In the next couple of months, America’s vaccination program is likely to undergo a radical shift. Suddenly gone will be today’s world of vaccine scarcity, where the anxious and eager spend hours scouring the Web for elusive appointments. We will enter the land of vaccine overabundance, where public health officials prod, wheedle and beg hesitant adults to please come in and get their shots.
At that point, we’ll collectively confront questions that have mostly been theoretical: What’s the best way to overcome the understandable anxiety of those who worry about undetected dangers of novel vaccine technologies? How do we locate vaccination centers to be convenient for people in rural areas?
Most controversial will be this question: What circumstances justify requiring vaccination? Can it be mandatory for someone to work in a nursing home, enroll in a public school, attend a concert, get on an airplane? Which is to say, how much risk should the rest of us have to accept to respect the conscience rights and bodily autonomy of fellow citizens who don’t want to get vaccinated?
In December, I had a spirited Twitter exchange about this with Noah Rothman of Commentary Magazine. I was, and remain, strongly in favor of vaccine passports. But Rothman isn’t wrong to worry about the effects of a society as divided as ours further partitioning itself with an “immunity caste.” The caste line is likely to harden existing educational and partisan barriers that are already dangerously ossified.
We also need to reckon with the pragmatic concerns raised by Michael Brendan Dougherty of National Review, who notes that while vaccine passports are often sold as a way to open things up, they would actually “close things down, because it bars people from doing things they’ve already been doing throughout the pandemic: shopping, traveling, gathering together, attending weddings and funerals. You would be instituting new and harsher restrictions at the very time the pandemic was ending.”
Raising the privacy costs of, say, booking travel or concert tickets might curtail economic activity that we’re desperate to restore. And the strictures would disproportionately fall on not just poor or rural Americans but certain groups who aren’t eligible for vaccination, including children.
As a libertarian, I’d add that creating a vaccine passport creates an instrument of some coercive power; if such a thing exists, private entities will use it. Which of course is the point; advocates are trying to create a better incentive for vaccination than free doughnuts. All of us should be wary of initiatives that effectively create a condition of participating in public life — especially if coercion becomes a substitute for persuasion.
And yet we should remember that the unvaccinated aren’t the only ones at risk of being shut out of normal life; there are also the people whose immune systems can’t make good use of a vaccine. A recent study of 436 transplant patients nationwide, whose immune systems are suppressed to prevent rejection of their new organs, showed poor antibody response after the first shot of an mRNA vaccine. Between cancer patients, transplant recipients and people receiving treatment for autoimmune diseases, a lot of Americans are on immunosuppressive drugs. Shouldn’t we worry more about them than about the people who choose to stay vulnerable to COVID-19?
We should worry, too about the cost that choosing not to get vaccinated imposes on everyone who is vaccinated: creating a reservoir of disease that can spread to us, whether because our immunity wanes or because a variant mutates enough to evade our defenses. People would get sick: some might die and many others might need booster shots. If someone gets to force extra shots on someone else, I’d argue it should be the people who have already chosen to protect not just themselves but also the community.
As for the economic costs, I’m skeptical that the net effect of vaccination passports will be to reduce economic activity. Rather, we’re making it less costly for people who are relatively risk-averse and have been avoiding public places, and more costly for the more risk-tolerant who don’t want to get vaccinated. Before vaccines, there were good arguments for both sides of that tradeoff, but as vaccines become broadly available, banning vaccine passports would essentially be subsidizing pointless risks.
That’s not to say there aren’t real concerns to address, even beyond those Rothman and Dougherty raise. Vaccine passports are going too far if they become so ubiquitous that they are effectively a mandate — if, say, you need one to enter a grocery store or access health care. They should not be deployed until everyone has at least a chance to get a shot. And they must be paired with aggressive efforts both to overcome people’s fears and make it as convenient as possible to get vaccinated.
Most important, we should remember the real costs we’re imposing on others, and ourselves, by choosing this course. Vaccine passports may be the best of a set of bad options, but that doesn’t make them a good thing.
Follow Megan McArdle on Twitter, @asymmetricinfo.