The U.S. has made great progress toward vaccinating the population against COVID-19. There is still a long way to go, but at the current rate every adult who wants to get vaccinated will be able to do so within the next few months. Meanwhile vaccine trials with children are underway and trials with adolescents have already yielded promising results. In theory, this means that if everyone was willing to be vaccinated, we could have a fully vaccinated population by the end of the year and reaching herd immunity over the summer is not out of the question. There is of course one problem: not everyone is willing to be vaccinated.
It is interesting to compare the media narratives about this segment of the population. On the right, the narrative is that the (nebulously defined) establishment is intent on infringing on freedoms and those who disregard pandemic recommendations are victims of oppression and/or heroic defenders of liberty. This drumbeat has become familiar over the last year. First it was lockdowns, then masks, and now vaccines and the still hypothetical “vaccine passports”. I think there are certainly some legitimate concerns about whether it is wise or appropriate for governments to mandate these sorts of things (although that argument could just as easily apply to preventing private businesses from requiring masks or vaccine cards). However, these legitimate concerns are undermined when people refuse to adopt sensible mitigation measures that are voluntary. If this was really a matter of concern about the proper role of government, then people would oppose mandates and then choose to wear their masks and get their vaccines anyway, but that is not what is actually happening. Instead, many seem intent on trying to argue (based on remarkably flimsy evidence and shoddy reasoning) that these measures don’t work and that any efforts to persuade people to adopt the types of behavioral changes that are in everyone’s best interest are brainwashing or propaganda. I have written about why this is nonsense before, but today I want to discuss a different topic.
On the left, the narrative has been that anyone that questions the conventional wisdom must be ignorant or hateful or worse. The anger toward those who are reluctant to get vaccinated is palpable. As a result, some have started to make the case that there is no point in trying to persuade people to get vaccinated. Instead, we should just ostracize them and let them get COVID like they deserve. It is this argument that I want to push back against in this post. Although I share the frustration about vaccine hesitancy, adopting this stance would be profoundly misguided.
As I have discussed previously, herd immunity is a phenomenon in which a population can become immune to future large scale outbreaks. It doesn’t mean that people won’t get sick, but it does mean that we won’t see the virus spread very far and as a result the pandemic will slowly fizzle out. Reaching herd immunity requires that a significant percentage of the population be immune to the virus. Early estimates placed the herd immunity threshold for COVID around 60%. However, as testing improved, it became apparent that the virus was spreading faster than previously believed. Current estimates place the threshold well above 70% and possibly even higher now that more virulent strains have emerged. So, if a significant percentage of the population refuses to get vaccinated, we will have a hard time reaching herd immunity the easy way. Instead, the virus will keep circulating until enough people have been infected.
Now I know what you are thinking, “Yes, that is sad, but won’t that just affect the unvaccinated people?” Unfortunately not.
First off, it will take a lot longer to reach herd immunity that way. This means it will take longer for the pandemic to subside. If you are as eager to get back to normal life and as sick of pandemic precautions as I am, then you don’t want this to drag on any longer then it needs to. And even if you are fully vaccinated and living your best life, there is a segment of the population that will be reluctant to do so and that will continue to be a drag on the economy until the level of circulation for COVID is dramatically reduced.
Secondly, herd immunity is a local phenomenon. It depends on the behavior and susceptibility of each population. So if one town has high vaccination rates and reaches herd immunity, but the neighboring town does not, then the unvaccinated town can sustain the pandemic putting any susceptible visitors at risk and seeding new infection clusters in neighboring areas through travel. A number of studies have looked at the effect of having unvaccinated clusters in the population, and they all point to the same conclusion: that having clusters of unvaccinated people make a population significantly more vulnerable to outbreaks even if the total number of vaccinated people is the same. In other words, it is much better to have your unvaccinated people spread out than clumped together. Unfortunately, that is precisely what is happening today. Vaccine hesitancy is highly correlated with political affiliation which makes it probable that the vaccine holdouts will form the sorts of clusters that increase the risk of further spread and raise the herd immunity threshold for everyone.
Thirdly, herd immunity is a temporary phenomenon. Whether immunity is acquired through infection or vaccination, it tends to wane over time. This is due to immune individuals regaining susceptibility and new individuals joining the population (through birth and migration). This means that a population that has herd immunity now may become susceptible again at some point in the future. With a novel pathogen like the SARS-COV-2, it is hard to know how long that immunity will last. We simply have not had enough time to observe this waning immunity occur at scale. It could take years or months. So, we need to be mindful of the fact that unless this virus is eradicated (unlikely), immunity will probably need to be replenished regularly. There is an easy way to do this (boost shots) and a hard way (more infections). Unless we want to deal with COVID19 outbreaks on a regular basis, it would behoove all of us to get used to the idea of receiving vaccines for COVID periodically and the more people that adopt this perspective the better.
Fourthly, we are very fortunate that the COVID-19 vaccines are highly effective (90%+) above and beyond many other types of vaccines such as those for influenza (40% to 60%). They dramatically reduce the risk of infection and especially severe infection. However, no vaccine is 100% effective. This means that there will be some people who get the vaccine and remain susceptible. Allowing the virus to continue to circulate will put them at risk. For that reason, it is best to overshoot the herd immunity threshold and reduce the prevalence of the virus as much as possible in order to protect those few who do not acquire sufficient immunity.
Finally, anti-vaxxers are people too. Although we cannot (and should not) vaccinate people against their will, if we care about our neighbors, we should absolutely desire to see our neighbors vaccinated for their own health and safety. This is no time for schadenfreude, especially for Christians. We cannot relish people getting what they deserve, because we know what we deserve and that our only hope is that by the grace of God, we will not receive the consequences that we deserve (Romans 6:23, Psalms 103:10-11). Instead, we should hope and pray for those who are confused and try to speak the truth in love. We can't give up on them. We need them and they need us.
Unfortunately, the conversation about vaccination often has more to do with berating the ignorant and belittling the misinformed than compassion. If people do not believe that we have their best interest at heart, why would they ever listen? Ridiculing the vaccine hesitant is not going to win them over. Bombarding them with information is not going to persuade especially if it makes them feel inferior. And, hoping they will get what they deserve just makes matters worse.
The best way to change hearts and minds that I know is to respect those that we disagree with, to show compassion toward them, to listen to them, and to encourage them with the truth. It breaks my heart to see people sharing misinformation about vaccines and proudly broadcasting their opposition to the COVID-19 vaccines. Many of these people are my friends and it saddens me that they have been misled. I am concerned about the possibility that they will get sick and about the harm that their resistance could inflict on the people around them. At times, it makes me angry, but I have to remind myself that this is not about winning arguments; it is about saving lives. I have no illusions that it will be easy to change peoples’ minds about vaccination. But if I care about them, I have to keep trying. That is one of the reasons why I got the vaccine as soon as I was able. It’s not about virtue signalling; it is about setting an example and being willing to be one data point amongst millions showing that these vaccines are safe and effective. It is also one of the reasons why I keep writing this blog. The audience is small, and I have no expectation that this will change. But I still hold out hope that there is someone out there in need of persuasion who might read it and find the message that they need to hear.