On Vaccine Mandates & Liberty (Bauervic Essay Contest winner)
Introduction and context
It is one of humanity’s universal truths that disease will never be wholly eliminated. Microbial organisms and structures, both bacterial and viral, either naturally proliferating or artificially crafted — all posing threats to an individual’s well-being in near-limitless forms. It is upon this basis by which disease has written history on several occasions, its gangrenous hand choreographing its writhing pen to the signatures which slayed tens of millions of people. Many of these moments may spring to mind, including the Black Death of the 14th century, the several Cholera pandemics throughout the 19th century, the Spanish Flu of the early 20th century, and the Severe Acute Respiratory Syndrome (SARS) outbreak of the early 21st century (Piret & Boivin, 2021). However, these large-scale events were not all that disease could enact; the likes of smallpox, polio, and tetanus rarely experienced mass culminations of infectivity, yet were arguably just as feared as Cholera and influenza for their quiet infectivity and efficient lethality.
Of course, the human mind far supersedes those of all other organisms on Earth, thus effectively guaranteeing the invention and continuous development of the vaccine henceforth. Ultimately, it was upon smallpox which vaccines first established themselves; Buddhist monks of the 17th century applied cowpox to skin tears to protect against smallpox, while Edward Jenner conducted the first modern-form inoculation from smallpox in 1796 (The Immunisation Advisory Centre, 2020). Since these times, humanity had brought about the complete eradication of smallpox by 1979 and has forwarded significant advancements against the likes of polio, Human Immunodeficiency Virus and Acquired Immunodeficiency Syndrome (HIV/AIDS), sexually transmitted diseases, and the viruses that cause Hepatitis. Indeed, though it may very well take generations to accomplish, the possibility of mass inoculation toward most of Earth’s deadlier contagions is tangible.
The question, then, must be asked: how should this inoculation occur? It is a thought that has already jumped between the minds of countless individuals across many institutions throughout multiple centuries, though its dissection has only been carried into the public consciousness by the onset of the COVID-19 virus and the associated vaccine mandates implemented around the world. Certain strides have already been made in the discussion regarding compulsory inoculation, and at first glance, the Coronavirus pandemic is a relatively simple and relevant conduit for this discussion to take place. Political and philosophical zeal harbored by most of its participants denies this capacity, however — no measured, inquisitive approach can be taken upon a topic as complex as vaccine mandates with pools of skewed statistics, hidden agendas, and conflicting findings underpinning the conversation. It is for this reason that the disciplines of history, philosophy, economics and sociocultural studies up until COVID-19’s emergence are far more dependable. Consistently taking risks with poor information such as that which surrounds the Coronavirus would surely mean an adverse strike against the well-being of humanity.
As controversial as compulsory vaccination has become, the concept is nothing new — it has prevailed as a subject of debate and implementation for decades prior to Edward Jenner’s first modern inoculation. The first major instance of this controversy arose during the American Revolution, whereupon George Washington ordered in early 1777 to variolate the Continental Army against smallpox. This came despite a General Order about half a year previously which stated, in no uncertain terms, that “Any Officer in the Continental Army, who shall suffer himself to be inoculated, will be cashiered and turned out of the army, and have his name published in the News papers throughout the Continent, as an Enemy and Traitor to his country” (Hancock & Trumbull, 1776). Nevertheless, Washington persisted, introducing the variolation mandate for all soldiers passing through Philadelphia and Morristown, New Jersey (American Battlefield Trust, 2017). The desired effect was accomplished; smallpox’s grip over many soldiers’ minds and bodies waned significantly, allowing for greater ease of enlistment for the young men of the Thirteen Colonies.
