COVID Passports Redux

Competing analogies and externalities.

In Sunday’s post “New York Launches COVID Passport,” I responded to Jazz Shaw‘s concerns over the inequities the program would cause. Yesterday afternoon, he responded. What follows is my response to his response.

I should note at the outset that, while many readers will dismiss his commentary straight away because it appears under the Hot Air banner, I know Jazz a bit, having met him a few times at CPAC and other blogger gatherings and spoken with him on the phone and texted with him more recently to check on the status of our erstwhile co-host Doug Mataconis, with whom he is friends. While it’s fair to say that he’s more conservative than me at this point, I believe his arguments to be from sincerely-held positions rather than a regurgitation of Fox News talking points or some attempt to stir the pot or “own the libs.”

His first objection is to my assertion that these passports allow those who are vaccinated or have a recent positive test to bypass current restrictions, which I see as different from denying existing privileges to those who refuse to comply.

Let’s compare this situation to a scenario where there is an island suffering under famine conditions where everyone is starving. Then a government representative comes along and gives out magical cards to half of the population who were able to complete some government-mandated task. The card opens the door to an all-you-can-eat buffet. The remaining people, many of whom were unable to even get a chance to attempt the task, and others who refused, are, under James’ explanation, being told not to worry. It’s okay. You were already starving anyway, so nothing has changed. That sounds like a good way for a government representative to be ejected from the island by way of a plank over a shark-infested lagoon.

Reasoning by analogy is an excellent way to resolve these sort of disputes. As Malcolm Gladwell notes in a series of episodes in season 4 of his “Revisionist History” podcast, this is how the Jesuits became so famous for dispute resolution:

The Jesuits are intellectual, austere, and 500 years ago, the Jesuits pioneered a specific approach to solving problems that were new to the world. It’s called casuistry. […] [W]hen it comes to new problems, you can’t start by appealing to a principle. Principles don’t help because principles are the product of past experience and they’re only helpful so long as you’re still living in the world those past experiences helped create. When you’re confronted with a situation you haven’t encountered before, then you’re in uncharted territory. In those situations, the Jesuits argue, you have to proceed on a case-by-case basis. […] Thomas Aquinas, in the 13th century, wrote that a general rule applies generally and the more you descend into the particulars, the more it’s no longer a general rule. “Descend into the particulars,” understand what is distinctive about the case under consideration. That’s what the Jesuits started to do. How? First, they would find a standard case. That is, a case that’s in the same general territory where we’ve already reached agreement. So usury looks like an insurance premium and everyone agrees that usury is wrong. That’s a standard case. The Jesuits say, though, there’s another relevant standard case. Think of the captain of the ship, he’s also a kind of insurance. People pay him something like a premium to make sure the ship travels safely from point A to Point B and everyone agrees the captain is a good idea. Next, the Jesuits create what they call a taxonomy. They ask how close does the case in question come to the standard cases? So is the premium paid for maritime insurance more like something you would pay a loan shark or more like the money you would pay for a good captain? So they keep looking for all sorts of similarities and then they look for where’s the breaking point, where is it no longer legitimate.

So, we have taken to calling these indicators of vaccination “passports.” Passports are a standard case. They’re a form of government-issued identification that allows people who have met the legal requirements to travel to prove that they have done so and, in the modern age, accepting officials may scan them against a database to ensure that the person has not subsequently been deemed ineligible for travel.

Jazz says that, no, they’re not really like passports at all. Instead, they’re more like food for the starving and, we both agree, it would be wrong of the government to withhold food from starving people who had either refused to comply with some requirement or, worse, were medically unable to comply with the requirement or unable to secure an appointment to do so because the supply of appointments was exceeded by the demand.

Assuming I’m laying out the competing cases correctly, I believe the Excelsior Pass is much more like a passport than denying food to a hungry man while feeding others.

It helps his case considerably, though, if you add in that it is the government that created the “famine” to begin with and is now using the prospect of food in order to force compliance with “voluntary” inoculation. Jazz doesn’t make that argument directly but it’s a reasonable surmise from the facts.

Still, I believe it to be a poor analogy. New York’s governor did what most (but certainly not all) state governors and most (but not all!) governments in developed countries did in imposing various restrictions to normal activity to contain the spread of a novel coronavirus that has killed some 2.8 million people worldwide, 563,219 in the United States, and 50,441 in New York state alone.

