On mandatory COVID-19 vaccinations

There have been a few pandemic scares in my time, the most far reaching of those being the Swine Flu (H1N1) outbreak in 2009. Swine flu infected approximately 60.8 million Americans and the CDC found that 87% of deaths occurred in the under 65 age group with a death rate of roughly 0.02%. By comparison, the influenza virus (according to regular flu season data) has a death rate of 0.13% (roughly 7 times more deadly than H1N1). Public health officials didn't react strongly to stop the spread of H1N1 and they were vindicated in their response by sheer luck. Had the virus been more deadly or more transmissible their lack of reaction could have caused hundreds of thousands or millions of deaths.

With COVID-19, early signals from China were very worrying indeed. By January 2020 we saw footage of people collapsing in the streets, people being barricaded in their houses, dragged out of their cars at checkpoints, and trucks patrolling the streets spraying chemicals in the air. This overt propaganda (that included sock puppet accounts spreading pro-lockdown messaging on social media) was after the covert attempt to suppress information about COVID by imprisoning doctors and falsely claiming that human to human transmission was impossible.

I've heard many theories about the motivation behind this disinformation campaign, the most compelling of which being that China knew how serious this virus would be and they wanted to allow it to spread to the rest of the world so they didn't suffer alone. My theory is much simpler and it's based on a pattern we've seen many times in history. The nature of pathological totalitarian governments such as China or the USSR means very little tolerance for mistakes. As we saw in 1986 after the meltdown of the nuclear reactor in Chernobyl, the authorities engaged in a multi-year coverup to deflect blame. Similarly, during the H1N1 outbreak, local officials suppressed information about the outbreak and didn't warn the public, fearing reprisal from Beijing.

So, how deadly is SARS-Cov-2 as compared to influenza? According to the Johns Hopkins COVID dashboard the global death rate (197,872,410 cases; 4,217,383 deaths) is 2.13%. The death rate fluctuates considerably between countries with the USA having a rate of 1.73%, France at 1.81%, and Australia at 2.69%. Strangely, India (where we saw many reports of people dying in the streets when the delta variant started spreading) has a far lower death rate (1.34%) than other comparably richer countries. The death rate in the USA is 1.73%, or 13.3 times higher than the influenza death rate, so, clearly this is a serious illness and we should not be flippant about it, but the question remains: have we overreacted?

Lockdowns

The conversation about "15 days to slow the spread" started in mid-March 2020 in Australia and I agreed with the approach at the time. We didn't know how deadly the virus would be and needed to gather data to steer public health policy. For those of you with stone slabs for ceilings, the purpose of the 15 Days Doctrine (also; "flatten the curve") was to stop the initial wave of infections from overwhelming hospitals. Notably, the purpose was not to stop infections entirely. With 1.5 years of hindsight, we now know that (in the United States), 95.2% of deaths are in the 50-up age group and 79.2% of deaths are in the 65 and up age group (see figure 1 below). Deaths in the 30-39 age group represent 0.2% of cases which drops off dramatically for the 18-29 range (at 0.007% of cases) and when it comes to school-aged children (0-17 years old) the percentage of overall cases is 0.001% or 1 in 1000. The people least affected by this illness have paid the highest price as a result of the hysteria. They have to shoulder the mental burden of isolation during their most important developmental years, potentially being locked up with abusive parents (when school may have been their only respite from physical or verbal abuse), and online learning programs from a school system that is already a complete failure when it comes to academic outcomes. They will also have to shoulder the financial burden of the money printing required to prop up the stock market and pay off employees whose businesses were shut down by lockdown measures.

Figure 1. Deaths in the United States by age group as a proportion of deaths and of overall cases Data: cdc

As I noted earlier, 87% of H1N1 deaths occurred in the under 65 age group which is an almost perfect inverse of the pattern in COVID deaths. Knowing this, we could have designed a program to minimize the impact on the young while protecting the elderly and severely sick, but we didn't. It's like having a fire on your stove, and instead of reaching for a fire extinguisher you get in a plane and dump 12,000 liters of water on your house from overhead. With a common sense policy allowing freedom for those who are not at risk, the cost/benefit analysis is left up to individuals armed with the best information. If you are not in an at-risk group but you don't feel safe then you are perfectly welcome to wear masks, work from home, order all your groceries online, etc.