Following the American War for Independence and the creation of the modern vaccine, the first country-wide attempt at compulsory vaccination occurred in 1805. Marianne Elisa of Lucca, Napoleon Bonaparte’s sister, had attempted to enforce vaccination within France; her efforts ultimately failed, however, when she could not discern an appropriate method to enforce this rule (College of Physicians of Philadelphia, 2016). Apart from smaller advancements in vaccinology, such as the creation of a U.S. Vaccine Agency in 1813, no pushes were made by any government in the realm of compulsory inoculation until 1853, where the United Kingdom Vaccination Act was passed and implemented. This landmark law mandated that all infants must be vaccinated against smallpox within the first three months of their life, with their parent or parents receiving a fine or imprisonment for failing to do so. Germany followed suit about twenty-one years later, introducing a similar smallpox-inoculation mandate in 1874. Again, the intended effect was captured — between 1875 and 1886, average annual mortality fell in the country to 1.91 deaths per 100,000 citizens, with 1897 observing just five smallpox fatalities among a total population of over 54 million (College of Physicians of Philadelphia, 2016). Nevertheless, objections had been continuous and accumulated throughout the 19th century, leading to the creation of the Anti-Vaccination League of America in 1882. It must be noted, however, that this group attenuated their adversity toward vaccinations to the idea that smallpox was spread by filth rather than contagion — in other words, no liberty-related argument had ever been asserted.
Moving into the contemporary era, in 1893, a smallpox outbreak occurred in the town of Muncie, Indiana due to a neglect of vaccination by many of its residents. Curiously, despite an almost-complete quarantining of the town, the fumigation of all mail, the banning of all public gatherings, and enforcement of compulsory vaccination, 140 residents of the roughly 12,000-large population contracted the disease, with twenty of these citizens perishing (College of Physicians of Philadelphia, 2016). Five years later, Great Britain would provide an avenue for anti-vaccinationists to refuse inoculation by creating a conscience clause within the United Kingdom Vaccination Act, making it possible for individuals to seek exemptions to the mandatory smallpox vaccine.
It is the twentieth century, however, which is responsible for most of the vaccine mandate’s progression into society. In 1905, the U.S. Supreme Court ascertained the constitutionality of compulsory smallpox vaccines in the case of Jacobson v. Massachusetts. In 1922, the Court again upheld the constitutionality of compulsory vaccination by arguing in Zucht v. King that the school district of San Antonio, Texas could keep unvaccinated students from attending any school in said district. From here, anti-vaccination sentiments would only worsen, as an armed mob in 1926 managed to force health officers away from vaccinating the citizens of Georgetown, Delaware (College of Physicians of Philadelphia, 2016). Regardless, the United States government continued to uphold vaccine necessitation into the twenty-first century, particularly through minors. It is through the Center for Disease Control’s recommended vaccinations from birth to age 18 that individual states craft their own lists of vaccine mandates for applications to school attendance and childcare services (DeSilver 2021). Indeed, by the 1998-1999 school year, forty-six states mandated some sort of vaccine for all students from kindergarten to twelfth grade, while thirty states, the District of Colombia, and Puerto Rico enforced some sort of mandated vaccine for the collegiate level (Malone & Hinman). Typically, vaccines against the likes of Hepatitis, polio, tetanus, Diphtheria, influenza, chickenpox, and several others are included.
Through the philosophical lens
Contextualization of Liberty
The debate of vaccine mandates extends to the philosophical branch of thought most often, given the arguments between individual liberty and the well-being of society itself. There is no question as to what can, at least partially, explain this: the debate pitting the ideological but ultimately tangible concept of compulsory vaccination against the intangible and sometimes confounding philosophy of liberty. To remedy this and enable a proper discussion, the idea of liberty must be lifted to the same platform as that of vaccine mandates. Merriam-Webster provides an apt starting point through its dictionary definitions of the concept — that is, the “quality or state of being free,” where this freedom concerns “the power to do as one pleases,” “freedom from physical restraint,” “freedom from arbitrary or despotic control,” “the positive enjoyment of various social, political or economic rights and privileges” and “the power of choice” (2022). However, these determinations do not need to be extensively studied to understand how such a definition raises more questions than answers; it is still describing an idea, with only vague descriptors painting a rough picture of what liberty could be fully understood as. Thus, a deeper search is required that surfaces the distinction of negative liberty and positive liberty as described by Ian Carter of Stanford University.
