I think this is a pretty reasonable article, particularly the section on unintended consequences of these policies.
In a bureaucracy, policies are designed around fixing what is measured. If the only thing that is focused on is COVID-19 cases rather than general health, far more overall harm might be imposed on the public health from the vaccine passports.
> One of the most important risk factors for severe COVID-19 illness is obesity. Many people rely on gyms, especially during the winter months, to access physical activity and maintain their ideal body weight. Those who live in apartment dwellings may not have access to green spaces for exercise. Thus, by barring access to gyms, we are restricting physical activity, which in turn contributes to increasing rates of obesity and greater risk for severe disease.
I'm sure I'm not the only one who tends to gain more than a few pounds during winter. What do you think is going to happen when you impose significant barriers to a large number of people from working out? Many people are going to stop working out and gain far more weight. Not only does this have a significant impact on COVID outcomes, but also heart-disease and other health conditions.
Humans are pleasure-seeking creatures. What do you think will happen when you block them from going out peacefully anywhere fun for the winter? Winters in cities are already miserable experiences. People are going to turn to things that are accessible to them for pleasure: maybe drugs, alcohol, risky sexual and other behaviors, stuffing their faces with sugary food, etc.
The unintended consequences of vaccine mandates may lead to dramatically worse overall health outcome on a population level.
> 5. Why are people vaccine-hesitant? While it is easy to dismiss the unvaccinated as conspiracy theorists and selfish, this is overly simplistic and frankly inaccurate. The unvaccinated are disproportionately of lower socio-economic status, ethnic minorities and children. Many minority groups have legitimate reasons to distrust the medical establishment, based on a long and sordid history of racism and classism. Some are unable to get vaccinated because they cannot afford time off work for vaccination and post-vaccine side effects. It is imperative that we understand the unintended potential health equity impacts of vaccine certificates on specific population groups, and that we target our efforts to vaccinate these populations in a way that is respectful, accessible and meaningful.
This right here is what the priority should be.
Policy-makers, with private doctor(s!), chauffeurs and staff won't empathize and understand the burden of vaccination for the lowest 10% percentile. But that's the long tail is, and were we'll see outbreaks in the following months if we keep ignoring it.
While I don't subscribe to the idea that "disparity implies racism", this is most certainly a case where, if you accept that view, vaccine mandates must be interpreted as racist precisely because Black and Hispanics are disproportionately unvaccinated. And the points made in (5) stand regardless of whether you accept the disparity view.
But this is hardly the main point. (6) is more relevant (and the second part of (5) is worth also adding separately).
> 6. Are vaccine certificates ethical? One of the most sacred principles in medical ethics is autonomy, meaning that an individual has the right to decide what happens to their body. [...] Even the most well-informed individual cannot provide informed consent if their “choice” is coerced. Vaccine certificates render the individual in an impossible place of having to choose vaccination or loss of employment and exclusion from society. This impossible “choice” forces the hand of those in this predicament and ultimately results in consent under duress. [...] Loss of trust in the medical establishment can lead to poor health outcomes, as patients may avoid care and be less receptive to medical management. Given that we have exceeded numerous vaccine targets and offered protection to those at greatest risk, we should make every effort at this time to maintain patient autonomy and guide with openness rather than exclusion.
> Public health interventions need to take into account not only the immediate threat before us, but also the downstream negative effects that may occur as a result of our actions. The introduction of vaccine certificates threatens individual autonomy and societal norms, and runs the risk of further isolating marginalized groups without clear metrics to assess efficacy. The sacrifices that have been made throughout this pandemic are astonishing
Medical ethics is being thrown out the door and those pushing for vaccine coercion seem completely unable or unwilling to accept that that's what they're in favor of. And practically speaking, coercion, given the sickening and duplicitous politicization of the vaccine, is only going to result in skepticism toward the vaccine, which it has.
> Medical ethics is being thrown out the door and those pushing for vaccine coercion seem completely unable or unwilling to accept that that's what they're in favor of. And practically speaking, coercion, given the sickening and duplicitous politicization of the vaccine, is only going to result in skepticism toward the vaccine, which it has.
Ethics has always been a joke. A set of vague guidelines that wouldn't pass the stricter bar of being tested in court. It's basically anyone with a sliver of power playing judge and legislator.
