A simple solution to the vaccine mandate controversy

Make it a default, not a mandate.

In recent days, there have been numerous instances of people getting fired for refusing to take a COVID-19 vaccine. The head coach of the Washington State college football team was fired and filed a lawsuit against his university. An NBA star, Kyrie Irving, has been removed from his team. And hundreds of hospital workers around the nation have lost their jobs – at a time where the health care system is under stress – because they are unvaccinated.

The debates around the various vaccine mandates, employed by government and in some cases by employers, falls under predictable partisan lines. Republicans favor “freedom” to remain vaccine-free while Democrats favor “safety.” And it gets personal. Republicans, seeing Dr. Anthony Fauci as the primary force behind the push for vaccines, have called him a “demon doctor.” Democrats, in contrast, have practically celebrated when unvaccinated people have died of COVID-19; an article about a young unvaccinated couple who died, leaving 4 children behind, was the most popular site on the Washington Post for many days.

Many of you have probably seen this in your personal lives, too. I’ve seen many people in tears after vaccine debates. Friendships have been lost, and communities broken. (It’s particularly hard among animal rights activists because animals have been used in experiments to test mRNA vaccines. Many legitimately argue that the vaccines are therefore not vegan.)

But what if there were a better way forward, a simple solution that would serve the needs and desires of all sides, while keeping our broader community safe?

The key to finding such an answer lies in the work of sociologist Rob Willer, whose brilliant TED talk on “having better political conversations” is must-see for anyone interested in making change. And what Willer points out is that, to move forward on divisive issues, we must find solutions (and messaging) that fulfill the values of all sides to a dispute. And this is where so many of the solutions being offered fail.

When Democrats argue for vaccine mandates, they are not fulfilling the values of the significant minority that believes health care should be a question of personal freedom. “My body. My choice!” When Republicans argue against vaccine requirements, they fail to fulfill the values who are concerned about community spread. “You don’t have the right to hurt anyone else!” A good solution to the problem, in contrast, would integrate the concerns over autonomy and community safety. And the work of another influential academic, behavioral law and economics scholar Cass Sunstein, shows us how to move forward:

Make vaccines a default requirement, but allow people to opt out if they can demonstrate a major personal concern — whether medical, religious, or ethical.

Default rules have enormous impact, while allowing people to maintain their personal autonomy. For example, in Austria, the default rule on organ donations is that people must “opt out” of donating their organs at death. Over 90% of people participate. In Germany, just across the border, the default rule is that people must “opt in” — make a specific request that their organs be donated on death — and the donation rate is less than 15%. Austria’s default rule, in short, has saved thousands of lives.

Changing the default rule isn’t just about enacting better policy, however; it’s about upholding personal autonomy. If someone under the Austrian rule really does care about not having their body violated for organ transplantation, they have that right. They just have to go through some procedural obstacles to prove that it really matters to them, especially since another person’s life is at stake.

We could do the same for vaccines. Suppose we had a default rule that everyone, nationwide, should get the vaccine. We could enforce this rule with a light penalty, e.g., forfeiture of a round of $200 stimulus checks. With the rule established, we’d probably have no need for any other vaccine or even face mask requirements; people and businesses could operate freely.

Suppose we also allowed people who had serious concerns — e.g., someone who had a previous bad experience with a vaccine, such as anaphylactic shock (which is potentially deadly but probably occurs in only 1 in 100,000 cases of vaccine injection) — opt out if they could certify, using a a standard form, that they had seen two doctors who both advised them of the risks and benefits of a vaccine.

The majority of people who are currently unvaccinated would probably get vaccinated. The loss of $200, plus the inconvenience of having to visit two doctors for certifications, would be sufficient to get most people to take the easier route — and just get the shot. The few people who remained unvaccinated would be the ones who have the most serious fears and concerns,. And those few remaining unvaccinated folks, from a social welfare perspective, might be better off unvaccinated. The additional benefit to our society of going from 90% vaccinated to 96% vaccinated is probably small, compared to the benefit to the 6% of people who are among the most fearful about the vaccine, of feeling safe and free to choose health care they believe in.

While fraud (i.e., people submitting false papers) might be a concern, it’s probably not a major one. Even if 50% of the unvaccinated fraudulently submitted documents seeking an exemption, we would still increase the vaccination rate considerably. And there would be easy ways to cheaply combat fraud, e.g., randomly sampling 1 out of 100 certifications using machine learning. (I guess that means not all uses of machine learning are evil. But some of them still are.)

In short, a vaccine default would be effective, cheap, and fulfill the values of people on both sides of the aisle.

But this or other integrated solutions have not been the path our society has taken. Instead, we have talking heads on CNN attacking people who are refusing vaccines. Politicians attacking one another and stoking outrage. This includes Democrat Joe Biden saying, “Our patience is wearing thin and your refusal has cost all of us.” And Republican Rand Paul describing those who support vaccine “petty tyrants and feckless bureaucrats.” These attacks spread widely on social media and earn politicians points with their respective camps. What they absolutely do not do is fulfill the actual needs and values of the people in those camps.

So what do you think? Could a vaccine default be a solution to the months of pointless bickering we’ve seen on the issue? What are the weaknesses to that approach? And how can we create a political system that seeks more integrated solutions, instead of holding up politicians who use people’s legitimate anxiety to stir up anger and even hatred of the “other side”?