It’s Way too Early to Discuss a Vaccine Mandate

by James A. Bacon

Four days ago State Health Commissioner Dr. Norman Oliver said he planned to mandate a COVID-19 immunization once it’s safely released to the public. Yesterday Governor Ralph Northam said he’s not planning a mandate, despite what his top health official said.

When asked why the the Governor wasn’t embracing the stance of his top health official, Northam spokesperson Alena Yarmosky said in a statement, “We are focused on accessibility, affordability, and fair distribution of a vaccine—not on a mandate.”

“When a vaccine becomes available, we’re confident that Virginians will seek it out. That’s why we don’t have plans for a mandate,” Yarmosky continued in a separate email, reports WAVY TV.

I’m no expert on the subject of vaccines, to be sure, but it strikes me as way too premature to begin discussing a mandate. Many potential vaccine candidates are being tested, we don’t which one (or ones) will be approved, and we know nothing about the efficacy, side effects and trade-offs of each.

The FDA has issued guidelines saying that the efficacy rates for the COVID-19 vaccine should be at least 50%. Anthony Fauci, director of the National Institute of Allergy and Infectious Disease, has said he would “settle for a vaccine between 70% and 75% effective. Moncef Slaoui, former head of the vaccine program for GalxoSmithKline, has said, “I wouldn’t be surprised it it’s in the  90% [range].” The most effective vaccine ever, for measles, is about 97% to 98% effective. Flu vaccines range between 40% and 60% effective.

The logic for mandating a 50%-effective vaccine is not nearly as compelling as mandating a 98%-effective vaccine. Think of the public messaging problem: We’re going to compel you to get this vaccine even though there’s only a 50% chance it will help you. You’ll never know for sure if you’re protected, so you shouldn’t stop self-isolating and wearing a mask. The only thing you can know for certain is that, if you do get the virus, it didn’t work.

Meanwhile, vaccine experts are warning of potential side effects. Side effects identified in clinical trials of different vaccines include fatigue, fever, headache, muscle pain, and chills. Almost all are relatively mild and certainly preferable to contracting the disease. But they are a factor to consider.

Another concern is that embracing the first vaccine out of the gate might make it impossible to find enough subjects to test other vaccines that would have higher efficacy rates or fewer side effects.

Yet another factor to take into account is development of COVID-19 treatments that can significantly reduce the length of hospitalization and risk of death. According to Statista, there were 544 drugs and vaccines in development for the virus, as of Aug. 20, 2020. Most were in the preclinical phase, but 27 were in Phase 1 clinical, 53 in Phase II, 20 in Phase III, and one in the pre-registration phase. If the fatality rate of the virus falls to nearly zero, that would undermine the case for a mandate.

Given the fluidity of scientific developments, talk of a vaccine mandate would seem wildly premature. We don’t know (1) how effective the first vaccine across the regulatory finish line will be, (2) what side effects it will have, (3) the efficacy of other vaccine candidates following close behind in the development pipeline, (4) whether the COVID-19 epidemic is still raging or coming under control, or (5) what therapies may be available for those who catch the virus.

WRIC TV quoted Oliver four days ago as saying: “It is killing people now, we don’t have a treatment for it and if we develop a vaccine that can prevent it from spreading in the community we will save hundreds and hundreds of lives. “He added: “We would not launch a campaign around mass vaccination with anything that hasn’t proven to be safe.”

A recent NPR/PBS NewHouse/Marist poll found that 35% of U.S. adults would not choose to be vaccinated if a coronavirus vaccine were made available. Del. Dave LaRock,R-Loudoun, has filed a bill to prevent the state from forcing vaccines on individuals whose health or religion prevents them from being vaccinated. However, Oliver said public health takes precedent over choice.

Oliver’s office later clarified that he was sharing his personal opinion as a physician, not commissioner of health.

Cautious as always, Northam seems to be in no hurry to commit himself either for or against a mandate. Yarmonsky, his spokesperson. mentioned “accessibility, affordability, and fair distribution of a vaccine,” which, translated, means the Governor wants to ensure that all segments of the population have access to the vaccine when it comes. That’s a legitimate concern, of course, but it begs the larger questions about choosing between competing vaccine candidates and alternatives.

I’m not impressed by the way anyone in the Northam administration has framed the vaccine-mandate issue. But we can take some comfort in the fact that the Governor is keeping his options open.