I had not even considered the racial aspect. But I wonder, would it help to have black and Hispanic doctors reaching out to their respective demographics and talking to them about the vaccine? A booth with an "Ask me Anything" and shots available right away for those who change their mind?
The cost in vaccines isn't just in getting them. One has to take off work (twice) to get them, have transportation to get them, and be able to handle being potentially stuck in bed for 1-2 days after the second vaccine. I believe the last is probably leading to the most vaccine hesitancy. If I don't have sick leave, worry that I will get fired if I call in and/or have to take care of small children, I will probably keep putting off getting the vaccine hoping to find some more convenient time. Yes, of course, it will be worse if they get covid, but I doubt the calculation is: "I will never get the vaccine and hope I don't get covid". I suspect it is more "I will get the vaccine as soon as I get a chance to have two free days to schedule it"
> Those who are fully vaccinated may be amongst those denied access if they do not have a printer or mobile device, or if they have forgotten their documentation at home. This will especially impact the poor, those who are homeless, those with developmental delays or those who suffer from cognitive impairment.
If you are going out somewhere that would need a covid passport, you're going to need your wallet one way or other. So I think forgetting the paper that should already be in your wallet to be one of the weakest arguments yet.
And if they can afford to go to a place that would need the passport (restaurants, movies, et al) then they probably can also afford one of the 10 cents per page print shops you find all over the place.
So that particular argument doesn't fly. At least "taking time off work" has some merit, but even then you can schedule around it. Over the course of almost a year so far, you must have at least some time in there to do it.
So far in my work place, not one person has had to take time off due to illness from the shot. Sure there are people who do get ill from it, but it's a lot more rare than people make it out to be. Even in my friendship circle, only one person almost had to take time off, but inevitably didn't need to. A sore arm is nothing unless you're a professional bowler or whatever.
That's a great idea. The arguments against both are nearly identical, from my perspective.
There's a big difference in these scenarios, in that the argument FOR vaccine passports is much stronger, in that the vaccines provide some level of herd immunity. There is no evidence that voter fraud is occurring at high rates in the US to have voter ID barriers (the alleged purpose, though not the true one).
Intent also matters. The intent of vaccine passports is to reinforce the importance of herd immunity, to emphasize the legitimacy of the vaccines, and to protect frontline workers. The real intent of Voter ID laws (and voter roll purging, etc) is to disenfranchise. The intent taints the process, even if some of the components are reasonable (more options for valid photo-ID, more rigorous proof-of-residence rules, and more careful record keeping, etc).
What if the arguments being made against each, rather than for, are compared?
Vaccine passports will likely require photo id to ensure you are the person with the vaccination record. If requiring IDs to vote disenfranchises a portion of the population, wouldn't requiring IDs for X have the same effect? In example, what happens to those who cannot get an ID due to immigration status or other reasons?
If vaccines are accessible to poor people leading to more vacinnated populus, why are vaccine passports needed?
I'm not anti-vax but I don't understand why people think vaccines are going to solve everything, isn't covid here to stay? why make it another control measure?
Right now in Ontario 80% of covid cases are coming from non fully vaccinated individuals(1).
It costs $23k to treat a covid patient and $50k if they reach the ICU(2). Chances of not landing in the ICU are 99.9% if you're fully vaccinated(3).
Many health resources are going to treat covid instead of things like elective surgeries. Allowing non-essential businesses to fully open without a vaccine passport will only lead to more cases and more resources being wasted.
The thought of getting injured right now is scary because I could wait years for something like a herniated disc surgery (which is very debilitating). I'd much prefer we take steps to take as much strain off the health system as we can.
> The thought of getting injured right now is scary because I could wait years for something like a herniated disc surgery (which is very debilitating).
And yet how much do you pay year after year for healthcare via taxes?
I'm also from Canada. We pay the same amount despite the fact that we are in mid-pandemic. Therefore resources are allotted to dealing with the large number of Covid cases that end up in ICU.
This isn't a case of being "short changed" with our taxes. This is a case of large groups of people needlessly filling the emergency wards when there are clearer options that are easier on the population as a whole.
The goalposts sure seem to be shifting around Covid. At first it was merely "Flatten the curve" and now we're talking about much larger societal policy decisions, with no clear objective or aim.