The fundamental mistake that people make when advocating for universal lockdowns is a lack of consideration for the unseen consequences. This idea is best illustrated by Frederic Bastiat in his essay "That which is seen, and that which is not seen", where he lays out the Broken Window Fallacy. If someone throws a rock through a shopkeeper's window, people will often attempt to placate the shopkeeper by saying "at least you're giving work to a glazier who will use that to buy goods and enrich the community", however, what they fail to recognize is that the money used to replace the window could have been used to buy a new shirt. Whereas without the broken window the shopkeeper would have had a window and a new shirt, now he only has a window and the community is deprived of a shirt it could have afforded otherwise. According to a report by Douglas Allen, the lockdowns in Canada may have saved a cumulative 22,333 years of life as a result of the reduced COVID infections. The other side of the coin is the up to 6,300,000 years of lost life from:

• Babies who would have been born if not for the lockdown
• Cancer diagnoses that would have been caught with regular medical care
• Preventative medicine not provided
• Weight gained
• Alcoholism or drug abuse
• Suicides

As Douglas Allen says "the cost/benefit ratio of lockdowns in Canada, in terms of life-years saved, is between 3.6–282. That is, it is possible that lockdown will go down as one of the greatest peacetime policy failures in Canada’s history".

Indeed, in October 2020, more Japanese people committed suicide in that month alone than in the 10 months of COVID infections until that point. A survey by Grossman et al found that 60% of respondents reported increased drinking due to stress and boredom, and in Australia a survey revealed that nearly 10% of women have experienced domestic violence during the pandemic with 50% saying the abuse had become more frequent or severe since the pandemic began.

Vaccines

As if lockdowns weren't contentious enough, we turn to the topic of vaccines. My typical conversation about COVID vaccines follows this script:

"Are you going to get the vaccine?"

"No, I don't think so, I'm not at risk"

"Oh my God, you anti-vaxxer conspiracy theorist. You're killing grandma!"

The false dichotomy has been set up such that you can only be pro-COVID-vaccine or anti-all-vaccines. I won't virtue signal about vaccine support since that's become the new "I can't be racist, I have black friends", but I will say I'm happy to not be living in an iron lung. I am neither anti-vax, nor anti-COVID-vaccine. I'm pro-COVID-vaccine for those who are at risk and those who voluntarily choose to get it.

A typical talking point of the fervently pro-COVID-vaxxers is that they are doing it out of a sense of duty to the collective to reach herd immunity. This notion falsely assumes that everyone being vaccinated necessarily means the pandemic is over. A recent CDC study found that 74% of infections in a Massachusetts outbreak were among the fully vaccinated. Are you surprised? You shouldn't be - breakthrough infections were expected per the clinical data in trials. The number of breakthrough infections is almost certainly being understated since the bulk of these breakthrough infections are asymptomatic, and therefore, rarely cause alarm for individuals to get tested.

In Israel (which has one of the highest vaccination rates in the world) half of the cases in a recent outbreak were among the fully vaccinated, and researchers estimate that the Pfizer vaccine is now just 39% effective in preventing infections which has spurred talks about a third booster shot. This could be due to the spread of new variants (due to the narrow scope of the current generation of COVID vaccines) or due to a reduction in antibody levels among the vaccinated.

So, it has a marginal effect in preventing infections, but it's actually quite good at preventing severe symptoms. Armed with the data, we can conclude that an ideal goal would be "hybrid immunity" where at-risk individuals get the vaccine and the remainder of people are allowed to decide whether to be vaccinated based on their individual risk appetite. This would allow us to begin resuming normal life with no risk of overwhelming hospitals and with few deaths. Consider Figure 3 (below) which charts the death and hospitalization risk against age (with and without comorbidities) amongst the unvaccinated. As a 30 year old with no comorbid conditions, your risk of hospitalization (i.e. very severe symptoms) is a mere 2.7%. When you include those with asthma the percentage rises to 5.1%. Including obesity, the number climbs to 12.9%. Indeed, apart from age, obesity is the single biggest risk factor for COVID-19 (which makes the public health policy decision to lock people inside their homes and close gyms all the more absurd). In fact, lung cancer patients have better odds of survival than the obese.

Figure 3. Risk of hospitalization and death by age

The profit motive

The singular driving force of all living creatures (and thus, their evolution) is this: "Accruing the most resources with the least effort".

