What we owe anti-vaxxers in a life-threatening pandemic

See updates through December 18, 2021, at end of post.


A while ago, Nancy Gibbs penned an op-ed for the Washington Post arguing that medical providers should continue to provide even scarce intensive care to people who have refused the COVID-19 vaccine because—this is a slippery slope argument—many of us do things we shouldn’t or fail to do things we should. Once we exclude one group, people who have refused vaccines meant to control a life-threatening pandemic, where, really, do we draw the line? What, for example, about people who fail to quit cigarette smoking?[1]

In making this argument, however, Gibbs succumbs to the same fallacy as the anti-vaxxers. She fails, as they do, to meaningfully address that their “individual” decision affects many others, especially including the medical workers who would provide care. And she fails to address a scarcity of beds. Instead, she quotes New Mexico Health and Human Services Secretary David Scrase saying, “We’re going to have to choose who gets care and who doesn’t get care, and we don’t want to get to that point.”[2]

But even at the time she wrote that op-ed, we had already very clearly reached that point. People who suffer from conditions unrelated to COVID-19 are being turned away or are waiting while their conditions worsen because hospitals are already full of COVID-19 patients. Ambulances sometimes transport people across state lines trying to find less overwhelmed facilities. People, including children, are dying. And it is amply clear that the unvaccinated are to blame.[3]

And yet. Something still feels different about the debate over treating the unvaccinated. Health-care workers recount the trauma of too many shifts, too many deaths, too many avoidable tragedies. It’s soul-crushing to watch people die because they made bad choices. Partly it’s the maddening hypocrisy — the patients who proudly dismiss science right up until the moment their lives depend on it. Partly it’s the sanctimony, the assertion of personal freedom over any sense of public good.[4]

So I want to approach the issue more broadly, directly tackling the anti-vaxxer fallacy that Gibbs failed to meaningfully address. This is the fallacy that a vaccine is only meaningful for the recipient, not for others to whom the recipient might otherwise spread the disease. It assumes that the individual bears no responsibility to the group.

Yet humans are a social species, even if capitalism—and especially capitalist libertarians—encourage us to forget it. We depend upon each other, which probably has something to do with why we clustered into larger societies (with centralized authority) with the neolithic. In the context of COVID-19, people who, for some reason, truly cannot receive the vaccine or for whom the vaccine is, for some reason, less effective depend upon the rest of us to be vaccinated to protect them and we all depend on limiting the spread of COVID-19 to inhibit the development of variants that might further diminish the effectiveness of the vaccines we have.[5]

Which is to say, I really don’t want to hear about anybody’s religious exemptions.[6] Those who cite them are hypocrites.

People who refuse the vaccination for any non-medical reason break the social compact between us. They claim not to owe the rest of us anything. And it is time for us to reciprocally say we owe them nothing.

They certainly do not deserve the opportunity to put medical workers at risk (because no vaccine, even when administered to medical workers, is 100 percent effective). They certainly do not deserve the opportunity to put the vulnerable among us at risk. They do not deserve anything. Were it less expensive to do so, I would suggest they be exiled from the planet. I will not propose that they be exiled to deserts or distant oceans because of the environmental harm they would undoubtedly do in those places.

But I certainly resent still having to wear a mask for several hours per day as an Uber driver to protect them. I certainly resent that we still face this disease because they have refused any mitigation measures whatsoever. And I am appalled that people who urgently need care for non-psychopathic reasons have difficulty finding facilities. All of this is profoundly and obviously wrong.

As an oncologist friend explained to me, he does not shame lung cancer patients if they smoked for 30 years; nor does the emergency-room doc turn away from the drunk driver with lacerations or the gang member with the gunshot wound. We only ever have incomplete facts, and if caregivers shift from weighing who needs care most to who deserves it, the slope gets very slippery.[7]

Lung cancer patients, drunk drivers, and gang members have never overwhelmed emergency rooms or intensive care units across entire regions of the country the way COVID-19 patients have. They do not threaten the very people charged with their care the way that COVID-19 patients do. There is a difference and, though I think the morality here is exceedingly important, it isn’t simply a matter of moral judgment.

Medical workers are already making the choices Scrase warned us about. To divorce those choices from the morality and from the ethics of vaccine refusal is simply to bury one’s head in the sand; it is inevitably unjust to others who desperately need these facilities.

I will say it again: We owe anti-vaxxers absolutely nothing. Even when they can pay for it.


