vaccine passports

I am Against Vaccine Passports and I Am a Healthcare Worker

2 September 2021

16.8 MINS

I am strongly against vaccine mandates, even though I am a healthcare worker who intends to get vaccinated. Here’s why I think mandatory vaccines are a bad idea.

On 9 August, Washington Governor Jay Inslee announced a sweeping vaccine mandate, requiring all state and healthcare employees to submit to mandatory vaccination against COVID. This has since been expanded to include all educational workers, from kindergarten through higher education.

The Pentagon has likewise announced that it will begin rolling out a vaccine mandate following full FDA approval of the Pfizer COVID vaccine. All of this follows on the heels of the controversial European vaccine passports we have seen protested in the international news.

Since I fall into two of the above categories — as a healthcare worker and as a National Guardsman, and I strongly oppose both measures — I think the time has come to explain my position on vaccine mandates. I do not do this lightly, as it is not my personality to seek controversy or openly oppose the status quo.

I am by nature rather a conciliator, willing to go along as long as I am not asked to violate my conscience. I am what we call the “grey man” in Special Forces, meaning I seek to be unobtrusive and forgettable, so that I can be left alone to live my life as I see fit.

I think the time has come to break my silence, because I do not see many other people sounding what I feel to be a long-overdue alarm in a reasonable and measured way. Therefore, I am taking the time to write out what I think about mandatory vaccines and why.

I am a reasonably typical husband and father. I work as a Physician Assistant in Washington State, and I am also a National Guardsman. Before that, I was a Special Forces Medical Sergeant (a.k.a. “18D” for those who know what that means). I am also a committed Catholic. I think it fair to preface this by saying, for those who will not read to the end, that I do intend to get vaccinated.

I am, as I said, a National Guardsman. I have sworn an oath, to which I attach religious significance even if those who administered it do not, to obey all lawful orders of those appointed over me. By definition, this places the burden of proof upon me to demonstrate that an order is unlawful before I can be released from this oath of obedience.

This is part and parcel of joining the military; we foreswear certain fundamental human inalienable rights for the sake of a higher mission. We voluntarily place ourselves under obedience in a way that civilians do not.

The current directive about compulsory vaccines is not the first time in my nearly twenty-year career that I have been ordered to do something that I did not want to do and thought was ill-advised, yet I did anyway for the sake of that oath. If it gets bad enough, I will stop re-enlisting.

I explain this to demonstrate what I find bothersome about Governor Inslee’s vaccine mandate. I have never sworn an oath of obedience to him as a civilian. I have never promised to abide by the recommendations of his panel of experts.

In my status as a civilian, I owe him and the state nothing beyond the common allegiance of any other civilian. I do not work for a state healthcare agency. He does not pay my bills. So from where does he derive his authority to determine the terms and conditions of my employment?

The answer, of course, lies in licensing regulation. Because we operate in a system where the state ultimately endorses the authority to conduct business, the state also holds the power to revoke that authority. That this is foolish and unjust should be apparent, but it is too broad a topic to engage here.

Why have I, as a medical provider, not yet been vaccinated? Do I not believe in “the science?” Am I a closet anti-vaxxer? Hardly. I have a vaccination record longer than my arm after more than three years of overseas time in my military career. I have five reasons why I have not been vaccinated against COVID. I will list them in order of importance.

1. Supply shortage

When the vaccines first became available, there was a shortage. I had some critiques about the rollout scheme. Still, since the highest risk for severe disease from COVID seems to be the elderly, closely followed by hypertension, obesity and diabetes, I thought that it did not make sense for a young, healthy person to jump the others in the line. As long as supply remained low, it should have gone to the vulnerable first. Supply seems to have caught up to demand, so this is no longer a problem.

2. New technology

The mRNA technology is an exciting new development in immunology. I do not share the concerns of many who fear everything from infertility to antibody-dependent enhancement, to microchip implantation. (Why I should be afraid of that in a shot when we all carry one around with us all the time, I will never understand.)