Whether the restrictions were to draconian or lasted too long is certainly debatable. But, given the near-universality with which they were implemented and the near-consensus within the relevant medical communities that they were necessary, I would argue that they were more akin to mandatory evacuations ahead of a forecast natural disaster or a curfew during a period of civil unrest than starving one’s population to force them to bend a knee.*

No, of the two analogies, I believe “passport” is much closer. The government has a legitimate interest both in containing the spread of a deadly virus that spreads through casual aerial transmission and in getting the economy fully reopened so that people can get back to a more normal lifestyle. It is issuing an easily-checked ID to allow people wishing to enter certain public venues to prove that they’re unlikely to be infected.

Relatedly, he rejects my premise:

Also, even if we’re only looking at the optics here, I’ve seen the demo images of how the app functions. You wave your phone at the scanner and if you have a valid passport, a green check mark pops up and you’re allowed in. If not, a big red “X” appears and you are informed that you need to move along. I don’t know about you, but that certainly sounds like you’re being “denied access” to me.

Well, sure. But I don’t argue that those without a valid Excelsior Pass won’t be denied access to various venues but rather that they’re already being denied access. The state has restrictions on how many people can go into various public venues in order to allow sufficient space for social distancing. This system will give venue operators who wish to use it an escape hatch that allows them to return to normal capacity so long as the people can demonstrate that they’re at low risk for spreading COVID.

Next, he argues that I understate the number of people who may never get the shot:

The website that James is citing in saying that only people who have a history of severe allergic reactions are suggested not to get the shot is from Yale University. And it’s true that people who are subject to anaphylactic shock, particularly those with shellfish allergies, are being steered away. But when you check in with the CDC, that’s not the end of the list. People with autoimmune conditions and compromised immune systems are being told that there is no data from the trials to indicate that the vaccine won’t have a negative impact and they should consult their doctors before proceeding. The same goes for people with a history of serious respiratory ailments. If they consult their doctor and are told that there’s a chance this could go badly, do you think they’re going to whistle a merry tune on their way down to get a jab? That list is adding up to a lot of people already. What about them?

That’s a fair point. In my view, this is yet another case of the CDC being too cautious. They talk out of both sides of their mouth in these warnings, simultaneously stating that there’s no reason to think that any of those groups shouldn’t get those shots but that, out of an abundance of caution, they should seek out advice from people who almost certainly know less about the issue than the CDC. But, regardless, Jazz is right that this ass-covering refusal to provide clear advice might well scare a lot of folks away.

My “What about them?” response remains the same, though: they’re at increased risk to themselves and others and should act accordingly. Hopefully, enough people can get the vaccine to achieve herd immunity and allow those who can’t get the vaccine to return to normalcy. Until then, though, I don’t think these people should be allowed to put everyone else at risk.

There, I think, is our most fundamental agreement. While Jazz agrees with me in principle that those who refuse to get the vaccine should have to live with the consequences, he doesn’t think the government should be restricting their freedom in this manner to begin with.

If the government manages to jam through a program like this and make it permanent, there will be consequences for those who are considered safe to receive the vaccine and choose not to do so. But in a scenario where the consequences under discussion come in the form of government actions against citizens, there’s another layer to that onion. The government can only [exert] that type of power over you if we collectively allow them to do so. Your recourse at that point comes at the ballot box. And if this game runs the course that I’m expecting it to, you’ll want to keep that very much in mind.

Jazz and I share a libertarian bent. We both see liberty as the reasonable default position and are skeptical of government taking away liberties. But it’s a fundamental principle of libertarian thought that a person’s right to swing their fist ends at another man’s nose. Or, as John Stuart Mill put it in On Liberty,

[E]very one who receives the protection of society owes a return for the benefit, and the fact of living in society renders it indispensable that each should be bound to observe a certain line of conduct towards the rest. This conduct consists, first, in not injuring the interests of one another; or rather certain interests which, either by express legal provision or by tacit understanding, ought to be considered as rights; and secondly, in each person’s bearing his share (to be fixed on some equitable principle) of the labours and sacrifices incurred for defending the society or its members from injury and molestation. These conditions society is justified in enforcing, at all costs to those who endeavour to withhold fulfilment. Nor is this all that society may do. The acts of an individual may be hurtful to others, or wanting in due consideration for their welfare, without going the length of violating any of their constituted rights. The offender may then be justly punished by opinion though not by law. As soon as any part of a person’s conduct affects prejudicially the interests of others, society has jurisdiction over it, and the question whether the general welfare will or will not be promoted by interfering with it, becomes open to discussion. But there is no room for entertaining any such question when a person’s conduct affects the interests of no persons besides himself, or needs not affect them unless they like (all the persons concerned being of full age, and the ordinary amount of understanding). In all such cases there should be perfect freedom, legal and social, to do the action and stand the consequences.

This is what I meant by “negative externalities” in my previous post. People refusing to get vaccines put others at risk. Further, they make it necessary for others, including those vaccinated, to continue wearing masks, maintaining social distancing, and all the rest.