In simple terms, negative liberty is “the absence of obstacles, barriers or constraints,” while positive liberty “is the possibility of acting — or the fact of acting — in such a way as to take control of one’s life and realize one’s fundamental purposes” (Carter, 2003). Both concepts can be easily comprehended through the context of the Cold War, or more specifically, the fundamental philosophy differing the United States and the Soviet Union from each other. America’s liberty follows the negative trail in which there is an absence in government action upon individuals, therefore endorsing an individualistic state of being; the Soviet’s liberty, meanwhile, was positive in that there was a purpose or obligation for individuals to utilize self-determination to better society (the true state of the U.S.S.R. notwithstanding), thus promoting a collectivist state of being. However, both types possess their own flaws. One could assert that an individual could be practicing negative liberty so long as there exists no external force to infringe upon all levels of that liberty, regardless of the context surrounding that individual’s moment-to-moment life. Some could therefore posit that negative liberty is a poor ingredient to be used as the bedrock of a society. Conversely, positive liberty possesses the possibility of devolving into a paradox — one that relies on positive liberty being viewed as the more rational version, which eventually leads at some point to the spawning of authoritarian regimes.
The third version of liberty, then, would be the best option — Republican liberty, the concept underpinning the Western realm today. An offshoot of negative liberty, Republican liberty does not simply advocate for general non-interference by external actors. Rather, it shapes the conditions by which this non-interference should be guaranteed (Carter, 2003). Indeed, this is the genesis of American society and is responsible for components such as a constitution, separation of powers, the negative rights outlined in the Bill of Rights and further Amendments, the Electoral College, and its Federalist structure of government. Given the debate between vaccine mandates and liberty is most frequented in the West, this Republican liberty and the context with which it describes itself is the form of liberty that is most appropriate for the reality of the situation.
Dissemination of Vaccine Mandates and Republican Liberty
When examining vaccine mandates and Republican liberty side-by-side, an interesting quirk arises: the conflict therein is not much different from the mutual exclusivity of positive and negative liberty, nor of their natures themselves. Positive liberty, as mentioned previously, is that which requires the presence of self-determinative capacities within individuals to fulfill the obligation of procuring a better society. Vaccine mandates are self-explanatory — they are requirements put out by a governing body for citizens to be inoculated against any sort of illness or virus, with penalties of fines or restrictive measures put in place for those who do not comply. In essence, these mandates make obligatory the usage of self-realization and rational reasoning to enact benefits upon collective society; in this case, protecting the populace against the threat of outbreaks and pandemics. This link in turn necessitates that, on principle, vaccine mandates are both diametrically opposed to the Republican liberty underlining the United States and are susceptible to the same Paradox of Authoritarianism inherent in positive liberty.
Yet, this danger of vaccine mandates in a Republican liberty society is remarkably contained in application — American medical institutions, in their creation of many vaccines that are made compulsory, require upwards of a decade to create and thousands of laborers such as virologists, vaccinologists, clinical trial volunteers, and others before they can even hope for approval by the Food and Drug Administration, or FDA. Additionally, until the Coronavirus pandemic, widespread vaccine mandates were adopted almost exclusively for minors; these mandates also provided exemptions in many states, with forty-eight states allowing for exemptions on the basis of religion and fifteen on the basis of philosophy (Malone & Hinman). Therefore, compulsory vaccination as it exists outside of Coronavirus has created an effective compromise between positive and Republican liberty — one that weighs the importance of social welfare with avenues for rejection while confining the years-long process to only those citizens too young to fully comprehend the idea of agency. Such is the structure that COVID-19 compulsory vaccination advocates have tampered with through removal of some or all existing mandate compromises. Indeed, some edicts maintain the student-only form existent in the mandates for traditional vaccines, but in the case of the pending Assembly Bill 1993, led by Buffy Wicks of California’s 15th District, all employees and contractors in the state would be obligated for full vaccination starting January 1, 2023 (Lagasse 2022). The unequivocal and blatant commitment toward positive liberty in this decision enables the two dangers of vaccine mandates within American society to roam free; California is in essence rejecting the Republican liberty supported by founding doctrines and institutions while embracing the idea of authoritarianism advancing upon its territory. Regardless, the philosophical discussion encompasses only one aspect of the picture-at-large in the end, hence the necessity of the economic and sociocultural angles to fully understand the debate of vaccine mandates and liberty.
Through the economic lens
Beyond the philosophy and theory of compulsory vaccination is the economic impact of such a proposal; in other words, the practical application (or lack therein, for anti-vaccinationists) of such mandates and whether they are feasible against economic liberties. It is an aspect scantly considered within mainstream discourse outside of COVID-19, and even when visiting the Coronavirus topic, relevant conversations surround the impact of the mandates on state and national economies, not the economic feasibility of the mandates themselves. Thus, it is not necessarily incorrect for the mandates’ external impacts to be combed over like they have, but without examining their internal machinations, well-informed considerations cannot possibly be centered upon the whole of reality.