Nevertheless, I am no technophile. I do not believe that something is good, safe or necessary simply because it is new or because experts endorse it. My stance on this is that we currently do not know if there might be long-term adverse effects, although, with the number of vaccines given out, we will have sufficient data to pick up on almost anything in the next few years.

It is essentially the largest, most widespread medical experiment in history, not to mention a psychological and sociological experiment. Still, my preference would be to go with a tried-and-true technology (live or dead virus) and watch everyone else to see the long-term effects of the new technology.

3. Side effects

Of the thousands of vaccines I have administered or overseen in my career, I have not seen one that produces side effects like the COVID vaccine. For most young people, the vaccine is worse than the disease.

While these side effects are generally no worse than a flu-like syndrome for a couple of days, they are still a count against the vaccines, and I need a pretty strong motivation to willingly undergo that.

4. Ethical sourcing

Currently, no COVID vaccines are available that were not manufactured, developed, or tested using cell lines derived from aborted children. I have been holding out for the Sanofi-Pasteur, but it turns out it has also been tested on aborted fetal cell lines.

The BAT/Kentucky or Covavaxin candidates look good so far, but with the FDA approval of Pfizer, as well as the likely upcoming approval of Moderna and Johnson and Johnson, all other candidates may be removed from the Emergency Use Authorization track entirely. Suffice it to say, it looks like no other options will be coming in time to resolve my dilemma.

For those to whom fetal stem cell research is a non-issue, this may not make sense. I suppose I must explain that I oppose the exploitation of any human being for the sake of another, whether that human being is pre-born or born, young or old. I object to this for the same reason I object to sweatshops, to child porn, to corporate greed, to intersectional politics, to any number of other evils.

I understand that in today’s complicated, interconnected world, total non-involvement in systemic exploitation is impossible. For heaven’s sake, the computer I type this on may have been manufactured on the backs of slave labour in China, for all I know.

I get vaccines for my kids and recommend them for other people’s kids for life-threatening diseases, even though I know that some of these vaccines are made using the cell lines of murdered children. The reason for this is that I know the Catholic theology on the topic: that a remote material cooperation in an evil is permissible if:

  1. There is a grave need, e.g. a serious and imminent threat to personal life or public health.
  2. There is no ethically sourced alternative.
  3. We protest the unethical origins of the vaccine that we use.

Given the USCCB and Vatican statements on the topic, you may wonder why I object to this at all. I know that most US Bishops support taking the vaccine, despite moral reservations about the source of the vaccines. They reason that, in the context of the global health crisis, it is an act of charity to protect the health of one’s neighbour and that this outweighs the remote connection to the evil of the abortion that procured the cell line by which the vaccines are derived.

Yet, there is a caveat to the church leaders’ recommendation that we accept the vaccine. This is the two-fold requirement that there must be a grave public health risk to not getting vaccinated, and that one must register their objection to the exploitation of human life that is the source of that vaccine.

I must pause on this, for it is crucial to my argument. We have this dilemma of unethically developed vaccines because of a lack of meaningful protest against this practice. As I have maintained from the beginning, I argue that pharmaceutical companies have no respect for human life, understood according to Catholic principles.

Simply saying “I protest!” while lining up to receive their products, either paying for it directly or allowing the government to buy it for you, effects no change. There must, at some point, come a real, concerted boycott of these vaccines, or nothing will change.

Again, as I have from the beginning, I continue to maintain that COVID represented a golden opportunity (now sadly lost) for Christians to send a resounding message by refusing across the board to take any vaccine developed from or tested on fetal cell lines (e.g. HEK-293).

Clearly, this is not going to happen. Nevertheless, my only option for a real, meaningful protest right now is to refuse the vaccine and to have conversations with my colleagues about why I make that choice.

Still, church leadership is correct. Suppose there is a clear and grave risk to human life from not taking a vaccination. In that case, I should at least pause to consider whether the need outweighs the remoteness of the vaccine’s involvement in the evil of abortion.1 This leads to the most complex part of my argument.

5. Lack of necessity

The COVID vaccine is unnecessary for me. Let me be clear: I am not saying that the vaccine is unnecessary for everyone. I am saying that they are unnecessary for me — and that the ability to make this kind of individualised medical decision is a critical and endangered component of Western medical ethics.

