On August, 23, 2021, the Food and Drug Administration (FDA) gave full approval to the Covid-19 vaccine. Comirnaty (this is a dignified blog, I won’t go there), made by Pfizer-BioNTech, is the first approved vaccine for people 16 and up. It’s still under emergency use for people who are 12-15 years old. The emergency use approval is also in effect for people with weaker immune systems who need a third dose.
Anyone who is reading this will know how deadly this virus is. As of this month, it’s killed more than 4.5M people worldwide. Covid has already upended or forever changed the lives of countless families. And we haven’t even had the pandemic-themed baby names boom yet! One trend that came out faster than babies named Cove was the start of vaccine mandates. Companies were already requiring their employees to get vaccinated even before FDA approval. The FDA announcement only helped give traction to the rush for mandates.
Through the lens of racial equity, is that fair? Like most decisions made by people in power, it’s always a good idea to think about it first. I believe that we should mandate the covid vaccination, and we can do it with compassion. Here’s how I think we could mandate the vaccine while avoiding harm to marginalized communities.
First of all, why can corporations or the state mandate vaccines at all? Government vaccine mandates are more than a century old. The u.s supreme court ruled in favor of mandates in 1905’s Jacobson v. Massachusetts. The city of Cambridge, Massachusetts required smallpox vaccinations for people living there. The supreme court ruled that it was constitutional to fine the pastor who refused to get the jab. Or, series of jabs: the smallpox vaccines were so much grislier compared to the tiny shot we use today!
Another myth circulating around vaccination is the belief that BIPOCs are the problem. Early on, we heard the narrative that people of color were less likely to have gotten the vaccine. People spent months trying to pathologize what was ultimately an access issue. Even vaccines intended for BIPOC communities that want them can still go to better-connected white people.
In fact, the biggest driver of vaccine hesitancy is now found among white americans. Even so, white politicians blame BIPOC community members for spreading covid. The governor of Florida blamed immigrants. The lieutenant governor of Texas blamed democrats and African Americans. Both of them did this while also railing against the vaccine and mask mandates.
Now, in many parts of the country, vaccine mandates are becoming the norm. Whether it’s to eat at a restaurant or board a flight, vaccines and masks are the safest way to be around other people. How might these requirements affect people of color differently than white people?
What does it take for the average person to follow the vaccine mandate? They might have needed to use a computer or smartphone to get an appointment. They might have driven to the vaccine site. They might have needed to take a day or two off work to recover. How would a person with a disability navigate that process? What about a person who can’t read in English? Or someone who can’t read the language that they speak?
And when a mandate goes into effect, what happens to a person who violates the mandate? How are they punished? How easy is it for them to change their mind and get the vaccine?
The CDC’s vaccine card was not designed for the purpose we invented for them. I have an old yellow immunization booklet. I have no idea where it is right now. The covid card is just as clunky. It doesn’t fit in a wallet, it bends easily in a pocket. What happens if you lose your card? Different states allow different digital alternatives. My state’s digital system, MyIR, has my records on file. But that system is only in use in a handful of states. Other states maintain their own proprietary system.
As widespread as the vaccines are, they are not yet universal. Children under 12 can’t get the vaccine yet. Neither can people with allergic reactions to any of the vaccine’s ingredients. But all these groups still play a role in our covid-free future. What can they do to protect themselves? How can they still protect others?
now, mandate away!
We’ve now considered many of the risks associated with establishing a mandate. How should we create one? Our policy would need to include these guidelines.
- The vaccine should be free and easy to access at many different locations.
- People who get a vaccine have the support they need to overcome any obstacles or barriers.
- Vaccine cards should be easy to use, read, and replace.
- If a digital version of the card is available, it should address any privacy or identity concerns.
- Enforcers of the mandate at every level should know how to read the card (and how to spot fakes). They should know where to direct people who are not vaccinated.
While we’re considering all these things, we need to address global equity, too. Billions of people still don’t have access to the vaccine. The u.s. government is planning a third dose of the vaccine that may add only a small percentage more of protection. Meanwhile, here and abroad, unvaccinated people are still the biggest source of spread.
Doing our part for the health of our communities has become a political issue. But vaccine mandates are a net good. Vaccine mandates do convince people to get the shot. We’ve delayed and compromised away our safety for people who will fight any effort to stop the spread. As we move to mandate, we have to consider helping people get there.
There’s one more caution about vaccines that goes all the way back to Jacobson vs. Massachusetts. That supreme court ruling may have helped launch the Anti-Vaccination League of America. Their arguments are the same then as they are now.
There’s a rich discussion to be had around personal health versus community health. This vaccine asks us to take a small risk in our lives for the benefit of everyone around you, including you. I have a colleague who has counted every single day of the pandemic since it began. Hospital workers have been beyond capacity for more than 20 months now. This virus is taking its toll on people in so many ways. The longer the pandemic lasts, the longer its effects will linger. Covid will linger not just in our bodies or our hospitals. It will change our psyche.
What we need is to think back, to the early days of the pandemic, to the time when we were all supposed to be in this together.