I don’t love any of this. While Virginia was pretty early in adopting statewide shutdowns, it has been less draconian than California, New York, and others in restrictions after the first few weeks of “flattening the curve.” There are still significant restrictions on restaurants and the like. More frustratingly, the schools are just now opening for in-person instruction and only in half-measures; that’s ostensibly changing in the fall.

But, like it or not, most of us live in a low-trust society. Few live in a “Mayberry,” where everyone knows one another and is naturally going to look out for each other by doing the right thing. Most people we encounter are strangers and there’s little incentive save intrinsic decency to look out for their well-being.

That leaves us with three choices: 1) we simply accept the risk that comes with that reality and let the virus run its course; 2) accept government intervention in the form of continued restrictions until herd immunity happens on its own; or 3) accept government interventions in the form of vaccine passports, which not only frees people up to return to normal faster but also acts as a nudge to faster vaccination and, hopefully, herd immunity.

A lot of Hot Air readers, although I suspect not Jazz, would prefer option 1. It maximizes freedom in the libertarian, negative sense: people are free to do what they want without coercion from the state. My problem with that is that it negates the very reason for creating states in the first place. We have seen what happens when there are no restrictions: the worst among us will act with reckless disregard for their fellow man, with the rest either forced to segregate themselves even more than is the case with option 2 or accept a significantly-increased risk of death.

Option 2 is arguably the most “fair,” especially in a world where not everyone who wants a vaccine can get one or, indeed, are recommended not to do so because of prior medical conditions.** That’s a legitimate concern and it’s more problematic still when it’s the government both imposing the restrictions on normalcy and dictating who is at the front of the line. In my judgment, though, that’s outweighed by the economic benefits of accelerating opening and the aforementioned nudge factor.

____________________________

*It occurs to me that a more plausible analogy that Jazz might have deployed instead is requiring a photo ID to vote. That’s much closer to the Excelsior Pass than his starvation example. Like a passport, an ID card is a government-issued means of proving you are who you say you are. And, in both the cases of travel and voting, they’re fundamental human rights that are being withheld absent compliance with the requirements to obtain the necessary documents. And it has the benefit for his side of the debate that I’m on the record as being opposed, which would be useful except that he‘s in favor of it! While I reflexively agree with him that it’s not all that hard to obtain a photo ID, having carried one since I was 10, I’m mildly opposed to requiring a photo ID for voting because we know that it disproportionately harms disadvantaged populations, making it more difficult for them to vote (a more fundamental right than going to a restaurant or wedding reception) with very little public benefit (the evidence for the type of voting fraud that would be stopped with a photo ID is next to nonexistent).

**While there is no Excelsior Pass equivalent in Virginia yet, I’ll soon be eligible. I’m scheduled to get my second shot tomorrow and will therefore be “fully vaccinated” two weeks later. Alas, that will do me little good until my wife gets her shots and we have no projection yet as to when that will be.

FILED UNDER: *FEATURED, COVID-19, Society
James Joyner
About James Joyner
James Joyner is Professor and Department Head of Security Studies at Marine Corps University's Command and Staff College and a nonresident senior fellow at the Scowcroft Center for Strategy and Security at the Atlantic Council. He's a former Army officer and Desert Storm vet. Views expressed here are his own. Follow James on Twitter @DrJJoyner.

Comments

  1. Daryl and his brother Darryl says:

    Amusing that the same people who scream for ID requirements for voting are now screaming that this is the work of Satan, and the Mark of the Beast!!!
    Proof that you have been vaccinated is nothing more than proof you are smart, or more accurately, that you are not some kind of deranged conspiracy theorist.
    Being able to separate out those people easily seems like a benefit to society.

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  2. Daryl and his brother Darryl says:

    @Daryl and his brother Darryl:
    Not to mention that similar things have existed forever and haven’t been a problem. Immunization records are often required for travel.
    When did Republicans become universally dumb? It’s really becoming tiring…

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  3. Blue Galangal says:

    @Daryl and his brother Darryl: I mean… in my former job, my boss, who traveled widely on several continents, had an “immunization record” that he carried around and got updated when he got vaccines. This is nothing new. This is *old* technology that our country (and others) have recommended/required for donkey’s years.

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  4. Kathy says:

    Yeah, that analogy sucks. A better one would be this:

    Imagine there’s a deadly pandemic and finally a vaccine becomes available. Next the government wants to limit the lifting of restrictions to those who have received the vaccine, because their risk of either catching or transmitting the disease to the unvaccinated is now very low.

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  5. Scott says:

    I just listened to a podcast just yesterday on this subject.

