Kia Ora whānau Aotearoa. After countless sleepless nights and the shedding of tears as I’ve seen my country, my beautiful Aotearoa New Zealand torn and hurting, I feel compelled once again by my convictions to write to you in aroha and fervour. I want to address the question at the heart of vaccine mandates. Partly because I haven’t yet seen it properly distilled, certainly not in coherent public debate, certainly not by the media, and certainly not by the Government. That might seem surprising because it’s very much in our face. Discussed about everywhere but typically in clunky half-formed and poor arguments. I have often found us talking at cross purposes – providing the answer to one question as if it were another. Like answering the question “should we mandate vaccines” with “vaccines save lives”. I’ve witnessed us shouting at each other. I’ve seen us attempting to silence each other when we even explore anything that diverges from the “official narrative”. I have my own apologies to make in this respect. But never do we seem to truly distil the question, which is what I will attempt to do in this post.
I’ve tried over the past weeks and months to wrestle with and boil down as best I could the essence of the question, or even what the question is. I’ll start with what the question is not.
The question is not whether vaccine mandates and passports reduce risk. They may well do. They certainly have not delivered on the promise on which they were initially justified. That is, if we accept this level of discrimination, the vulnerable would be well protected and we could begin to return to normal. Despite an incredibly high vaccination rate, COVID continues to adapt and spread rampantly. This is not to disparage the vaccines or make a case against them. They are what they are: limited. It’s not a reason not to use them.
I hesitate to use analogy, because it’s a shortcut that often leads us down the wrong path towards flaky conclusions, but it can be helpful to test different ideas; for example, perspective on risk and fear. There are a great many risks of harm that could be reduced with extreme measures. For example, we could stop using cars and replace them all with a massive fleet of buses which go past every home several times a day. This would all but eliminate 300+ deaths and countless horrific life-changing injuries every year. Isn’t there some irony in that when someone gets in their car to drive to a vaccination centre, they may be statistically at greater risk of injury from getting out on the road than from facing covid unvaccinated? Yet we don’t live in fear as we glide along our highways, windows down, invigorated by the scent of Kānuka. And yet when I walk the streets of Ōtāhuhu I see people walking and driving alone, masked to the hilt seemingly enfeebled and broken down by fear from relentless government and media messaging. But as I said, the crux of the question is not whether or how much risk might be reduced by vaccine mandates.
The question is also not – whether the COVID vaccine is effective – it is clearly effective for at least a few months after administration; not very effective at preventing the spread as we’ve seen with the current variant, but effective at significantly reducing the severity of illness – yay for medical technology.
The question is also not – should people ideally do everything they can to protect others, especially those who are more vulnerable. I think there’s a reasonable ethical argument for that. Likewise, in terms of public health and the public health system, we should live good healthy lives and not unfairly burden the system. Much of the cost we all pay into the health system comes as the result of people’s personal choices. Whether it be too many beersies or pushing the boundaries on a mountain bike. That’s the price we pay to live and allow others to live the life they want to. Some might prefer a user pays system, personally I’m not in favour, I don’t think it makes our society better. You can see this in other countries. The point is – personal choice vs. health care consumption is not confined to COVID.
The real issue that lies at the heart of vaccine mandates is the ethics of consent and whether informed consent should be the foundation of public health – a bottom line. A good argument can be made that hesitancy about a specific vaccine (not ideological opposition to all vaccines, which is fairly rare, albeit noisy) is an indication of a failure of public trust (Doidge, 2021). That is, people are hesitant because they do not trust government institutions or drug companies. That is, governments and corporations have failed to build trust (Doidge, 2021). In this respect, mandates are jet fuel on the flame of distrust and will certainly have far reaching societal consequences for decades to come. I weep now as I think about this scar forming on our community from this injury we’ve inflicted on ourselves. And it’s too late now – the mandates will be repealed but the damage has been done. In a way it’s like house price inflation – the damage has been done, we can’t go backwards. The only thing to do is to rebuild, repair, to heal. It takes a long time.
But that still doesn’t get to the heart of the question. It’s really a simple question, but it’s not one that can be answered with science or through government risk assessment. It’s a question of values and about what kind of society we want to live in and what kind of rights we want. It’s a question best asked and answered outside the context of the current pandemic and vaccines. It’s a question that has sadly been scorned and scoffed at lately, despite being hard won through painful lessons of history (Doidge, 2021). Until very recently, it was taken for granted that public health was built on a foundation of informed consent. That is, the public health system will not do anything to you without informing you and obtaining your full consent. That’s why when you receive a prostate exam or some such procedure the doctor will inform you carefully about the procedure and make sure you are ok with it.
Now we arrive at the question itself - should individuals have the final say about what medicines go into their body or do we want that to be controlled by the state as and when they see fit, using their best judgment - including administration of medicines that have been developed and approved at breakneck speed?
To answer this question, we might use a thing that’s often talked about but seems to be in short supply of late – empathy. Empathy is not another word for “kindness” and it’s not about being a smiley gladhands. Empathy is to transport your mind and your heart into someone else’s situation and to feel what they must be feeling.