Pfizer made US$7.8bn in Q2 of 2021 alone and is forecasting sales of US$33.5bn for 2021. In Figure 4 below you'll note that for the US market, Pfizer makes $19.5 per vaccine. If the US government was to mandate vaccines for everyone and they placed their orders exclusively with Pfizer, that would mean approximately $13bn in the US market alone. You don't have to be an economics expert to see that the incentives are aligned to get as many people vaccinated as possible, and given the growing calls for booster shots, the gravy train keeps rolling for these pharmaceutical companies. It doesn't matter to the pharmaceutical companies whether people need the vaccine or not, their singular focus is on generating profits based on vaccines sold. This doesn't make Pfizer immoral (perhaps amoral), - they're simply responding to the incentives provided by the government.

Figure 4. Cost per shot for COVID vaccines

As a self-professed capitalist, I have no issue with companies making money, including pharmaceutical companies. The cost of the regulatory burden for developing new drugs, and the fact that close to 90% of all drugs are rejected by the FDA, the companies have to recoup costs not just for the development of the drugs that make it to market, but also the drugs that don't. When profits arise in a free market they are the result of voluntary interactions between the company and the individual. The individual decides that the product is worth more to them than their money. The nature of mandatory vaccination means that the profits are derived not from voluntary interactions, but by coercion at gunpoint. I've heard several people falsely claim that the vaccine is free, and to those people I say: there ain't no such thing as a free lunch. The vaccine is being paid for one of two ways: taxation or inflation.

In a free market the decision making would be completely decentralized. Health insurance companies would analyze the risk to them for each individual to get COVID (accounting for lifestyle factors such as obesity, cigarette smoking, etc.) to determine the cost to them with and without the vaccinations. They would also look at the clinical data for each vaccination and determine the risk of long-term side-effects as a result of vaccinations, and if they determine that it would be cheaper/less risky for them if people were vaccinated, they would add a premium loading for those who refuse to get the vaccination. If you are at risk and you refuse the vaccine, then you may have to pay 20-50% higher premiums because the insurance companies know you're more likely to need expensive medical care as a result of infections.

Consensus does not constitute conclusion

Trust the science Galileo, we all know the universe revolves around the Earth.

A cursory examination of the history of philosophy and science tells a dramatic tale where no good deed goes unpunished and many of the things which we now take for granted are paid for by the blood of those who refuse to conform to consensus. Socrates was sentenced to death for "corrupting the youth" and failing to acknowledge the gods of the city. Similarly, at the time of his death, Galileo was completely blind after 9 years of house arrest for the heretical pronouncement that the Earth revolves around the sun... Ironically, in both of these examples the offending party was persecuted for going against the religious narrative. Today, in our very secular, (allegedly) rational society, a new religion has been born. You run counter to the prevailing pop-sci narrative at your own peril as The Templar of the "I Fucking Love Science" Facebook page will shout you down and ostracize you from society. In the words of the immortal Anthony Fauci, the great prophet of the cult of Scientism, "attacks on me are attacks on science".

From a pragmatic standpoint, the percentage of the public who have received COVID vaccinations is entirely arbitrary. The only thing that matters is; are the vulnerable vaccinated? If you are 70 years old, you should probably get vaccinated. If you are a 30 year old with no comorbidities you don't need to get vaccinated, and indeed you probably shouldn't, but ultimately it is YOUR choice.

Coercion is not consent

For the people on the political left who used to be skeptical of government overreach, the inherent self-contradiction of advocating for mandatory vaccines is particularly offensive. If you concede that there are things the government can force you to do (at gunpoint) for your health, then you have to concede that there are things that the government can force you NOT to do (at gunpoint) for your health. Like have an abortion, or get gender reassignment surgery, for example. By giving up bodily autonomy you open the door for all forms of medical tyranny.

The statist doctrine of mandatory vaccination can only possibly lead to the fractionation of society into castes where rights are deprived from those who don't kowtow to the dictates of the state. This obviously violates the 800 year history of Man's natural rights enshrined in law since the Magna Carta was written. In every medical procedure, the doctor is required to explain the risks, and the procedure only goes forward if the individual (or their kin) gives informed consent. If a treatment will fix your eyes but you'll lose a leg in the process we all agree that it's vital for the patient to understand the implications of the treatment, and decide that the consequences of not getting the treatment are greater than the consequences of getting the treatment. You cannot express informed consent for a procedure which you're being forced to undergo any more than you can call kidnapping "marriage", or rape "lovemaking". You cannot take what can only be given voluntarily.

Luke Boyle BAppSc, major in microbiology, since credentials are required to have an opinion now.