    In the Bubble: Toolkit: Will I Need a Vaccine Passport‪? Find it wherever you get your podcasts.

    Dr. Bob teams up with NYU medical ethicist Arthur Caplan to tackle your questions about what exactly vaccine passports are, when they might be a reality in the US, how to make sure they’re handled equitably, where you’d need to show them, and much more. Dr. Bob says vaccine passports will dominate conversations this summer, so get ahead of the curve and dive into the topic right now with this Toolkit!

    A couple of point jumped out at me.

    – There are a number of legal issues that derive from the fact that the vaccines are still under Emergency Use Authorization
    – International travel will drive a lot of this
    – Businesses will drive the requirement initially rather than government
    – Our chaotic healthcare system will be a big hinderance to actually showing proof of vaccination
    – Definitely a lot of precedent to requiring vaccines (international travel, schools, etc.)

    It will be interesting to see this play out

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  6. James Joyner says:

    @Blue Galangal: More-or-less, yes. We’ve required, for as long as I can remember, proof of vaccination to enroll kids in public schools (mandatory!) and international travel (voluntary).

    @Kathy: Ha. Well, Gladwell would argue it’s a novel case and that people who don’t agree with you aren’t going to be convinced, so you’re better moving off a standard case. You could start with, for example, requiring vaccines for schoolchildren and see if that person agrees that it’s a reasonable policy.

    @Scott: The “Emergency Authorization” angle is big. It’s ostensibly why so many in the military are opting out—and are being allowed a choice to begin with.

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  7. Scott says:

    Hopefully, enough people can get the vaccine to achieve herd immunity and allow those who can’t get the vaccine to return to normalcy. Until then, though, I don’t think these people should be allowed to put everyone else at risk.

    I mentioned this in the Tues Forum but I have my doubts about herd immunity. The number thrown around is 75-80% (though the new variants have a higher R nought number and will require a higher percentage). Since the under 16 population is around 20-25% and combined with the normal amount of recalcitrant malcontents, I don’t think we are going to reach it. The antivaxxer movement is growing. It’s where the loony left meets the loony right and it won’t be good.

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  8. gVOR08 says:

    Lets modify Shaw’s analogy to make it a bit more analogous. Let’s add that the reason there’s a famine is that a tsunami destroyed the only dock and food shipments can’t be unloaded. Then let’s make it not an arbitrary task but doing a day’s work on repairing the dock. Add that there are only enough tools and material for a few people to work on the dock, but the government has a crash program cutting timber and forging hammers and in a few months anyone who’s willing will be able to work a day on the dock and get a permanent pass for the buffet. And as the dock is partially repaired just enough food can be offloaded to support the buffet. And there are a small number of people physically unable to work on the dock but they can still get into the buffet if they can show they are unable to work and don’t currently have the measles. (I believe you noted yesterday a current negative test would suffice for the passport.) In order to reason from analogies, the analogy must be, well, analogous.

    Would Shaw still feel the slackers and free riders should be entitled to the buffet? Shaw’s arguments smell of an underlying belief that COVID is just the flu and masks and restrictions are just arbitrary acts of repression. I fear you give his argument more respect, and a more serious response, than is due.

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  9. Michael Cain says:

    @Daryl and his brother Darryl: When I was in grad school most recently, my acceptance letter included a section that pointed out it was “provisional” until I produced a vaccination history. Or, being an oldster, a birth certificate or other acceptable document that showed I was old enough they could assume I had all the common childhood diseases we now vaccinate against. During the first quarter I met a freshman who had had a bitter fight with his mother when he spent the summer before school started going through a compressed schedule of shots to get all the childhood vaccinations.

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  10. Teve says:

    Pfizer announced Covid vaccine trials on kids 5 days ago. Vaccinating kids is months away, but it’s coming.

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  11. gVOR08 says:

    @James Joyner:

    The “Emergency Authorization” angle is big. It’s ostensibly why so many in the military are opting out—and are being allowed a choice to begin with.

    IIRC there was a case during Gulf War I of a reservist who fought a combat assignment arguing that he never agreed to let the Army tell him to do something dangerous. He lost, presumably on the grounds that when he signed up it was obvious that ordering people to do dangerous stuff is what the Army is for. Now your telling me the Army has opted out of that point of view? They’re going to fail to reach herd immunity in the ranks by accommodating vaccine reluctance?

    And the worst of it is that with a bunch of Koch fueled libertarians on the Supremes, the Army might lose a similar case.

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  12. Daryl and his brother Darryl says:

    @Kathy:
    A better one would be this:
    Imagine there’s something as innocuous as official immunization records, that you keep with your travel documents, which have existed “forever”. Then imagine that ~40% of a certain nation had lost their collective minds and became part of a cult that worships a fat orange deity in elevator shoes.
    That’s the only operative analogy.