Frankly - If the US was a person, I'd say we're having a severe allergic reaction. The response is worse than the disease. On both sides of the political spectrum we're seeing a tendency towards authoritarian controls and in-group/out-group dynamics, and I have a sinking feeling it's not going to end well.
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None of that means you personally shouldn't get vaccinated. I'd strongly suggest it, and wish we'd had a vaccine earlier - I lost both of my grandmothers to covid.
But we've clearly lost touch with how to actually talk with a person you don't agree with - and since neither side has any real discourse with the other, we're reverting to control measures that I don't think are good for democracy.
I imagine any fees/fines/consequences for not having a vaccine passport will be relatively more of a burden for the poor to bear. This same argument has been made for/against requiring voter id laws in the US.
Does this reflect genuine concern for the poor, or is it a bad faith tactic to try to shoot down a policy for other (perhaps unstated) reasons or priorities? Because I've seen a lot of the latter lately.
Especially with something like vaccine passports, any special issue the poor disproportionally experience is probably better dealt with through some kind of mitigation (e.g. make vaccines free, arrange free transportation or mobile clinics, mandate paid recovery days) than by scrapping the idea entirely. It's stupid to let a small issue prevent a bigger issue from getting addressed.
>Does this reflect genuine concern for the poor, or is it a bad faith tactic to try to shoot down a policy for other
Does it matter?
>Especially with something like vaccine passports, any special issue the poor disproportionally experience is probably better dealt with through some kind of mitigation (e.g. make vaccines free, arrange free transportation or mobile clinics, mandate paid recovery days) than by scrapping the idea entirely.
Most policies aimed at helping poor people usually are usually either counterproductive or poorly done.
>> Does this reflect genuine concern for the poor, or is it a bad faith tactic to try to shoot down a policy for other
> Does it matter?
Yes. For instance: does it matter if someone makes a convincing argument to lure you into a trap? Focusing on the argument in isolation can make you a fool. Motives matter.
> Most policies aimed at helping poor people usually are usually either counterproductive or poorly done.
Eh, I'm skeptical. That's the kind of statement usually made by people who are philosophically opposed to helping poor people or to government action in general.
And even if (say) historical anti-poverty programs did not help the poor, that's irrelevant to mitigations to make a vaccine passport policy work better for poor people.
The way to help poor people is the put the least roadblocks in their way. Government policies that assume that they work only aggravate the issue for the people for whom it doesn't work (creating outcasts).
EDIT: E.g. give everyone 500$ but hike up the price, what about the people that weren't eligible for some bureaucratic dumb reason?
A logical argument does not depend on the person that makes it (which is why its logical). Heuristically you can use the locutor to save you the trouble of analyzing it but you have to realize it's a heuristic and the argument might still be right.
> The way to help poor people is the put the least roadblocks in their way.
That's little more than ideology.
> Government policies that assume that they work only aggravate the issue for the people for whom it doesn't work (creating outcasts).
> EDIT: E.g. give everyone 500$ but hike up the price, what about the people that weren't eligible for some bureaucratic dumb reason?
You're letting the perfect be the enemy of the good, perhaps as an excuse for an ideology that advocates inaction.
> A logical argument does not depend on the person that makes it (which is why its logical). Heuristically you can use the locutor to save you the trouble of analyzing it but you have to realize it's a heuristic and the argument might still be right.
Yes, in an ivory tower that's sufficient, but in the real world it isn't. For instance, you will never have all the information. If you try to act like a logical robot, you can be tricked by with a logical argument that passes all your checks but is contradicted by facts you don't know or aren't attending to.
>perhaps as an excuse for an ideology that advocates inaction.
You assume my motives a lot. I advocate positive action, aka give 500$ to everyone but don't hike up the price. Or in other words, mandate paid sick days whether or not there are passports (and don't use the fact that there are sick days to justify implementing them).
The passport is a disincentive to not getting the vaccine, how about we incentive people to get it instead?
A big problem for this sort of intervention, and one of the reasons why covid is as socioeconomically predestined as it is, is that many of the sort of people a mandatory paid recovery day would benefit from are paid under-the-table or in other informal work arrangements. If your way of putting food on the table involves standing outside Home Depot until a crew needs you, a benefit administered through the above-board employment system is useless and you're going to be turning up for work (and infecting your co-workers) regardless.