Update, November 19, 2021: The story at a German hospital goes into more detail about what it is like to care for COVID-19 patients[8] than I saw in comparable coverage in the U.S.[9] But it all looks to me, really, like the same horrific story, a story exacerbated by vaccine refusal and COVID-19 denial.


Update, December 17, 2021, revised December 18, 2021: Among the conspiracy theories I’ve heard in my car from Uber passengers is the claim that 5G causes COVID-19.[10] So yes, I absolutely had to laugh when I saw that “[n]ecklaces and accessories claiming to ‘protect’ people from 5G mobile networks have been found to be radioactive.”[11] Honestly, these people fully deserve the horrible deaths that COVID-19 is capable of producing[12] and, as medical systems are again swamped and medical staff are burning out,[13] vaccine-refusers must absolutely be denied medical care, because this is unfair to medical workers and it is unfair to everyone else who needs care.[14]

Paul Waldman wishes to correct me. He seems to think, without offering supporting evidence, that some people are honestly misinformed[15] but the only way we’re getting out of this pandemic is with vaccination, because unvaccinated people are opportunities for the virus to mutate, producing new variants that endanger us all,[16] and even those who have been infected can be reinfected,[17] reproducing the danger. It’s amply clear, as indeed Waldman himself has repeatedly conceded, that many Republicans are refusing to be vaccinated, prolonging the pandemic and endangering even vaccinated people.[18]

So here’s what it’s coming down to: Either they die or we all die. And that’s true whether they’re honestly misinformed or not.


Update, December 19, 2021: I take up the question of “honest misinformation” in the pandemic in a new blog post entitled, “The COVID-19 anti-vaccination double standard.”