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  13. Kathy says:

    @James Joyner:

    I vaguely recall that Gladwell episode. I’d argue that one year experience with a pandemic makes it one of the better known cases for the global population at large.

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  14. Teve says:

    @Michael Cain: when I started college in my early 20s I wasn’t in communication with my parents and it was easier just to get all the vaccinations again. And I’m very pro vaccine so I didn’t mind anyway. MMR, TDAP, etc etc.

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  15. Jen says:

    @Blue Galangal: I too, have an immunization record. So does, IIRC, our host Dr. Joyner. It’s a yellow WHO immunization record book.

    When my husband and I traveled to Morocco for vacation some years ago, we were told by the company coordinating our travel that we needed proof of vaccination for something (I can’t remember which shot now). We took our shot records, went to the doctor, and got our boosters. This was recorded and we went on vacation.

    I genuinely don’t understand why this “BUT MY FREEDOM” nonsense is being entertained. Kids need vaccinations to go to school, and this used to be strictly enforced. It’s only recently that all of these ridiculous loosening of these mandates has been permitted, and it appears to be making society dumber.

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  16. JKB says:

    @James Joyner: The “Emergency Authorization” angle is big. It’s ostensibly why so many in the military are opting out—and are being allowed a choice to begin with.

    Right now, the vaccine passport idea is not based on science. Right now, the “vaccines” are only documented for emergency use as having a high efficacy at preventing symptomatic COVID-19. They have proven quite effective in this limited aspect. Data from those who’ve have the prophylactic injection of chemicals does look very promising for conferring immunity to the SARS-CoV-2 virus, even sterilizing immunity (meaning you don’t shed the virus if exposed).

    So right now, all the vaccine passport would do is say these people who are unlikely to need medical assistance if exposed to the SARS-CoV-2 virus. Of course, that naturally applies to all under the age of 49 according to the case/hospitalization/death data for the virus. The “vaccines” may have a 95% efficacy (depending on age), but those under 50 only have a 0.5% chance of death if they get the virus and few are hospitalized with to treat COVID-19 illness.

    So really a vaccine passport, even if/when the vaccines are proven to confer sterilizing immunity, will only indicate that the passport holder is not a threat to the an unvaccinated person over 50. Right now, it would only mean, according to the FDA emergency use approval, that those with passports are unlikely to need medical assistance if they are exposed to the virus.

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  17. Daryl and his brother Darryl says:

    As all of this is discussed I like to keep in mind that upwards of 40% of the Americans who have died from COVID, died needlessly because of the Republican parties ineptitude. So anything, that any Republican has to say, should be regarded in that light.

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  18. Jen says:

    @James Joyner:

    “….and international travel (voluntary).”

    What are you saying is voluntary here, the travel, or the vaccination? Travel is not always voluntary. I grew up overseas and am lumping employment in here–if your employer transfers you overseas, yes you have the option to leave the job. What I’m saying is that you can’t take the transfer but then refuse to be vaccinated, many countries won’t let you in.

    Similarly, our trip to Morocco was voluntary–we wanted to go there on vacation. But the booster shot wasn’t voluntary, we had to have it or we couldn’t get in the country. Etc.

    The bottom line is that the government–whichever one it is–has the right/responsibility to protect public health. They also ostensibly have the responsibility to support economic recovery. Both of these things are strongly aided/supported by stopping the spread of a potentially deadly virus. Why is this so hard for many to comprehend?

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  19. Daryl and his brother Darryl says:

    @JKB:
    But I should have an ID to vote, correct?

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  20. Joe says:

    @Teve: When I was a kid, I would occasionally bring my mom a school form for her to complete my vaccination history. She would just sit right down and complete it without reference to any documents. The same for my several siblings. When I got old enough that I ought to know this for myself, I asked her how she could remember all the shots and dates. She told me that she just made all the dates up because she knew we all got the shots.

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  21. Raoul says:

    Fun column this was. I would think that someone that is immu-compromised would welcome vaccine passports for obvious reasons. Also, they way I have read it, the vaccine passports will come from private entities so then what according to the conservative mind? I think the conservative mind often gets confused between privileges and rights.

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  22. Daryl and his brother Darryl says:

    @Jen:

    Why is this so hard for many to comprehend?

    Because they are Republicans and so, ipso facto, are dumb.

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  23. Barry says:

    James, the thing here ofr me is that the right has overwhelmingly used bad faith arguments from the very beginning. It’s been quite deliberate, and any contradictions have been a selling point (e.g., a hoax that’s also a Chinese biowarfare attack).

    In addition, the right is overwhelmingly in favor of higher and tighter ID requirements for voting.

