Immunization

October 01, 2021

My feed from the NY Times this week led with the story of how the US owes its existence as a nation partly to an immunization mandate.  In 1777, smallpox was a big enough problem for the bedraggled American army that George Washington thought it could jeopardize the Revolution.  An outbreak had already led to one American defeat, at the Battle of Quebec. To prevent more, Washington ordered immunizations for all troops who had not yet had the virus.  This was done quietly so the British would not hear how many Americans were sick.  The number of smallpox cases plummeted, and Washington’s army survived a war of attrition against the world’s most powerful country.  Ron Chernow wrote in his 2010 Pulitzer Prize-winning biography of Washington that the immunization mandate, “was as important as any military measure Washington adopted during the war.”  Mandatory immunizations are still part of the military.

While mandatory immunization for many diseases are common and largely accepted, that was not always the case.  In 1901 a deadly smallpox epidemic tore through the Northeast, prompting the Boston and Cambridge boards of health to order the vaccination of all residents.  Some refused to get the shot, claiming the vaccine order violated their personal liberties under the Constitution.  A Swedish-born pastor named Henning Jacobson took his anti-vaccine crusade all the way to the US Supreme Court.  The justices issued a landmark 1905 ruling that legitimized the government’s authority to “reasonably” infringe upon personal freedoms during a public health crisis by issuing a fine to those who refused vaccination.  While immunization treatments became safer (the Revolutionary War method killed 2 to 3 percent of recipients), and mandates became more common, they also tend to generate hostility from a small minority of Americans.

Federal and local covid-19 vaccine mandates requiring immunization seem to be working.  Tyson Foods now has a 91% vaccination rate among its employees.  New York City school teachers and staff are required to show proof that they have received at least one covid-19 vaccine shot.  A California judge ordered vaccine mandates for prison guards and staff, and Gov. Gavin Newsom says a school vaccine mandate is on the table.  There is also opposition to mandatory immunization.  A New York state mandate that all health care workers be required to be vaccinated has sparked multiple legal challenges and fear of staffing shortages.  Since the current administration announced new federal vaccine mandates affecting roughly two-thirds of the US workforce (100 million people) it has received backlash from congressional Republicans, as well as state and local officials.  Many seem to believe saving people’s lives is an “unreasonable” infringement.

Thoughts:  One of the reasons for the immunization mandates for covid-19 comes from the increased risk with the Delta variant.  Roughly 1 in 500 people in the US have died from covid-19, and vaccination rates have slowed despite the uptick in delta variant cases.  Meanwhile, more than 98% of people hospitalized with a covid-19 diagnosis between June and August 2021 were unvaccinated.  The longer the virus goes unchecked the greater likelihood it will mutate into a variant not controlled by the current vaccines.  Our Republican Lieutenant Governor even says, if you do not like wearing a mask and are sick of going to funerals, get the shot.  Immunization is a faster and safer way to reach herd immunity than spreading the virus.  Follow the science.  Change is coming and it starts with you.

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