  1. [1]Nancy Gibbs, “Do the unvaccinated deserve scarce ICU beds?” Washington Post, September 1, 2021, https://www.washingtonpost.com/opinions/2021/09/01/do-unvaccinated-deserve-scarce-icu-beds/
  2. [2]David Scrase, quoted in Nancy Gibbs, “Do the unvaccinated deserve scarce ICU beds?” Washington Post, September 1, 2021, https://www.washingtonpost.com/opinions/2021/09/01/do-unvaccinated-deserve-scarce-icu-beds/
  3. [3]Timothy Bella, “Alabama man dies after being turned away from 43 hospitals as covid packs ICUs, family says,” Washington Post, September 12, 2021, https://www.washingtonpost.com/health/2021/09/12/alabama-ray-demonia-hospitals-icu/; Rebecca Boone, “COVID-19 surge forces health care rationing in parts of West,” ABC News, September 16, 2021, https://abcnews.go.com/Health/wireStory/idaho-rations-health-care-statewide-covid-surge-continues-80056295; Hailey Branson-Potts, “Mortuaries fill, hospitals clog in rural California towns with low vaccination rates,“ Los Angeles Times, August 28, 2021, https://www.latimes.com/california/story/2021-08-28/la-me-rural-california-covid-surge-vaccinations-lag; Jenny Deam, “A Boy Went to a COVID-Swamped ER. He Waited for Hours. Then His Appendix Burst,” ProPublica, September 15, 2021, https://www.propublica.org/article/a-boy-went-to-a-covid-swamped-er-he-waited-for-hours-then-his-appendix-burst; Marisa Fernandez, “As hospitals fill, more ambulances forced to wait,” Axios, August 27, 2021, https://www.axios.com/local-ems-covid-surge-wait-times-611657fc-8ddf-4b32-a6dc-c7f2eb799487.html; Emma Goldberg and Emily Anthes, “Hospitalizations for children sharply increase as Delta surges, C.D.C. studies find,” New York Times, September 3, 2021, https://www.nytimes.com/2021/09/03/health/delta-children-hospitalization-rates.html; Michael Hiltzik, “‘Death panels’ arrive — in COVID-stricken Republican Idaho,” Los Angeles Times, September 17, 2021, https://www.latimes.com/business/story/2021-09-17/death-panels-republican-covid-stricken-idaho; Michael McGough, “Sacramento hospitals ‘at capacity’ and COVID deaths at 6-month high as delta spreads,” Sacramento Bee, August 26, 2021, https://www.sacbee.com/news/coronavirus/article253761928.html; Luke Money, “ICU beds filling up in San Joaquin Valley, triggering hospital surge order,” Los Angeles Times, September 3, 2021, https://www.latimes.com/california/story/2021-09-03/icu-bed-filling-up-in-san-joaquin-valley-triggering-hospital-surge-order; Betsy Phillips, “I was supposed to have life-saving surgery. Tennessee’s covid-19 surge cost me a hospital bed,” Washington Post, September 14, 2021, https://www.washingtonpost.com/opinions/2021/09/14/tennessee-covid-19-surge-hospital-beds-surgery/; Lena H. Sun and Joel Achenbach, “Unvaccinated people were 11 times more likely to die of covid-19, CDC report finds,” Washington Post, September 10, 2021, https://www.washingtonpost.com/health/2021/09/10/moderna-most-effective-covid-vaccine-studies/; Sudhin Thanawala and Jay Reeves, “Virus surge breaks hospital records amid rising toll on kids,” Sacramento Bee, August 26, 2021, https://www.sacbee.com/news/article253764343.html
  4. [4]Nancy Gibbs, “Do the unvaccinated deserve scarce ICU beds?” Washington Post, September 1, 2021, https://www.washingtonpost.com/opinions/2021/09/01/do-unvaccinated-deserve-scarce-icu-beds/
  5. [5]Maggie Fox, “Unvaccinated people are ‘variant factories,’ infectious diseases expert says,” CNN, July 3, 2021, https://www.cnn.com/2021/07/03/health/unvaccinated-variant-factories/index.html
  6. [6]Sarah Pulliam Bailey, “This pastor will sign a religious exemption for vaccines if you donate to his church,” Washington Post, September 15, 2021, https://www.washingtonpost.com/religion/2021/09/15/pastor-donate-vaccine-religious-exemption/
  7. [7]Nancy Gibbs, “Do the unvaccinated deserve scarce ICU beds?” Washington Post, September 1, 2021, https://www.washingtonpost.com/opinions/2021/09/01/do-unvaccinated-deserve-scarce-icu-beds/
  8. [8]Tobias Großekemper, “The Violence of the Fourth Wave: ‘One Thing We Have Learned Is that COVID Is an Asshole,’” Spiegel, November 19, 2021, https://www.spiegel.de/international/germany/the-violence-of-the-fourth-wave-one-thing-we-have-learned-is-that-covid-is-an-asshole-a-9da60dbf-6311-472a-9fdf-60a6442b1235