    I favor some *medically necessary* exemptions, but “I don’t want to” is not one of them.

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  24. James Joyner says:

    @gVOR08:

    Now your telling me the Army has opted out of that point of view? They’re going to fail to reach herd immunity in the ranks by accommodating vaccine reluctance?

    I’ve had former Army colleagues tell me they’re not getting the vaccine because they don’t think it’s safe. I pointed out that they pumped all manner of shit into us on the way to Saudi, so what’s one more?

    Still, I think all of the shots they required of us back in 1990 were approved under normal order. The COVID vaccines have been rushed through under emergency rules. I think that’s appropriate —and indeed think we should do that more regularly—but can understand the reluctance to order it. Especially since the military population (young, healthy) is very low risk from serious consequences from COVID.

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  25. Michael Reynolds says:

    This is why I so often contemplate going expat. It’s not that other countries don’t have tendentious ideologues complicating even the simplest things, but they’re not my tendentious ideologues, so I can chalk the stupid up to being ‘foreign.’

    My entire adult life ‘conservatives’ have argued against requiring ID* because: 666, mark of the beast, dontcha know. Now, they’ve discovered that Black people vote, so in an instant they all changed sides and now demand government ID’s. But oops, not a covid passport because hey, that has nothing to do with stopping Black people from voting but could lead to the Fascist Amerika that they actually crave, while pretending to be civil libertarians.

    *Thanks, by the way. Super helpful when I was a fugitive.

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  26. Kathy says:

    Let’s switch analogy for a principle: personal responsibility.

    It is everyone’s responsibility to take care of one’s self in order to maintain good health. It’s also everyone’s responsibility not to expose others to dangers to their health.

    Many on the right refuse to do either by maintaining social distance or wearing masks. now they are refusing to get vaccinated.

    This leads me to ask the question: what the f**k do they expect will end this pandemic without much greater loss of life and more disastrous damage to the economy? Thoughts and prayers’ Magic? Miracles?

    Take some responsibility for your actions and get the shots. and stop acting like toddlers who think their tantrums are all powerful.

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  27. Andy says:

    While this has been an interesting intellectual exercise to read, I think it’s ultimately irrelevant. In a couple of months, almost all Covid restrictions will be lifted and the need for some kind of passport will be pointless. Heck, changes here in Colorado mean that I’ll likely be able to visit my sister face-to-face in her memory care facility next month. Our governor is already working on the timing to rescind the mask mandate.

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  28. Gustopher says:

    In the end, it all comes down to how you answer this: Is this a health issue with civil rights implications, or a civil rights issue with health implications?

    It’s a bad analogy, but it reminds me of this:

    I’m queer. I’m not allowed to give blood* because of the risk of HIV, despite the blood being tested for it, etc. A lot of folks in the LGBTetc community found this vile, dehumanizing, based in bigotry, etc., and many of them would just lie and give blood anyway.

    Throughout the 90s and the 00s, this was a surprisingly big issue for queer folks. It seems to have gone away when same sex marriage was legalized, and I would say that it was more of a cultural marker of acceptance rather than a deep desire to give blood.

    At no point was I ever tempted to violate the rule, lie and give blood. Even though I was sure that the rule was bullshit. We have a government, and we have professionals making these decisions, and while they may sometimes be wrong or bigoted, it’s a health issue first with mild civil rights implications. It’s part of the social contract.

    It’s a bad analogy to the vaccination passports, because all that I am being denied is a small pin after donating 5 gallons. But fundamentally, it’s the same dilemma — is it a health issue first, or a civil rights issue?

    (It might not be a bad analogy to the masks though — do you substitute your own beliefs over those of the experts and the government when the cost of compliance is minimal? And there were some very performative gays who would be as stereotypically gay as possible while claiming not to be so they could donate blood)

    (And now I’m reminded of the people who insist on using phones to text while on an airplane. Does the social contract require you to follow rules that you think are dumb, which cause a minor inconvenience, and which if you’re wrong about will kill a lot more people than just you?)

    ——
    *: this policy might have changed since I was put on blood thinners and have another reason why I can’t give blood.

    Also, everyone eligible should give blood. I bleed a lot, so I might need it. And if I don’t, someone else will.

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  29. Andy says:

    @Gustopher:

    I’m queer. I’m not allowed to give blood* because of the risk of HIV, despite the blood being tested for it, etc. A lot of folks in the LGBTetc community found this vile, dehumanizing, based in bigotry, etc., and many of them would just lie and give blood anyway.

    I couldn’t give blood for about 15 years simply because I lived in the UK during the mad cow outbreak there. When younger, I couldn’t give blood for five years after taking Accutane, a common acne drug.