Again, abstracting yourself from the present pandemic, a generic ‘empathy thought experiment’ could go something like this:
“There is a medicine which the state wants me to take but for some reason, I REALLY don’t want to take it.” When you transport yourself to this situation, which option do you choose?
I want to be informed about the options and then be given the choice. I want the right to make the final decision about whether to take the medicine, and not to be coerced into taking it with threats such as losing my ability to provide for my family or being excluded from society
I think that ultimately the state should decide what medicines I take for the good of all the comrades. So even though I don’t want the medicine, and if I refuse, I’m ok for the state to discriminate and apply sanctions against me based on my choice
If you choose option 2 and you also support the current COVID-19 vaccine mandates, fair enough.
If you choose option 1 and you also support the current COVID-19 vaccine mandates then I believe your position is untenable.
But you may have a more detailed answer, as many do – ”It’s not that simple, Rhys!” Your answer might go something like this – “Well it depends on what the situation is, and it depends on what the medicine is”.
I’ll take the liberty to rephrase your answer – “If I do want the medicine then I think the state should be able to force everyone to take it, and informed consent should be kicked to the kerb. However, if I do not want the medicine then I want the right to decide for myself. See, it depends!”.
It’s not hard to see that this viewpoint is untenable and hypocritical. Essentially, you’re only prepared to defend the right when it concerns you. The rest of the time you’re quite happy to withhold it from others, essentially throwing your fellow kiwis under the bus.
That’s the way rights work: you either have them or you don’t. You can’t have the right to informed consent sometimes (but only when you need it). Please don’t misunderstand this – I’m not saying that any right is absolute. The rights we want and award to each other are always a negotiation and a balancing act. If you believe we should do away with the right to informed consent and you consider the possible reduction in risk to the community is worth giving it up – ok, fair enough. It’s not what I want, but fair enough if that’s what you want. However, you cannot pick and choose when you want the right and when you do not. You can’t have it both ways. That’s pure hypocrisy.
What about a real-world example of practicing empathy? Getting close to the situation at hand now. This is a personal story of a friend. They were taken to hospital with fever and chest pain after their second dose of Comirnaty (the Pfizer vaccine). The fever was put down to common side effects of the vaccine, and the chest pain was put down to something like acid reflux. After the third dose they suffered more severe chest pain and were taken to hospital again and diagnosed with myocarditis, a rare but serious side effect of Comirnaty. Now the question is – should this person be able to make the decision about the 4th booster presuming the pandemic continues with new variants, etc. Transport yourself – would you want the choice? As it stands, under the law this person cannot choose. The decision is not even between them and their own doctor – the Ministry (central government) has the final say on exemptions. Please don’t argue that there is still choice. Where can you go? The petrol station and the supermarket? You’re an outcast – “unvaccinated vermin” as a cafe owner was apparently overheard saying to someone who could not present a vaccine passport (unverified). What have we become, Aotearoa?
Perhaps you’ll assume the Ministry will act fairly in a case like this and grant an exception. However, informed consent means not having to justify refusal of a medical treatment. There are many reasons someone might not want the COVID vaccine. For example, people who find themselves on the bottom rungs of society, struggling with the cost of housing might not have much faith in their government and may not trust them. As discussed above, forcing people further erodes trust. Interestingly, this is not a concern of the elites who drive the COVID narrative through the media. Likewise, people might not trust Pfizer – a company who “was fined $2.3 billion for promoting the painkiller Bextra, later taken off the market over safety concerns, at dangerously high doses (misbranding it with ‘the intent to defraud or mislead’) … the largest criminal fine ever imposed in the US, until it was beaten by GSK [GlaxoSmithKline]” (Angell, 2005). Relatedly, some are concerned about the speed at which these vaccines have been developed and approved. Never has a vaccine been produced and distributed so quickly, and only time will tell what the long-term effects might be. For most of us, we’re willing to take the chance. Should we be forced to? Others have had severe reactions such as anaphylaxis to other medications and simply do not want to take the risk. However, under the current law it is up to the state to moralise about what constitutes an acceptable reason to refuse the medicine.
If you still say to me, “I don’t care about the right to informed consent, I just want the risk reduced as much as possible by any means and that’s why I support the mandates.” I have no beef with you. That’s where your values lie, I’ll accept that. Although I’ll still try to convince you that I don’t owe you my body, and that you don’t owe me yours.
If however, you do consider informed consent important but you refuse to confront the question of COVID vaccine mandates, or if you refuse to defend a right you think you’d like to use in the future (e.g. if you decide you don’t want the 4th, 5th or 10th booster for ANY reason) then we cannot see eye to eye, and I ask you, please reconsider your position. Please demand an immediate end to vaccine mandates – even if it does increase our risk, there are many risks in life.
Please Aotearoa, let’s start to put things back together, we have so many more challenges to face, together.
References Angell, M. (2005). The truth about the drug companies : how they deceive us and what to do about it (1st ed ed.). Random House.
Doidge, N. (2021). Needle Points. https://cdn.sanity.io/files/z2aip6ei/production/d9f27923a752427f6ce856f064f4d445c00d932b.pdf?dl=Needle%20Points.pdf
P.s. The above article by Norman Doidge which examines why people might be vaccine hesitant is extremely enlightening and compelling.