Like any economic entity, vaccine mandates carry with them a cost-benefit trade-off. On one hand, these mandates have effectively guaranteed the sustainability of the vaccine production industry while improving the health of societies across the globe. Compulsory vaccination of children, as mentioned previously, is especially responsible for this; each dollar spent on child vaccination in the United States saved each taxpayer $3, ultimately contributing to a total of 103 million childhood disease cases being prevented between 1924 and 2013 (Rémy et. al., 2015). These cases being resolved thus allowed these 103 million children greater chances to remain healthy and live through adulthood, causing the size and productivity of the American workforce to be considerably larger throughout the decades than if mandates did not exist. Such results can occur despite the relatively miniscule proportion of funds that are sunk into inoculation programs — 80 percent of vaccine production occurs on the European continent, yet within France, programs for these vaccines required only 0.3 percent of their health expenditure budget (Rémy et. al., 2015). To phrase it differently, these child-focused programs throughout the United States and Europe have become highly efficient through decades of study, application, and continued innovation.
Traditional vaccine mandates still proclaim associated costs, however. The most acute of these within the developed world is the stripping-away of some economic liberties enjoyed by citizens. Vaccines and vaccine mandates will always require money to operate, after all, meaning the American taxpayer must still absorb the financial cost of their state’s inoculation programs. Indeed, as of 2016, the average cost of vaccine administration per child was roughly $30 in the United States, though Medicaid could lower the cost to as low as $3.30 in certain areas (Diasio, 2016). Additionally, the conflict surrounding a child’s vaccination status again becomes relevant; unless an exemption is granted to the parent or parents, the vast majority of education systems across the country would prohibit the child from participating in them, effectively removing their liberty to choose the career path that aligns best with their future needs and wants. For a system supported by a bedrock of free-enterprise principles which is meant to fuel open-market activities, this economic outcome is perhaps the one schism that the aforementioned philosophical compromise cannot cover.
Coronavirus vaccine mandates, keeping in line with their philosophical faults, vastly overstep or attempted to overstep their boundaries within the context of economic liberty. The most prolific of these cases surrounded the attempt by President Joe Biden to usher the Occupational Safety and Health Administration (OSHA) into mandating that all private businesses with more than 100 employees would be obligated to create compulsory vaccination policies. It can be easily ascertained that, had this effort been a success, very little of it would see any benefit rise over its costs. Per the Retail Industry Leaders Association, monetary costs could have been in the millions of dollars per week, and even then, OSHA would have been hard-pressed to sufficiently inspect as much as 100,000 employers with its 800-member evaluation force (Leonhardt, 2021). Nevertheless, rules similar to this that have been successfully adopted by some states ultimately undermine the liberty maintained by Americans to be skeptic of what enters their body and to operate in the free market without government interference. Other vaccines and their mandates, unlike those for Coronavirus, have been able to build up their reputability through their many decades of research and development and have been proven safe in how the vaccines successfully inoculate individuals. Two questions must follow: how can liberty, economic or otherwise, be assured at all through vaccines cultivated in a year’s time when they possess seldom any safety record and are fundamentally different from most other modern vaccines? How can these liberties be assured when such an unproven product is being forced upon individuals not only by state governments, but by public and private businesses across the country? Though the answers to these questions are clear, the economic costs of such vaccines and vaccine mandates are not — a grave realization which the United States economy may very well have to endure through.
