Some might balk at this comparison, but here are the similarities. Both causes of severe bodily harm are largely preventable — covid-19 through vaccination, and drunken driving by not driving after drinking alcohol. Both are individual decisions with societal consequences.
Both can cause substantial mortality, though deaths due to coronavirus far outstrip those due to drunken driving. About 10,000 people die per year in impaired-driving accidents in the United States, less than the number who died from covid-19 last week alone. More than 650,000 Americans have succumbed to the virus thus far, which is more than all recorded intoxication-related fatalities in the last 40 years combined.
As two statistically minded people, a public health physician and a neuroscientist, we suggest an additional way to consider this analogy, using the concept of relative odds. For both drunken driving and going unvaccinated, we asked the same question: How large is the increased risk? Our standard for comparison is the likelihood of accident or death when the risk factor is not present.
In the case of coronavirus, recent data from the Centers for Disease Control and Prevention shows that vaccination reduces the risk of becoming infected by a factor of five and the risk of death by 11. This is comparable to the risk of a crash when driving drunk, which is 14 times higher than for a sober person.
Some who argue that vaccination is solely a matter of individual choice would say that you can choose to protect yourself. If you’re vaccinated, why do you care if others around you aren’t? But again, consider the analogy: Three out of every eight people killed are not the intoxicated driver, but their passengers or people in other vehicles. Similarly, with covid-19, the risk is borne not only by the person making the decision but also by others who cross their path.
The vaccine is simultaneously like a great seat belt and a choice to drive sober. The seat belt reduces your chance of severe injury in an accident. Driving sober reduces the risk of the accident in the first place. The vaccine does both, but it still matters if you’re surrounded by reckless drivers. No vaccine is 100 percent effective, and the more virus is around us — in this case, carried by the unvaccinated, who are five times more likely to be infected and thus to spread coronavirus — the more likely the vaccinated are to become infected.
Then there’s the matter of children too young to be vaccinated and the medically frail who could become very ill if they have even a mild breakthrough infection. Why should their right to remain free from covid-19 be secondary to the right of someone not to be vaccinated?
Detractors might say that being unvaccinated is not the same thing as knowingly driving while impaired. That’s true, just as it’s true that many drivers who may have a blood alcohol level above the legal limit may not be driving dangerously. Most of the time, such drivers will not get into an accident. And some drivers who aren’t intoxicated could also cause a crash. But none of this negates the fact that drunken driving increases the risk of accidents and is therefore a hazard to the public.
Impaired driving differs in one important way from remaining unvaccinated: It carries legal and social penalties. We are not suggesting criminal liability for the unvaccinated. But we are pointing out that civilized society exists in part to protect the public’s health and safety. In 2015, conservative commentator Ben Domenech argued that “the protection against life-threatening plague is one of the original reasons government exists.”
Want to remain unvaccinated? That’s your choice. But just as it’s your choice to drink alcohol and then have someone else drive you, individuals who wish to forgo the vaccine should then comply with masking and distancing when around others.
If you decide to remain unvaccinated and are still going out, unmasked and unconstrained, to restaurants, gyms, bars and concerts, that no longer affects only you — similar to if you decide to get behind the wheel of a car while impaired. Your right to remain unvaccinated stops when you interact with those who did not choose to become exposed to a potentially deadly disease.
With the pandemic raging here, the United States should look to France, Israel, Italy and other countries that have instituted vaccination requirements in public settings. Awareness campaigns and stricter laws have reduced drunken-driving-related deaths by half. Analogous measures applied to the 80 million unvaccinated people in the United States can save many lives from covid-19 as well.