Nobody asked me…

The last several months have seen many COVID-19 vaccine milestones. Nationally, we’ve managed to crawl past the 50% vaccinated milestone, even if many rural counties are hovering at or below 40%. On November 2, the CDC recommended the Pfizer vaccine for children ages 5 through 11 . On November 4, the Occupational Health and Safety Administration (OSHA) released a rule requiring all companies employing 100 or more people to mandate the vaccine or mandate masks and weekly testing protocols. And New York City has passed sweeping vaccine mandates, hoping to prevent the desolation of last spring. As a healthcare worker in New Mexico, I’ve had a vaccine mandate for months. For years, actually, if you count the other vaccines and safety protocols I’m required to follow for things like the flu, measles, tuberculosis, or hepatitis. I’m going to get my booster before I leave work today.

Over the last few months, most people seem to have accepted that this vaccine is something they’ll have to choose if they want to continue living life in their communities. Others have chosen to leave their jobs instead. A few of these people are brainwashed and think there are microchips in the vaccines. A lot of people are just scared or confused. They worry about potential side effects and safety. Some people describe personal values or beliefs that they have weighed in order to come to a thoughtful decision for themselves.

Here’s the thing though: this vaccine? It’s not about them. It’s not about you. It’s not even about me, though I’ll admit in my weaker moments I’ve shouted why me, as if I alone stood at the center of this maelstrom. This vaccine is not just a personal choice, it affects other people. Significantly. It’s about community level protection and mitigation. It’s caring for people other than yourself or your immediate family. It’s recognizing the downstream effects of an overrun health system. People keep talking about freedom: the freedom to refuse a vaccine, the freedom to not wear a mask, the freedom to do whatever you please. But the argument for vaccine mandates is also about freedom: freedom for the vulnerable to be able to safely participate in their communities, freedom from disease and fear, freedom from chaos. I want freedom too. 

Some people do understand this. They’re not confused. They aren’t worried about microchips. Maybe they’re a little scared, but mostly they’re clinging to a self-serving false view of freedom.

I’ve seen a lot of posts in the last several months telling me that as a healthcare worker, I shouldn’t be upset about taking care of unvaccinated people because I also take care of cancer patients who smoke and diabetics who eat cake. Putting aside the tacit admission of vaccine efficacy in these sentiments, I do take care of unvaccinated people. All day. In fact, an overwhelming majority of patients in the hospital with COVID right now are unvaccinated. And it is upsetting. My hospital has been at 150% capacity for months. Every unvaccinated patient in the hospital is taking a bed from someone with a heart attack or stroke or life threatening infection. They are a nexus of destruction, harm, and disregard. It is upsetting. It is similar to that gut wrenching feeling we have when we save the life of a gunman and his victims. We swore to take care of everyone. We do it, every day, because people are better than their worst choices.  We do it, even when the philosophy is more complicated in practice. But our ICUs are full of gunmen and our guts are perpetually wrenched.

Vaccine science is not about protecting the individual. Of course, they do protect you. They lessen the morbidity of the disease or can prevent you from contracting it all together. But that’s not the point. Most of the time, the individual benefits of vaccines are secondary. Their purpose is to protect large groups of people from communicable diseases. For the most part, smoking and eating cake do not directly affect your community. Spreading measles, tuberculosis, or COVID-19 and then overwhelming your health system with unpredictable surges, unequivocally does harm your community. 

Most people understand this tradeoff between their individual freedom and the benefit and well being of their community. Anyone who flies on a plane and allows the TSA agent to pat them down, just on the off chance it can prevent an unlikely but scary aerospace terrorist attack, understands the tradeoff. No one is forcing us to fly. We could take a train and avoid the invasion of privacy. Is this a consequence of our choice or coercion? What about your job or a restaurant requiring you to be vaccinated? You could find a new job or eat somewhere else if you want to avoid the poke. Is this a consequence of your choice or coercion? Does it matter? Society gets to weigh the harm to your individual rights and freedoms against the harm to your community’s health and freedom. Regard for others is part of living in a free, civilized society.

Your freedom, your right to refuse the vaccine is part of this calculation. But it is not the only consideration. We’re also considering your elderly neighbor’s freedom to go grocery shopping without undue risk to herself. We’re considering your son’s teacher’s father’s right to an empty hospital bed when he has a heart attack. We’re considering your niece’s right to our full attention in the trauma bay after her car accident. Your actions and choices have consequences. If you refuse the vaccine, it means you can’t go to the gym or eat inside at restaurants. It also may mean that several people die who may have otherwise lived. You will never know those people. My colleagues and I will. And we want freedom too.