Through the sociocultural lens
The sociocultural lens, like the economic lens, is a perspective often neglected in favor of aspects considered more pertinent to the idea of vaccine mandates. Yet, it is precisely what is forwarded in the philosophical and economic realms that seep into the hands of a society’s culture — for better or for worse. To this end, the schism packed within said sociocultural landscape is not new; opposition to vaccines and mandates has existed since before the contemporary era, though this strife has intensified since the onset of the COVID-19 pandemic. Take, for example, the infamous remarks made by President Joe Biden on December 16, 2021 as a representation of these times. Following a meeting with the COVID-19 Response Team, President Biden relayed a “direct message to the American people,” asserting that “we are looking at a winter of severe illness and death — if you’re unvaccinated — for themselves, their families, and the hospitals they’ll soon overwhelm. But there’s good news: if you’re vaccinated and you had your booster shot, you’re protected from severe illness and death — period” (The White House). Contrary to what unconstructive and tribalistic discussion participants proclaim on this subject, the issue with President Biden’s words lie in how they were received. In other words, it is not about what either side of the aisle believes regarding the remarks, but how the schism between the aisles has grown as a result of the inflammatory and disciplinary connotations inherent in the President’s message. It is indicative of the growing strain pulling at the philosophical compromise between vaccine mandates and the Republican liberty professed by America’s founding doctrines; it is a rebuke of the costs to economic liberty that are absorbed when compliance to compulsory vaccination is induced. Furthermore, just as how the philosophical and economic aspects trickle down into the social aspect of politics and governance, so too do they trickle down to the cultural component that is the mortar binding citizens together. Such was the case with the incident surrounding Carmine’s, a restaurant on Manhattan Island in New York City. At the time, the city had induced mandatory vaccination for many public activities; Carmine’s obliged to this by requiring proof of vaccination before individuals can enter and dine, yet on September 16, 2021, an unprovoked fight broke out over this requirement between three Texan women and one of Carmine’s hostesses (Rivoli, 2021). This assault should never have occurred regardless of the blatant affront to the liberties of the three Texans, though it nevertheless brings the expanding sociocultural rift under the proverbial microscope.
Indeed, it matters not whether someone is for or against vaccines and vaccine mandates — only that, through cases such as President Biden’s speech and the incident at Carmine’s, the present-day debate and execution on these same mandates has produced a level of sociocultural stratification. The most prolific example of this can be seen in Austria, where a measure that induced compulsory vaccination against COVID-19 for all citizens 18 years or older was implemented on February 5, 2022 (Druml & Czech, 2022). Though Austria does not possess quite the same governmental, philosophical, and economic principles seen and practiced in the United States, this is nonetheless a direction America could advance toward. Austrian officials, after all, are democratically elected as representatives of constituents. Even with these same officials announcing the temporary suspension of this edict on March 9, thus stopping it before enforcement began, a similar situation could arise in the United States. Vaccine mandates have been shown as diametrically opposed in principle to that of Republican liberty cherished by the West — it follows, then, that those in America who favor further regulations in favor of compulsory vaccination reject the philosophical compromise, rebuke their belief in Republican liberty as something at least comparable in importance to health security, and forsake traditional sociocultural standards. Such is the sociocultural state of affairs at the ultimate end of the Paradox of Authoritarianism.
How should inoculation against disease occur? The answer, writ large, is blunt in its rejection of the simplistic and straightforward — could not be formulated any other way. Compulsory vaccination finds its home in the idea of liberty obligating self-determination to serve towards the betterment of society. Compulsory vaccination, previously contained in ways that minimized economic costs using extensively studied methods, now induces the loss of customers from mandate-abiding businesses, the necessitation of certain market restructuring requirements, and the worsening of labor shortages and unemployment across the country through the onset of the COVID-19 vaccine mandate. Compulsory vaccination in the traditional sense had been an aspect of life considered second-nature by American citizens, something achieved through the careful balancing act performed by the Philosophical Compromise — something under threat by a Coronavirus mandate that ushers in social stratification and tears into the American cultural fabric.
Compulsory inoculation from disease should solely occur, therefore, in the cases where Republican liberty can be preserved and respected as much as possible. It must be remembered, however, that the fundamental contradictions between government mandates and liberty renders it impossible for either to be fully realized, for if this occurs, the other by virtue of their nature must be stamped out of society. Nevertheless, there does exist one glaring flaw in this idea: the fact that setups such as the Compromise, which denotes that public health be advanced through the state-mandated inoculation of children, would make little sense for a vaccine against a Coronavirus that mainly targets the elderly and immunocompromised. While significant, this issue is not unsolvable. An apt workaround would involve recommending the current COVID-19 vaccine rather than requiring it, then when a vaccine can be developed that utilizes tried-and-true procedures to create a preventative formula, it could be phased into the Compromise as another inoculation for children to receive atop the likes of tetanus, polio, and Hepatitis B. The existing vaccine, which minimizes effects but does not fully prevent infection, would be phased out. Perhaps then humanity can begin the dismantling of yet another illness — yet another entry in the perpetual effort to bring Disease’s festering pen off the pages of history for good.