First of all, I must defend my statement that the vaccine is unnecessary for me. How did I arrive at this conclusion? Very simply, I have been exposed to COVID several hundred times in the last year and a half and have never had a positive test.

I, along with my colleagues in my office, my wife, kids, in-laws, and nearly everyone else in my circle, had a respiratory infection from January through March of 2020, which may or may not have been COVID. Some of us are convinced that it was; others are not.

I think it likely was, since most of us work in the medical field and have likewise been exposed to COVID many times, and only two from that circle ended up testing positive in the whole last year.

Be that as it may, I have been in rooms with COVID patients, with no protection other than a surgical mask, for countless hours over the last few years. I have leaned my head in their car windows and had them cough on me to listen to their lungs. I have never tested positive, even when I was getting tested once or twice a week. This is an in vivo experience that demonstrates that my immune system is up to the task.

Does Everyone Need to Get Vaccinated?

How does this square with the research that the CDC and other authorities keep citing to say that absolutely everyone needs to get vaccinated? Well, there are two answers to that.

First, the research is not as monolithic as the voices on either side of the polarised divide would have us believe. For instance, the CDC maintains that vaccine-acquired immunity is superior to infection-acquired immunity, a stance echoed by most experts quoted in the mainstream media. The reasoning for this statement comes from two basic kinds of studies.

The first and the most common is the in vitro study, which compares markers of immunity isolated from people with natural infection to those isolated from people who have been vaccinated. I listen to these studies, but do not place too much stock in them.

This is the same sort of study that told us that azithromycin would cure COVID for everybody and that people would lose their immunity to COVID within six months of infection because their antibody levels went down. Both fall prey to the same critique, which should be well known to every practising medical provider. Just because something works in a lab doesn’t mean it works in real life.

More to the point is the second class of studies, the population-based studies, what we might call in vivo. These look at the behaviour of the virus in real-life populations that have and have not been vaccinated. The results to date have been a mixed bag.

For instance, the CDC quotes a study from Kentucky involving 246 case-patients with COVID reinfection, compared with 492 age-matched controls who had not been reinfected. Those who had not been reinfected were more likely to have been vaccinated than those who were reinfected. The statistical analysis showed that people with previous COVID but no vaccination were 2.34 times more likely to be reinfected than previous COVID and vaccine.

There are several critiques to this study. First, the comparison does not support the thesis. They are not comparing natural vs. induced immunity, but rather natural immunity alone vs. natural + induced immunity. Of course, double coverage would be higher.

Secondly, the study reports only relative risk, not absolute risk. But absolute risk is critical for any real-world decision-making. If you tell me that I have double the risk of getting struck by lightning if I live in Florida than in Washington, that is a relative risk of 2x. But if my absolute risk is one in 500,000 Florida and one in 1,000,000 in Washington, this consideration will not figure highly in my decision about where to live.

(For example, Denmark’s massive national cohort study showed an absolute risk of reinfection of 0.6% across the general population. This study has significant limitations, mainly because it does not describe the severity of reinfections. However, it still shows a very low absolute risk of infection for previously infected patients.)

Thirdly, there were 246 participants in this study. With a population this small, unknown or unidentified selection bias can profoundly affect the results beyond what can be reflected in diagnostic statistics.

This, of course, raises the question of why the sample size was so small since, so far, Kentucky has had roughly 562,000 cases of COVID. One would think that if reinfection was a common occurrence, the authors of this study might have done better than 246 case patients.

Compare this to a pre-print of a study of 52,238 employees of the Cleveland Clinic Health System. That study compared reinfection rates among vaccinated vs. previously infected but unvaccinated employees.

It found zero cases of reinfection among previously infected but unvaccinated patients. It also found no statistically significant protective effect of the vaccine among previously infected individuals.

“Of the 2154 SARS-CoV-2 infections during the study period, 2139 (99.3%) occurred among those not previously infected who remained unvaccinated or were waiting to get vaccinated, and 15 (0.7%) occurred among those not previously infected who were vaccinated.