  9. [9]Mike Baker, “In Alaska’s Covid Crisis, Doctors Must Decide Who Lives and Who Dies,” New York Times, October 3, 2021, https://www.nytimes.com/2021/10/03/us/coronavirus-crisis-alaska.html; Timothy Bella, “An Alabama doctor watched patients reject the coronavirus vaccine. Now he’s refusing to treat them,” Washington Post, August 18, 2021, https://www.washingtonpost.com/health/2021/08/18/alabama-doctor-unvaccinated-patients-valentine/; Rebecca Boone, “COVID-19 surge forces health care rationing in parts of West,” ABC News, September 16, 2021, https://abcnews.go.com/Health/wireStory/idaho-rations-health-care-statewide-covid-surge-continues-80056295; Hailey Branson-Potts, “Mortuaries fill, hospitals clog in rural California towns with low vaccination rates,“ Los Angeles Times, August 28, 2021, https://www.latimes.com/california/story/2021-08-28/la-me-rural-california-covid-surge-vaccinations-lag; Ariana Eunjung Cha et al., “Faced with a crush of patients, besieged NYC hospitals struggle with life-or-death decisions,” Washington Post, March 31, 2020, https://www.washingtonpost.com/health/2020/03/31/new-york-city-hospitals-coronavirus/; Jenny Deam, “A Boy Went to a COVID-Swamped ER. He Waited for Hours. Then His Appendix Burst,” ProPublica, September 15, 2021, https://www.propublica.org/article/a-boy-went-to-a-covid-swamped-er-he-waited-for-hours-then-his-appendix-burst; Marisa Fernandez, “As hospitals fill, more ambulances forced to wait,” Axios, August 27, 2021, https://www.axios.com/local-ems-covid-surge-wait-times-611657fc-8ddf-4b32-a6dc-c7f2eb799487.html; Michael Hiltzik, “‘Death panels’ arrive — in COVID-stricken Republican Idaho,” Los Angeles Times, September 17, 2021, https://www.latimes.com/business/story/2021-09-17/death-panels-republican-covid-stricken-idaho; Christina Baker Kline, “My father should be in surgery rehab. But with beds full of the unvaccinated, he died in covid quarantine,” Washington Post, September 29, 2021, https://www.washingtonpost.com/opinions/2021/09/28/christina-baker-kline-father-death-covid-quarantine/; Hannah Knowles and Caroline Anders, “Hospital system says it will deny transplants to the unvaccinated in ‘almost all situations,’” Washington Post, October 6, 2021, https://www.washingtonpost.com/health/2021/10/05/uchealth-transplant-unvaccinated/; Oliver Laughland and Jessica Glenza, “Inside a Tennessee hospital grappling with Delta and vaccine hesitancy,” Guardian, July 24, 2021, https://www.theguardian.com/us-news/2021/jul/24/tennessee-coronavirus-covid-delta-variant-cases-vaccines; Katie MacBride, [Twitter thread], Thread Reader App, August 21, 2021, https://threadreaderapp.com/thread/1429287685244420101.html; Michael McGough, “Sacramento hospitals ‘at capacity’ and COVID deaths at 6-month high as delta spreads,” Sacramento Bee, August 26, 2021, https://www.sacbee.com/news/coronavirus/article253761928.html; Dennis Pillion, “‘I’m sorry, but it’s too late’: Alabama doctor on treating unvaccinated, dying COVID patients,” Advance Local, July 21, 2021, https://www.al.com/news/2021/07/im-sorry-but-its-too-late-alabama-doctor-on-treating-unvaccinated-dying-covid-patients.html; Jim Salter, “COVID-related attacks prompt hospital to issue panic buttons,” Associated Press, September 28, 2021, https://apnews.com/article/coronavirus-pandemic-business-covid-19-pandemic-missouri-springfield-397f9fca72155f35035df85c9f2e0941; Paige Williams, “Mississippi’s Hospital System Is Rapidly Approaching Statewide Failure,” New Yorker, August 17, 2021, https://www.newyorker.com/news/us-journal/mississippis-hospital-system-is-rapidly-approaching-statewide-failure
  10. [10]David Benfell, “Doubting the ‘Fox News bubble,’” Not Housebroken, April 28, 2021, https://disunitedstates.org/2020/09/07/doubting-the-fox-news-bubble/; Stephan Lewandowsky et al., “The COVID-19 Vaccine Communication Handbook,” HackMD, December 6, 2021, https://hackmd.io/@scibehC19vax/home
  11. [11]British Broadcasting Corporation, “Anti-5G necklaces found to be radioactive,” December 17, 2021, https://www.bbc.com/news/technology-59703523
  12. [12]Maria Godoy, “How COVID-19 Kills: The New Coronavirus Disease Can Take A Deadly Turn,” National Public Radio, March 17, 2020, https://www.npr.org/sections/goatsandsoda/2020/02/14/805289669/how-covid-19-kills-the-new-coronavirus-disease-can-take-a-deadly-turn; Tobias Großekemper, “The Violence of the Fourth Wave: ‘One Thing We Have Learned Is that COVID Is an Asshole,’” Spiegel, November 19, 2021, https://www.spiegel.de/international/germany/the-violence-of-the-fourth-wave-one-thing-we-have-learned-is-that-covid-is-an-asshole-a-9da60dbf-6311-472a-9fdf-60a6442b1235; “ICU is full of the unvaccinated – my patience with them is wearing thin,” Guardian, November 21, 2021, https://www.theguardian.com/world/2021/nov/21/icu-is-full-of-the-unvaccinated-my-patience-with-them-is-wearing-thin
