring employee vaccination, nine states have prohibited private businesses from doing so. The Indiana legislature appears poised this session to restrict business mandates as well. What happened to the conservative philosophy of small, nonintrusive government?

Biden’s mandatory immunization rules conflict with most state vaccination prohibitions. Federal regulations preempt state laws. We may be headed for a showdown.

Two previous Supreme Court decisions upheld the constitutionally of vaccine mandates at least at the state level. Constitutionally, public health enforcement is largely reserved to the states. Federal mandates are more uncertain. Federal courts have recently issued conflicting decisions on the constitutionality of the mandates and now a series of suits raised by more than two dozen states, including Indiana, will play out in federal courts. Undoubtedly, the controversy will wind up in the conservative-dominated Supreme Court. Will the court rule contrary to its own precedent? Anyone’s guess.

Important in determining constitutionally has been the belief that individual liberties are never absolute, always balanced with the common good, and mitigated when producing harm to others. I’m a firm believer.

If not vaccinated, get vaccinated. If vaccinated get boosted. It’s the logical thing to do.