Alabama Republican Gov. Kay Ivey, responding to a question of how to persuade the unvaccinated, commented recently: “It’s time to start blaming the unvaccinated folks. It’s the unvaccinated folks who are letting us down.”

Dr. Kenneth Krell

Dr. Kenneth Krell

But blaming is likely to be just as unsuccessful as the persuasion, appeals to logic and to altruism that have been such a miserable failure in convincing the unvaccinated thus far to roll up their sleeves.

It’s past time, with cases accelerating due to the delta variant, to take another approach. The rest of us need to protect ourselves from the unvaccinated.

Just as we learned many years ago that individuals do not have a right to spread tuberculosis to the rest of the community, so that same principle needs to be applied to this current pandemic. You simply do not have a right to endanger our physical, economic and social recovery in the name of some “freedom” to infect others.

Just as patients with TB can be restricted from endangering the community by confining them from activities that could infect others, so we need restrictions on what the unvaccinated can do.

And we’re starting to see those efforts, beginning with health care workers. Despite the uproar from the far-right “freedom” coalition, it is entirely logical and necessary to require health care workers to be vaccinated. Your freedom stops at endangering a vulnerable, hospitalized, often immunosuppressed, population. It is utmost idiocy to allow spread to hospitalized or nursing home patients who may not get the same advantage from being vaccinated that most of us achieve.

The same principle should apply to child care workers, school personnel and others who may expose children younger than 12, who do not yet have the advantage of the vaccine.

But beyond protecting those vulnerable groups, it’s time to consider that the unvaccinated don’t get to threaten the social and economic recovery for the rest of us. If I can’t go to a concert because I could pick up COVID-19 (despite a 99.5 % of not getting severe disease) and pass it to an immunocompromised relative, it needs to become the responsibility of the unvaccinated to refrain from those activities. And since the unvaccinated almost certainly won’t even mask, they need to be prohibited from attendance.

And further restrictions need to evolve to stem this recent increase in cases before our hospitals and social and economic recovery become endangered. Want to attend college? You must be vaccinated. Want to work for a responsible employer trying to protect their workers? You must be vaccinated. Want to go to the grocery store? You must be vaccinated.

Certainly, we’re not ready to require confinement of the unvaccinated to their residences. Especially given the political atmosphere in a state like Idaho, where the governor has prohibited “vaccine passports.” But we must get past blame, past cajoling, past appeals to logic and move toward those steps that will stem the resurgence of COVID-19 cases that endangers all of us — the vaccinated and the unvaccinated. That risk is as much social and economic as it is physical, with the risk of rollbacks in allowed activities if cases continue to increase. We can’t wrestle the skeptical to the ground and administer vaccines, but we can reasonably place restrictions on what they can do, just as required for other endangering diseases like TB.

We need to surrender the illusion that more persuasion, more nagging, more rational arguments will somehow convince the hardcore opposition to surrender. It isn’t working. Vaccine rates have plateaued and don’t appear to be increasing substantially.

Let’s give up the persuasion approach. It won’t work. I’m reminded of a patient recently unvaccinated with COVID-19, who I reminded that having COVID-19 didn’t confer life-long immunity and he needed to get vaccinated after recovery. He listened politely, then informed the nurse after I left that there was no way he was ever getting vaccinated. He progressed to require intubation, still clinging to that false belief that somehow COVID-19 was preferable to vaccination. We will never convince such individuals to voluntarily accept vaccination. Yes, there are many people in the hesitant group, but they are a dwindling minority, and we must have a strategy for dealing with the hard-core refusers or we will be as endangered as Britain is becoming.

Individually, you do get to decide whether to get vaccinated, but you don’t get to decide whether you endanger the recovery for the rest of us.

Krell is an intensivist at EIRMC.

Recommended for you