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12 responses to “It’s Way too Early to Discuss a Vaccine Mandate

  1. My initial reaction is as it was on the masks: Can they promise we can all get the vaccine? No. Pass all the mandates you want, it will still take months to get this distributed even to those eagerly standing in line. It couldn’t be until fall ’21 that you could require it for school children, given the challenges of getting it out. Adding this to the required vaccinations for admission to school would certainly be in line with past practices.

    There is a whiff of anti-vax hysteria behind some of this. Before COVID came along, other diseases well controlled by vaccination were coming back thanks to those (count to 10….) misguided people.

    I’d much rather have the argument over one or more vaccines than face 2021 without one or more of them.

  2. Order 66 (2021): All customer-facing employees shall be vaccinated. All patrons shall be vaccinated, except those taking a medical exemption. The Health Department and other State agency shall enforce this mandate by taking your business license.

    The governor will publicly state something slightly different that Order 66. There will be a toll-free, anonymous hotline brave citizen storm-troopers may call if they think a business isn’t doing what the Governor said publicly.

    And thus, the businessman order was vanquished and the Republic fell.

    (If you’re not well versed in star wars mythology, then ignore Larry’s confused responses.)

  3. Some folks won’t want the vaccines because they already have been opposed long before COVID19 and this will continue.

    Some will paying attention to what Trump and his minions are saying versus what science is saying.

    Some will equate vaccines with masks…. and their “rights”.

    COVID19 is telling us a lot about ourselves and how we feel about science and government.

    I know.. that’s “confusing”!

    • If Trump rushes, as he has intimated, a pre-Phase 3 vaccine, I’ll let his minions take it first. Dead Republicans have been known to vote, but damned few of them.

      Well, maybe not vote, but they do sign Scott Taylor petitions.

    • If everyone just followed your advice to do what the Governor says, then it wouldn’t be confusing. I’m all for people wearing masks, and getting vaccines, so it would be a lot easier on me too.

      Thing is, reality doesn’t work that way and calling people deplorable minions because they won’t do what you say ain’t gonna fix it (calling people progressive lunatics because they want to tell you what to do doesn’t seem to work either, at least not yet.)

  4. I firmly support vaccination. I just got my flu shot yesterday, I’m up to date on everything else, my daughter is fully vaccinated, and my son will be too when he’s born. The Drs office requested for my my wife to participate in a vaccine trial (can’t remember for what) for pregnant women. We declined. Why, if I believe in vaccines, you ask? Because I prefer to let other people be guinea pigs. The same for this. I won’t be getting a vaccine immediately after release with no long term tests of a vaccine that was rushed through production. I’ll let others take the risk and in a few years when we have a chance to see potential longer term effects then I’ll consider getting it myself. Mandate or no mandate, it’s a firm no for me.

    • Aspirin or Vioxx? Aspirin, thank you.

      Tylenol 3 is okay too. Over the past 20 years, when I had any injury, or medical procedures, and the Doc said, “I’ll write you a prescription for pain,” I always said, “Make it Tylenol 3, or I won’t even fill it.”

      I like the idea of “taken by billions safely.”

      • Wonder if Dorothy Hammill has any regrets about those Vioxx commercials..

        • I dunno. Isn’t there some sort of advertising laws, or liabilities, that prevent celebrity endorsements by people who don’t actually use the product? In which case, she was victimized twice.

          Good ol’ Pat Boone and his acne cream…

  5. What goods a mandate if you can say No?

    If an employee says they won’t wear a mask, they don’t have a job. If a vaccine mandate is implemented, it will be designed to highly “inconvenience” you in some way and will be made political.

  6. The best scientist and doctors in the world make mistakes…. Add in politics and politicians and you have an ugly mess…
    I’ll let the guinea pigs test this stuff for a year or three or more…
    In the meantime at 68 I’ll maintain my health the way I always have..
    Weight under control… right down the middle of the BMI chart (that’s about 10% body fat,,,,, and I’ll bet every other person on this site needs to lose 10 or more pounds) which of course means no diabetes, heart problems etc that go with being overweight… no smoking or other stupid drug stuff that can only kill and no one on this site seems to care, and daily exercise….. and PS…. not taking any pills or prescriptions….
    and PPS…. the one thing all citizens could do to improve their health is lose some weight, easy to do,,, get some of that sugar and other simple carbs out of their lives…
    But no,,, most folks would rather be fat and take pills to sorta keep them going….

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