Not one of the 2579 previously infected subjects had a SARS-CoV-2 infection, including 1359 who remained unvaccinated for the duration of the study.”

There are critiques for this study as well. For one thing, it is not yet peer-reviewed. Secondly, it does not test the duration of immunity. It nevertheless paints a drastically different picture than the CDC study quoted above.

What about the large (n=1597) cohort study from Italy that found that natural infection provides a hazard ratio of 0.07 for subsequent COVID infection, roughly 93% protection against the disease compared with no previous infection?

Or what about this report of Israeli data indicating a possibly superior level of protection from natural immunity vs. vaccination? I reference this one with the caveat that I have been unable to find the original data, and I am sceptical of science reporting in popular media.

[EDIT: Three days after finishing this article, I came across a pre-print of a study based on the same information showing a 13-fold higher risk of infection with the Delta variant for vaccinated people without prior infection compared to unvaccinated people with prior infection. So, for once, the popular media didn’t get it completely wrong.]

Vaccination is Not the Only Route to Immunity

Suffice it to say that there is sufficient data to call into question the recent narrative that vaccination is the only route to immunity. This is not to question the validity of vaccination as a public and personal health measure, only to say that it is not the only choice that makes sense for every given case. Hence my opposition to vaccine mandates and vaccine passports.

I mentioned above that there are two reasons why my experience doesn’t square with the CDC’s recommendations. The first was that more data is available than what the CDC has referenced in the public statements that I have seen. The second is that data is just that: data. It is statistics, which by its very nature is an imperfect guide to practice.

When we talk about odds of reinfection and hazard ratios, we speak like statisticians, not like clinicians. Every clinician knows that the statistics do not perfectly represent actual patients. So, for example, when the data tells us that people under the age of 25 have a 1 in 10,000 chance of dying from COVID, this means nothing to that one 25-year-old who dies and his family. He did not have a 1 in 10,000 chance; he had a 1 in 1 chance of dying. He just didn’t know it.

I encounter this every day in practice. When I prescribe lisinopril, which I do several times per week, the data tells me that I can expect a small percentage will get a chronic dry cough, and an even smaller percentage will get angioedema. The data does not tell me which ones will get this. Only experience can tell me that. I have to try the medications and observe the results. When a patient gets a cough or angioedema, I know that he does not do well on lisinopril. Until then, I just don’t know.

Immunity is the same way. Data tells me that I have a 0.1 per cent risk of getting COVID again, assuming that I have already been infected. Experience tells me that I won’t get it. It would have happened by now, I think.

So personal protection simply is not a consideration for me in deciding whether or not to get a shot. But while it is an individual decision, it has communal consequences. I may carry the virus asymptomatically and shed it and infect other people. If this is a valid concern, then the common good outweighs my own individual interest and all but mandates that I take the shot, assuming, of course, that vaccination does prevent or minimise asymptomatic spread.

So far, I have found no studies demonstrating for or against reinfection as a source of infection or a significant driver of the pandemic. The SIREN study revealed 80% protection against reinfection, in keeping with the Denmark study above. It also showed a 49% asymptomatic rate among reinfected, compared with 17.2% among those with no previous infection. The authors cautioned that reinfected individuals could be contagious but did not find (or look for) any direct evidence of that contagion.

In fact, all the advice I can find on this topic is couched in terms of “may” and “probably.” This is to be expected. I have no idea how one would conduct such a study, given that reinfection seems to be such a rare event, a few dozen cases for every 10,000 people who have been infected. I would imagine viral shedding would be lower in reinfection, so we are talking about an event rate that is quite hard to study.

Natural Immunity v. Vaccine Immunity

The question then is whether vaccination offers a significant advantage over natural immunity in reducing transmission rates. While I have not been able to find direct evidence of this, I have seen clinically more than a few breakthrough infections of people who have been vaccinated. This is not an uncommon occurrence. It represents a small percentage of the total number who have been vaccinated.