  13. [13]Sarah Gantz and Stacey Burling, “Pa. hospitals are really busy. They beg you to get your flu and COVID-19 vaccines,” Philadelphia Inquirer, December 10, 2021, https://www.inquirer.com/health/coronavirus/covid-hospitalizations-pennsylvania-unvaccinated-20211210.html; Megan Guza, “Covid-driven hospital surge ‘not a sustainable situation’ in Western Pa., expert says,” Pittsburgh Tribune-Review, December 9, 2021, https://triblive.com/local/regional/covid-driven-hospital-surge-not-a-sustainable-situation-in-western-pa-expert-says/; Chico Harlan, “Highly vaccinated countries thought they were over the worst. Denmark says the pandemic’s toughest month is just beginning,” Washington Post, December 18, 2021, https://www.washingtonpost.com/world/2021/12/18/omicron-variant-denmark/; Jeff Himler, “Covid cases create ‘desperate’ situation at Westmoreland hospitals,” Pittsburgh Tribune-Review, December 14, 2021, https://triblive.com/local/westmoreland/covid-cases-create-desperate-situation-at-westmoreland-hospitals/; Michael Rubinkam, “COVID surge: Pennsylvania hospital chain runs out of beds,” Associated Press, December 8, 2021, https://apnews.com/article/coronavirus-pandemic-business-health-pennsylvania-a14addad0c7c7d67c71ad6f3364dbefa; Ed White, “Hits ‘keep coming’: Hospitals struggle as COVID beds fill,” Associated Press, December 18, 2021, https://apnews.com/article/coronavirus-pandemic-health-detroit-nebraska-kansas-5e98f09c578a231be1411516e9dfff58
  14. [14]David Benfell, “What we owe anti-vaxxers in a life-threatening pandemic,” Not Housebroken, November 19, 2021, https://disunitedstates.org/2021/09/28/what-we-owe-anti-vaxxers-in-a-life-threatening-pandemic/
  15. [15]Paul Waldman, “The red covid wave is here,” Washington Post, December 17, 2021, https://www.washingtonpost.com/opinions/2021/12/17/red-covid-wave-is-here/
  16. [16]Joel Achenbach, “New study on delta variant reveals importance of receiving both vaccine shots, highlights challenges posed by mutations,” Washington Post, July 8, 2021, https://www.washingtonpost.com/health/delta-variant-vaccines/2021/07/08/05b1bc5e-df75-11eb-ae31-6b7c5c34f0d6_story.html; Maggie Fox, “Unvaccinated people are ‘variant factories,’ infectious diseases expert says,” CNN, July 3, 2021, https://www.cnn.com/2021/07/03/health/unvaccinated-variant-factories/index.html
  17. [17]Linda Geddes, “Without Covid-19 jab, ‘reinfection may occur every 16 months,’” Guardian, October 19, 2021, https://www.theguardian.com/world/2021/oct/19/without-covid-19-jab-reinfection-may-occur-every-16-months-say-scientists
  18. [18]Max Boot, “Republicans are preventing America from reaching Biden’s vaccination goal,” Washington Post, July 6, 2021, https://www.washingtonpost.com/opinions/2021/07/06/republican-antivaxxers-biden-vaccination-goal/; Philip Bump, “A third of White conservatives refuse to get vaccinated — a refusal shown in polling and the real world,” Washington Post, July 6, 2021, https://www.washingtonpost.com/politics/2021/07/06/third-white-conservatives-refuse-get-vaccine-refusal-shown-both-polling-real-world/; Dan Diamond, Hannah Knowles, and Tyler Pager, “Vaccine hesitancy morphs into hostility, as opposition to shots hardens,” Washington Post, July 15, 2021, https://www.washingtonpost.com/politics/covid-vaccines-biden-trump/2021/07/15/adaf6c7e-e4bd-11eb-a41e-c8442c213fa8_story.html; Ron Kampeas, “In latest Nazi analogy, Marjorie Taylor Greene invokes ‘medical brown shirts’ in decrying vaccination outreach,” Jewish Telegraphic Agency, July 7, 2021, https://www.jta.org/quick-reads/in-latest-nazi-analogy-marjorie-taylor-greene-invokes-medical-brown-shirts-in-decrying-vaccination-outreach; Dhruv Khullar, “One half of America is protected. The other is approaching a perilous moment in the pandemic,” New Yorker, June 23, 2021, https://www.newyorker.com/science/medical-dispatch/the-delta-variant-is-a-grave-danger-to-the-unvaccinated; Ed Kilgore, “The Willfully Unvaccinated Are the Newest Republican Martyrs,” New York, July 13, 2021, https://nymag.com/intelligencer/2021/07/the-willfully-unvaccinated-are-the-newest-republican-martyrs.html; Grace Panetta, “GOP Rep. Lauren Boebert calls Biden’s door-to-door vaccinators ‘needle Nazis,’” Yahoo! News, July 8, 2021, https://news.yahoo.com/gop-rep-lauren-boebert-calls-130015902.html; Ed Pilkington and Lauren Aratani, “US seeing ‘pandemic of the unvaccinated’ as cases rise in every state,” Guardian, July 16, 2021, https://www.theguardian.com/world/2021/jul/16/covid-19-us-delta-variant-unvaccinated; Greg Sargent, “A vile new Trump-GOP claim about vaccines suggests trouble ahead,” Washington Post, July 19, 2021, https://www.washingtonpost.com/opinions/2021/07/19/vile-new-trump-gop-claim-about-vaccines-suggests-trouble-ahead/; Paul Waldman, “Right-wing anti-vaccine hysteria is increasing. We’ll all pay the price,” Washington Post, July 8, 2021, https://www.washingtonpost.com/opinions/2021/07/08/right-wing-anti-vaccine-hysteria-is-increasing-well-all-pay-price/; Paul Waldman, “The red covid wave is here,” Washington Post, December 17, 2021, https://www.washingtonpost.com/opinions/2021/12/17/red-covid-wave-is-here/

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