I generally agree with the thrust of your comment, but it's easy to underestimate the additional barriers faced by the poor. I won't get into the whole litany of disadvantages here, but I think you get the idea. The whole thing honestly smells a little like the "well, why don't they just get an ID?" shit in voter-identificaton debates, just from the other side.
> I generally agree with the thrust of your comment, but it's easy to underestimate the additional barriers faced by the poor.
Oh, I totally agree that more thought would need to be put into than my drive-by examples. I just object to the common attitude that some policy should be scrapped because of some marginal issue vs. modified to mitigate that issue. Policies need to be evaluated holistically, and if an issue causes one to be scrapped, it should probably be a fundamental one.
This article asserts none of its top level claims, it merely brings up a series of questions they feel are important for the discussion. There are below the fold assertions that are outright false, such as "Vaccine certificates render the individual in an impossible place of having to choose vaccination or loss of employment and exclusion from society." Vaccines are free. Vaccination is hundreds of times safer than infection, and infection has a much higher societal cost. If you can't afford the vaccine, you definitely can't afford the illness. Given this structure, this article looks suspiciously like JAQing off.
Assuming that the article is in good conscience, I'm just going to give a quick answer on each of the points.
1. What is the intent and what are the end points? Vaccine certificates impose a significant burden on the population.
Yes, vaccine certificates would impose a burden. However, unchecked covid19 imposes a huge societal burden as well. Given current knowledge, covid19 has a much higher cost than a vaccine certificate. A 1-2 year expiration on a vaccine certificate law would be one way these concerns could be balanced.
2. Can we stop transmission with vaccine certificates?
False dichotomy. We don't need to completely stop covid19. We just need to lower the societal cost. Vaccines are very good at doing that, and this article doesn't really have a strong argument as to why vaccine certificates wouldn't at push vaccination numbers higher.
3. What are the logistical considerations of such a program?
Similar any similar nation wide legal system. Also, I can't help feel that this article uses "Think of the homeless!" the way that some people like to use "Think of the children!" The homeless aren't the only members of society (in fact, they're a smaller population than the children) and their concerns must be balanced against everyone else's. Given the extreme cost of dealing with covid19, both financially and in terms of medical resource utilization (both resources that the homeless use as well), it's reasonable to believe that a higher vaccination rate will improve resources available for the homeless.
4. What are the unintended consequences?
Something. There's always an unintended consequence. Yet life goes on, and legislative bodies still pass laws. This point isn't an argument against a vaccine certificate, it's merely an argument that such a law should be well crafted. Something I agree with 110%. Given the extreme cost of covid19, it's also fair to say that even a flawed implementation could still be very useful.
5. Why are people vaccine-hesitant?
A valid question, but much like point 4, not particularly an argument against vaccine certificates. One thing that I have to iterate again is that if you think the vaccine is expensive, think how much worse the illness can be.
6. Are vaccine certificates ethical?
Vaccination records have been considered ethical for some time, this article makes no argument as to why covid19 vaccines are special.
In a bureaucracy, policies are designed around fixing what is measured. If the only thing that is focused on is COVID-19 cases rather than general health, far more overall harm might be imposed on the public health from the vaccine passports.
> One of the most important risk factors for severe COVID-19 illness is obesity. Many people rely on gyms, especially during the winter months, to access physical activity and maintain their ideal body weight. Those who live in apartment dwellings may not have access to green spaces for exercise. Thus, by barring access to gyms, we are restricting physical activity, which in turn contributes to increasing rates of obesity and greater risk for severe disease.
I'm sure I'm not the only one who tends to gain more than a few pounds during winter. What do you think is going to happen when you impose significant barriers to a large number of people from working out? Many people are going to stop working out and gain far more weight. Not only does this have a significant impact on COVID outcomes, but also heart-disease and other health conditions.
Humans are pleasure-seeking creatures. What do you think will happen when you block them from going out peacefully anywhere fun for the winter? Winters in cities are already miserable experiences. People are going to turn to things that are accessible to them for pleasure: maybe drugs, alcohol, risky sexual and other behaviors, stuffing their faces with sugary food, etc.
The unintended consequences of vaccine mandates may lead to dramatically worse overall health outcome on a population level.