Editorial: There is no absolute right to refuse vaccination

LOS ANGELES, CA - MARCH 04: Medical assistant Cynthia Vicente, left, gives the Moderna COVID-19 Vaccine to Armando Zavala, 49, right, at the South Central Family Health Center on Thursday, March 4, 2021 in Los Angeles, CA. According to David A. Roman Director of Development and Communications at the South Central Family Health Center, "South Central Family Health Center is currently receiving about 100 vaccines per week for its 24,000 patients; we have nearly 4,000 patients ages 65 and older. Our ability to vaccinate the community is predicated on the availability of vaccines, and the manner in which those vaccines are allocated. At the current rate, it would take 240 weeks to vaccinate all our patients, without providing additional vaccines to the community at large. That would be unacceptable by any standard. SCFHC is happy to see that the State of California is making a commitment to ensuring that at least 40% of the vaccines are distributed to low-income and hard to reach populations dominated by African American and Hispanic communities. Making all Community Health Centers key partners in the state's vaccination plan would be a great way to ensure that vaccines are distributed to the people most impacted by the COVID-19 pandemic, and allowing us to prioritize the vaccination needs of our patients first would go a long way to reducing vaccination barriers. Until the state puts its new plan into action and the vaccines in the hands of Community Health Centers, we believe that inequitable vaccine access for African American and Latino patients will continue to be the norm." (Francine Orr / Los Angeles Times)
Medical assistant Cynthia Vicente, left, gives the Moderna COVID-19 vaccine to Armando Zavala, 49, right, at the South Central Family Health Center in March. (Los Angeles Times)

More than half of American (and Californian) adults have received at least one dose of a COVID-19 vaccine, and nearly a third are fully vaccinated. Vaccination has now been opened to everyone 16 and older. Our biggest worry in the coming months isn't whether we'll be able to deliver enough doses; it's whether enough people will seek them.

We’re getting closer to the point where every American who wants to be vaccinated will have gotten their needle stick. A quarter of Americans say they don't plan to be vaccinated; in vaccine-friendlier California, that’s 1 in 5.

Of those who don’t plan to be immunized, some worry about the newness of the vaccines, while others just don’t like vaccines in general, despite the mountains of proof about how many lives they save, and some stubbornly refuse to believe that COVID-19 is all that dangerous. They should take a sobering look at India, where vaccine hesitancy has been identified as one of the major factors, along with new variants and complacency about risks, behind a horrific surge in cases and deaths.

Now, as businesses in the U.S. beckon employees back to the office, colleges prepare for the return of students in the fall, and stadiums, arenas and concert halls open, vaccine resistance is colliding with efforts to fully restart the economy and, over time, ditch the masks and social distancing. Numerous Republican officials have opposed "vaccine passports" that would grant services or entry only to people who'd been vaccinated. Some parents are declaring that they don’t want to have their children inoculated in order to return to school, should the vaccines be approved for people younger than 16. Some teachers don’t want the shots, either. Or nurses.

Drawing the lines on vaccine mandates can be tricky. We don’t require flu vaccination for public school students, but we do require the shots that guard against measles, mumps and rubella and a host of other diseases.

Yet some things are clear.

No one has the right to sicken anyone else or start a new spike in cases through carelessness or their own sense of “personal choice.” At the same time, people who have a valid medical reason not to be vaccinated — and they are extremely few — should get a pass.

Private businesses and employers have a right to set the rules for their customers, employees and anyone else who comes through their doors. Medical staff shouldn’t be allowed to sicken patients — or one another — with a potentially deadly virus. Foreign visitors to the United States also should have to show that they have gotten the shots or submit to quarantine, just as U.S. tourists to the European Union will have to do this summer.

At the other end of the spectrum, should widespread vaccination and advances in treatment bring COVID-19 to the point where it is no more dangerous than the flu — which isn’t exactly safe, killing 30,000 to 50,000 Americans a year on average — the rules should be no more onerous than they are for that disease. Here’s hoping that day isn’t too far off.

And unvaccinated people should be able to go to uncrowded outdoor settings where the chance of passing the illness on to others is extremely small, such as when walking down an uncrowded sidewalk. That’s already true under new guidelines by the Centers for Disease Control and Prevention and many municipal rules.

Schools appear to be safe environments for now, but they can’t move to full-time, normal activity without vaccination. That will have to wait until the vaccines have been approved for children. At that point, just as immunization is required for all kinds of diseases at school, the same should be true of the COVID-19 vaccines. Teachers and other staff also should be required to get their shots. There is more chance of adults passing it to one another than of students spreading the disease.

One problem is that public schools and colleges — as well as courthouses, Social Security offices and other public institutions — cannot require anyone to get a COVID vaccination until the vaccines receive final approval. Existing law demands that people be told they have the right to refuse pharmaceuticals before that stage.

The Pfizer and Moderna vaccines could receive approval by autumn, but variants of the virus keep cropping up, and if the vaccine boosters to fight those variants are considered new pharmaceuticals, they may remain under emergency-use rules. Congress needs to update the law so that vaccine refusers don't have a chance to endanger those who take wise medical precautions.

This story originally appeared in Los Angeles Times.