    The people managing the blood supply are extremely risk-averse. That’s probably a good thing.

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  30. drj says:

    This is what I meant by “negative externalities” in my previous post. People refusing to get vaccines put others at risk.

    This, of course, is the key point and why the famine analogy fails.

    In fact, the famine analogy only works (sort of) if the wellbeing of others is wholly disregarded – which, of course. is typical for “conservative” thought (or conservative “thought,” if you prefer).

    Same thing with gun control. Metal detectors at school entrances, transparent backpacks for students, and active shooter drills are never part of the equation because they concern others – who should simply take care of themselves.

    Pollution/climate change? Likewise.

    It’s all so infantile.

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  31. Jen says:

    @Andy:

    The people managing the blood supply are extremely risk-averse. That’s probably a good thing.

    Indeed it is. I read the book “Nine Pints,” and there’s considerable background in that as to why blood donation centers are so risk-adverse.

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  32. Gustopher says:

    @Andy:

    The people managing the blood supply are extremely risk-averse. That’s probably a good thing.

    Of course, they also used to restrict blood donations by black people, so ¯\_(ツ)_/¯

    Not all of their decisions are correct, or reasonable, or without bias. But, the consequences of not following their decisions are to increase the risk to everyone else, when you get the wrong rule.

    I mean, look what happened when they restricted blood donations to just white people. They started giving black people white blood, and then they started wanting to vote, and got all concerned about their property values… 😉

    Ok, bad example.

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  33. steve says:

    Wouldnt a better analogy be that we already require kids to be vaccinated in order to attend school? You need some vaccinations, and proof of such if you are an international traveler coming to the US. So we already have precedent for requiring vaccinations, and providing that proof, to participate in the broader world.

    Steve

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  34. R. Dave says:

    Respectfully, I have to say that both the passport and famine analogies are kind of terrible! The fundamental nature of the issue is that the government is restricting people from engaging in various activities that pose a risk to others unless they can demonstrate that they’ve taken certain specified risk-mitigating steps first. And happily, we have any number of highly analogous requirements available and in common practice – everything from driver’s licenses, to certain occupational licensing requirements, to various mechanical safety inspection certificates, and so on. No need to reach for some fantastical island famine scenario here!

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  35. R. Dave says:

    Also, I have to wonder whether Jazz Shaw favors or opposes legislation that prohibits private employers and businesses from requiring proof of vaccination as a condition to employment and/or entry. Ditto for legislation that provides a liability shield to employers/businesses that don’t require vaccination. Both of those are generally favored on the right, which gives the lie to their self-righteous claims of libertarianism, since it shows they’re perfectly happy to use governmental power to restrict the rights of some (i.e., private employers/business who want to require vaccination) to satisfy the wants of others (i.e., those who feel entitled to impose additional risk on others by not getting vaccinated).

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  36. Andy says:

    @steve:

    Wouldnt a better analogy be that we already require kids to be vaccinated in order to attend school? You need some vaccinations, and proof of such if you are an international traveler coming to the US. So we already have precedent for requiring vaccinations, and providing that proof, to participate in the broader world.

    I think the hindrance to that is that the vaccines aren’t officially approved. Given the tens of millions of people who’ve taken the vaccine, I’m not sure what the hold-up is on the FDA going from EUA to fully approved – at least for adults who aren’t pregnant.

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  37. Teve says:

    @Gustopher: they have now added antigen tests and they probably do PCR some, but in the beginning, for years, all they had for lab testing HIV 1 & 2 were antibody tests. And you can have HIV and not be producing detectable amounts of antibodies yet, for months. Thousands of people got HIV through blood transfusions as a result, especially via cryoprecipitate products.

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  38. Teve says:

    @R. Dave: when I had a job that involved me going in and out of Mayo Clinic labs on a regular basis, I had to submit proof every year that I had the flu vaccine, and before I started doing anything there, a TB test.

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  39. mattbernius says:

    Since it’s on topic, I want share a twitter thread from Cyd Harrell who is a leader in the design of Civic applications and services on this topic. In it she weighs out the complexities of implementing this type of passport approach.

    https://threadreaderapp.com/thread/1376951100612354051.html

    The short answer is that Never/Definitely lines on thought on this are really not productive and it’s better to get into questions about implementation and who gets included and excluded and at what costs.

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  40. Jen says:

    @Teve:

    Thousands of people got HIV through blood transfusions as a result, especially via cryoprecipitate products.

    Yes, and the book I referenced above examined the situation in the UK, where many of those people who received blood transfusions were hemophiliac children. It was such a massive case, the response was unsurprising.

