As far back as I can remember, I have believed that the last death in any war must be that war’s saddest and most pointless.
I can’t explain why I thought about this as a teenager, or maybe a preteen. Maybe it was because I came of age during the Vietnam War, which a large swath of America had come to believe was, itself, pointless. My parents were grateful that it took 11 years after they were married before their first child came along. That was me. My tardy arrival meant I was too young to volunteer or be drafted for service in Southeast Asia.
It also could have been because we heard occasional stories in those years of diehard Japanese servicemen emerging from far-off jungles. Such stories continued for decades after World War II. Often, these soldiers carried news of comrades who died during the long years of operating behind what they believed were enemy lines, having rejected reports of Japan’s surrender as mere American duplicity.
If the global battle against SARS-CoV-2 can be likened to a public health war, then inevitably, someone will become its last casualty. Will that death be similarly pointless, coming long after the conflict’s outcome has been decided?
Perhaps not. Maybe that last fatality will be a heroic doctor or nurse, an ambulance driver or EMT, a police officer or firefighter or bus driver who contracted the illness in the line of duty. Such a person will have made their sacrifice so others could live through the pandemic, or live decently as it raged. The risks such people take serve a worthy purpose. While such a final death would be tragic, it would not be pointless.
I can’t say the same for anyone who dies of COVID-19 complications because they declined to accept a vaccination, once such protection is readily available.
There seems to be a startling number of people who admit to such foolish intentions right now. A recent poll conducted by The Wall Street Journal and NBC News found that 17% of respondents said they would not get the vaccine under any circumstances. Another 10% said they would take a vaccine only if it was mandatory. There are probably others who sense the wiser reputational course is to keep their reticence to themselves. Maybe in America this phenomenon will pass with the rest of the 2020 election-season fever dreams. But given the tenacity and obliviousness of the anti-vaxx mob (I won’t dignify it as a movement), and the selectivity with which many people follow the science on matters such as genetically modified food, I am not encouraged.
So you don’t want to be first in line for a vaccine? Don’t worry – you won’t be. The leading candidates currently in phase 3 trials to determine their effectiveness have long since cleared earlier tests to evaluate safety, dosage and immune response. (This is not the same as demonstrating a particular level of actual immunity.) Once vaccines clear trials, the earliest doses will go to medical personnel, first responders and other highly vulnerable populations anyway. If you are not in those groups, or in one of the clinical trials, you will be far from the first to receive a vaccine, even if you get it as soon as you can.
Will there be a risk of adverse reactions? Of course. There are adverse reactions to every medical therapy. The relevant questions are their frequency and severity, compared to the offsetting benefit of disease reduction and amelioration. With COVID-19, vaccines offer both a personal benefit and a community benefit – the avoidance of transmission to others, especially those who are more vulnerable. By the time a vaccine reaches you, science will have demonstrated that adverse reactions are rare and, in most cases, comparatively mild. These public health costs will pale in comparison to the benefit of quickly eliminating community transmission of the new coronavirus.
Another consequence of my being born so long after my parents were married is that by the time I came along, polio vaccines were available. I knew people just a few years older than me who spent their entire lives in leg braces or wheelchairs after contracting polio as children. And they were the survivors; not everyone who got polio lived to adulthood.
We kids not only had to be immunized to go to school; we were immunized at school. One of the high points in the life of a New York City first grader during the Kennedy administration was getting a vaccine-laced sugar cube handed to you by the school nurse. There were people who protested such government coercion. People also protested public health measures such as adding fluoride to public water supplies to prevent tooth decay (a Communist plot, some asserted). Having actually seen the consequences of polio and poor dental health, neither policymakers nor the public at large were sympathetic to these objections. That generation of parents was a more practical one, at least in contrast to the vocal minority today who let their children acquire measles and other preventable disease.
Dr. Paul Offit, an infectious disease expert at the Children’s Hospital of Philadelphia, suggested that – ironically – effective past vaccine campaigns may have laid the groundwork for the anti-vaccine resurgence in recent years. Parents who have not seen the effects of diseases like polio for themselves may be more likely to dismiss the risks of contracting them. “Vaccines are a victim of their own success,” Offit told The New York Times.
Do you have a constitutional right to refuse a vaccine? I think you do; it’s your body – or your unfortunate child’s, if that child is underage. But do you have a constitutional right to board an airplane, sit in a classroom or attend a performance where you may become a disease vector to those who, because of age or comorbidity or other factors, can’t be vaccinated themselves? Nope.
Someone is going to be the last casualty of the war on COVID-19. Unless your personal exposure serves some higher purpose, becoming that casualty will make yours the most pointless death of the entire pandemic. Don’t sign up for that mission.