The Washington PostDemocracy Dies in Darkness

Vaccine mandates will backfire. People will resist even more.

Persuading, not dictating, is how Biden can avoid a crisis of legitimacy.

President Biden speaks to reporters outside the White House on Friday. (Evelyn Hockstein/Reuters)
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In recent weeks, calls for vaccine mandates have increasingly been heard: In a column headlined “Stop pleading with anti-vaxxers and start mandating vaccinations,” The Washington Post’s Max Boot implored President Biden to “stop making reasonable appeals to those who will not listen to reason.” Former Health and Human Services secretary Kathleen Sebelius lamented that “we’re going to tiptoe around mandates,” and she’s “kind of over that.” A coalition of medical professional organizations, including the American Medical Association, has asked for “all health care and long-term care employers to require their employees to be vaccinated against COVID-19.”

Meanwhile, there’s a top-down push to get reluctant citizens vaccinated: The White House and the Department of Education partnered with colleges and universities on a “Covid-19 College Vaccine Challenge.” On Monday, the Department of Veterans Affairs became the first federal agency to mandate vaccinations for more than 100,000 of its employees. On Thursday, Biden announced that civilian federal workers must be vaccinated or submit to regular coronavirus testing.

But if this rhetoric and these efforts lead to a de facto national vaccine mandate, it will backfire: Americans from all walks of life resist being told what to put into their bodies, and many will resent any politician or institution that makes them get vaccinated, creating a crisis of legitimacy for any government, university or business that forces constituents, students or employees to get vaccinated. Indeed, the president of the Federal Law Enforcement Officers Association has already said, “There will be a lot of pushback” from members of his organization against the federal employee mandate.

There’s been a lot of hand-wringing about partisan vaccine resistance — according to a recent Economist/YouGov poll, 29 percent of Republicans say they won’t get vaccinated, compared to 4 percent of Democrats — but that doesn’t tell the whole story. In mid-June, according to the Kaiser Family Foundation, when parents of children ages 12 and older (the youngest group authorized for vaccination) were asked by Kaiser Family if they would get their children vaccinated, 18 percent said they would wait and see, 10 percent said they would if required and 25 percent said “definitely not.” As FiveThirtyEight’s Geoffrey Skelley explains, “Unvaccinated Americans tend to be younger” and “more likely to be a person of color. The situation we’re in is not just because of politics but also because of access to the vaccine and broader skepticism of the health care system.”

I got a breakthrough covid infection. The worst part is the conflicting advice.

As Maya Goldenberg, author of “Vaccine Hesitancy: Public Trust, Expertise, and the War on Science” argues in a recent blog post, many of the vaccine-hesitant are well-educated, work in the health-care industry and have questions about how effective the vaccines are at stopping transmission, whether they’re safe to take during pregnancy or if they impact fertility.

On Thursday, The Post reported on an internal document at the Centers for Disease Control and Prevention that cited concerns about the effectiveness of vaccines in preventing the contraction of the delta variant of the coronavirus. On Friday, The Post reported on an analysis of CDC data from Massachusetts finding “that three-quarters of the people who became infected were fully vaccinated.”

Not only won’t mandates resolve many citizens’ concerns on these issues, they could lead many to feel that their concerns are being overlooked.

Furthermore, researchers have found that in some cases, vaccine resistance can be an expression of what the New York Times described as an ingrained “moral preference for liberty and individual rights.” Take NFL player Cole Beasley, who defiantly tweeted:

And the more that government flexes its political muscles to urge or enforce vaccine compliance, the greater incentive there is for populist politicians to push back, reinforcing the idea that the fight over vaccines is a fight about individual liberty: Earlier this month, not long after Biden floated the idea of a door-to-door vaccination outreach effort, Rep. Lauren Boebert (R-Colo.) rallied the crowd at the Conservative Political Action Conference, saying: “Don’t come knocking on my door with your ‘Fauci ouchie.’ You leave us the hell alone” — referencing Anthony S. Fauci, director of the National Institute of Allergy and Infectious Diseases, who has become, since last year, the public face of the nation’s vaccine response.

The debate is also about how much faith individual Americans have in the information they’re given. When Pfizer’s CEO announces that its coronavirus vaccine is 96 percent effective up to two months after a second dose, but only 84 percent effective four to six months after the second dose — on the heels of suggesting that a third “booster” shot may be needed — that raises alarm bells among skeptics. When the CDC goes back and forth on its mask-wearing guidance — loosening recommendations in May and tightening them again now — it invites the charge that public health officials are winging it, rather than making evidence-based calculations.

At a minimum, public health officials have to better educate the public about why the available vaccines are still being distributed with only an emergency-use authorization from the Food and Drug Administration, not full FDA approval. For a public accustomed to drug approval taking years, not months, the Trump administration’s fast-tracking of coronavirus vaccines, hailed by many — including (at least initially) former president Donald Trump — can raise suspicion among others.

Studies have found that mandates can provoke anger rather than encourage resisters to get vaccinated. The implementation of European-style incentives that make life more convenient for the vaccinated and less convenient for the unvaccinated could risk fostering greater resistance.

There’s no reason not to wear a mask — and still plenty of reasons to wear one

In December, Biden said he wouldn’t mandate vaccines but that he would “encourage people to do the right thing.” His position reflected an understanding of the nation he was preparing to lead: That persuading Americans — not dictating to them on how to respond to covid-19 — was both more politically tenable and would better serve his aim of bringing the pandemic under control. In June, Politico reported that the administration succeeded in increasing the vaccination rate for Hispanic Americans by relying on making vaccinations available through federally-backed community health centers. In April, Time magazine reported that the administration planned efforts to involve faith-based organizations and “organizations with ties to rural communities” in its vaccine outreach. That type of approach, with better messaging and less coercion, ought to be sustained and prioritized rather than slowly driving toward mandates.

The administration should go as far in the opposite direction as it can from those who deride vaccine skeptics, such as USA Today columnist Tom Nichols, who referred to vaccine resisters as “cynical and obstinate children” who should be shunned until they “grow up.”

Biden’s words have been measured and conciliatory, but his policies have steadily crept in the direction of the crowd that shows intolerance toward legitimate vaccine concerns.

A democracy must use democratic means — acknowledging unknowns, continuing outreach and avoiding stigmatization — even to combat something as serious and urgent as a pandemic. Making people get vaccinated, by contrast, will likely increase mistrust. Instead of “normalizing” the jab, it risks creating a permanent and hardened segment of our society, primed to oppose government efforts to deal with covid or other public health crises on the horizon.