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  41. gVOR08 says:

    @James Joyner: Now that I think about it, my memory of the Gulf War refusenik was wrong. It wasn’t that he was being ordered to the Middle East, it was that he was being ordered to get vaccinated. I think it was the smallpox shot he objected to. So it was even closer to the current situation.

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  42. JohnMcC says:

    @Teve: I was in the early stages of my RN career at the time of the AIDS crisis. A seldom mentioned side effect of the virus was that a generation of hemophiliacs was essentially wiped out. We have not yet reached an understanding of how bad it was.

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  43. Sleeping Dog says:

    @R. Dave:

    The fundamental nature of the issue is that the government is restricting people from engaging in various activities that pose a risk to others unless they can demonstrate that they’ve taken certain specified risk-mitigating steps first.

    Is government restricting or is government providing a consistent and accessible method for private individuals and businesses to screen customers? The existence of a passport doesn’t require businesses to use it, nor can Gov. DeSantis force deny businesses ther right to require a passport for entry.

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  44. OzarkHillbilly says:

    @JKB: Right now, the vaccine passport idea is not based on science.

    Yeah, that was enough for me.

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  45. de stijl says:

    Ya gotta get em the Dip-Tet boosters yearly or else they’ll develop lock- jaw ands night vision.

    You soak his thumb in iodine and you might get by without the othodonture, but it won’t knock a thing off the university.

    God bless Dot and Raising Arizona and the Coen brothers and Frances MacDormand.

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  46. Gustopher says:

    @Teve: By the 00s, they should have been at the spot where they could have relaxed the restrictions, or changed the questionnaire to be based on activities rather than identity.

    But, regardless, it just goes back to my point: part of the social contract is being willing to accept modest inconveniences for the ostensible benefit of the community at large — not try to substitute your own judgement (within reason…).

    Is it a health issue with civil rights affects, or a civil rights issue with health affects?

    It doesn’t surprise me that the party of “screw you, I got mine” is opposed to masks, vaccines, etc.

    @JohnMcC:

    A seldom mentioned side effect of the virus was that a generation of hemophiliacs was essentially wiped out. We have not yet reached an understanding of how bad it was.

    When they were able to test blood products, one of the pharma companies realized they had a whole lot of untested and possibly harmful medicines, so they did what any good corporation would do… they sold them in poor countries, and knowingly let a whole lot of people die as a result.

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  47. Jim Brown 32 says:

    @James Joyner: Same in my circle. We took the untested the untested Anthrax series (7 shots) but are scared of this one…STFU

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  48. Just nutha ignint cracker says:

    @Kathy: “… or transmitting the disease to the unvaccinated is now very low.” My understanding of how this particular vaccine works is that “very low” may be an overstatement on its effect. But I got no dog in this fight because I didn’t go places before the virus struck and am inured to wearing a mask now. Dragon, don’t dragon. Passport, don’t passport. It’s up to you.

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  49. Just nutha ignint cracker says:

    @Just nutha ignint cracker: For the record, in my part of the woods, we’re still at ~180 cases/100,000 population according to the county health department. I’m not sure I would define that as “flattening the curve,” but fortunately, I don’t have to decide that.

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  50. Andy says:

    @Jim Brown 32:

    We took the untested the untested Anthrax series (7 shots) but are scared of this one…STFU

    A lot of servicemembers refused to take the Anthrax vaccine and sued, resulting in the DoD withdrawing its use for several years due to a court order. It wasn’t actually untested IIRC, it had been approved by the FDA for many years which is why the military could make it a requirement, not optional.

    The Covid vaccines are new vaccines and not formally approved. Once formally approved, service personnel will have to take it, though undoubtedly a few will try to refuse, as was the case with Anthrax. I bet your experience is similar to mine, where every unit has one or more of “that guy” (it’s almost always a guy), well represented by the “Psycho” character in the movie “Stripes.”

    A very close friend of mine who is retired military but now a DoD civilian is part of a voluntary monitoring program for Covid. She wears a couple of thousand dollars worth of tech 24/7 to collect data that is aggregated to help identify the pattern of the disease and also the effects of the vaccine (she got both shots last month).

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  51. Kathy says:

    @Just nutha ignint cracker:

    That’s one point where we run against the abbreviated trials. Data from Israel, which holds one of the highest levels of vaccination as a percentage of the population, suggests transmission goes down as vaccinations go up.

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  52. Teve says:

    @JohnMcC:

    I was in the early stages of my RN career at the time of the AIDS crisis. A seldom mentioned side effect of the virus was that a generation of hemophiliacs was essentially wiped out. We have not yet reached an understanding of how bad it was.

    Yeah, hemophiliacs who needed cryo were rolling a pair of loaded dice every time. Just awful.

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