Still, it does open vaccine protection to the same criticism as natural immunity, namely, how much does it prevent or reduce transmission? Again, we do not know exactly. The best estimate I have seen is that the vaccine reduces the attack rate by about 70% (for alpha variant only). However, breakthrough cases have been demonstrated several times to have viral loads equal to those of unvaccinated individuals, especially with the Delta variant.

This does not mean that the vaccines do not work. They do seem to be reducing the risk of severe disease and hospitalisation. It is not part of my argument to try to minimise their effectiveness, only to point out that so far, no data indicate they are significantly more effective than natural infection in preventing severe disease and transmission of disease.

This brings me, finally, to the crux of my argument. Whether or not to vaccinate is a personal decision that ought to be made by each person in discussion with their medical provider. In the final analysis, it is also the individual’s responsibility to make that choice, not the state’s.

Put simply, vaccine passports, vaccine mandates or any other form of compulsory vaccination should be out of the question. Since it seems that I am at no grave risk of severe illness or disease myself, and there’s no indication that I pose a danger to anyone else, I must be free to morally refuse the vaccine based on its unethical sourcing from stem cell lines derived from murdered children.

I do not expect to convince everyone. It is, unfortunately, likely that I will get a hearing only from those who already agree with me. I hope, however, that I have been able to demonstrate that my decision not to get vaccinated thus far is not irrational fear-mongering but a considered and reasoned decision. I counsel different patients differently based upon their various health risks, family and professional circumstances. This is called doing medicine.

Will I get it wrong? Sometimes. This is a consequence of shared decision-making in medicine. It happens all the time. When I counsel a patient on the risks and benefits of any intervention, I have no control over whether or not they take it. Anyone who has ever tried to treat diabetes, hypertension or obesity knows that. We also know that you may try it, and it may not work.

Medicine is, among other things, the art of counselling people on critical decisions based on the fact that I am only slightly less uninformed than they are. This shared medical decision-making that respects the individual’s autonomy means absolutely nothing if it does not also respect their right to be wrong.

Healthcare providers are people as well. For the most part, we are reasonable people who try to make rational decisions based on the best information we have. I maintain that it is reasonable to believe that natural immunity to COVID is highly protective and that risk of transmission from reinfection is low.

I think it is appropriate to be unsure about the long-term health effects of new technology. For heaven’s sakes, how many times in the last ten years has a novel medical intervention or technology been trotted out and touted as the next best thing since sliced bread, only to fall by the wayside and be forgotten a few years later, or worse, turn out to cause harm? It is not cynical to say that if I have no compelling reason to try a new procedure or drug, it is wise not to try it. It is simply experience.

We also tend to object to being bullied by the government or corporate managers. This bullying happens every day in the outsized voice insurance companies have in determining what we do for our patients. After the 100th time being told that I cannot prescribe x, y, or z because it is not on the formulary and I need to try a, b, and c first, it gets a bit old.

This mandate by Governor Inslee and other state governors around the nation takes this bullying interference a giant step further. It strikes at the heart of the autonomy of the patient and the patient/provider relationship. I can understand the concerns of those who fear that this is just the next step in a long and gradual history of increasingly invasive government oversight. Only time will tell, but I will conclude with this quote from F. A. Hayek:

“‘Emergencies’ have always been the pretext on which the safeguards of individual liberty have been eroded.”2

This is why I am against vaccine mandates.

___

[1] I do not enter into this argument here because it is a separate consideration which would require its own in-depth analysis. For now it is enough to point out that there are numerous moral complexities involved, not least of which is that while the child in question is already dead, the people whose lives can be saved by a vaccine are alive, and in contrast, death from disease is a natural death, while death from abortion is a homicide, so the two are not morally equivalent. I do not have the space to address this adequately here, especially since in the end it must involve the prudential judgment of each individual.

[2] F. A. Hayek, “Law, Legislation and Liberty, Volume 3: The Political Order of a Free People.” Chapter 17: The Model Constitution: Section on “Emergency Powers.”

___

Originally published at Medium as “Why I Oppose COVID Vaccine Mandates“.
Photo: taa22/Adobe

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One Comment

  1. Julie Simonds 5 September 2021 at 3:23 pm - Reply

    I appreciate your well researched and thought-out argument.

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