“Freedom is not the right to do as we please, but rather the opportunity to please to do what is right.” – Reverend Peter Marshall (1902-1949; Prayer before the U. S. Senate, April 25, 1947.)
Editor-In-Chief, Chester “Trip” Buckenmaier III, MD, COL (ret.), MC, USA
Like many Americans, I have enjoyed the gradual return of regular activities as the COVID-19 pandemic appears to be waning as significant numbers of our population receive one of three available COVID vaccines. I have relished freedoms I took for granted 16 months ago, like eating in a restaurant, going to a movie, or entering a supermarket without a mask. I am thrilled that my entire immediate family has received the vaccination and justifiably pleased and amazed at the scientific prowess of our nation in creating vaccinations for COVID-19 in such a record time. The achievement these new vaccinations represent cannot be overstated, and I am in awe of the technology. As a federal healthcare worker, I was fortunate to receive my first dose of the Pfizer vaccination in December. I recall the event fondly as I felt a weight being lifted from my shoulders. As a student of medical history, as bad as this pandemic has been, I understand how much worse it could have been without the protection afforded the population from the vaccinations. Perhaps this explains my poor behavior recently during a conversation with one of my daughters.
Like many folks, I have worked diligently to avoid situations where I might encounter the virus and have continued these behaviors post-vaccination. I recently assisted in moving one of my daughters into a new apartment. Her long-term boyfriend and his friend also helped with the move. I assumed (assumption – the mother of all disasters) that everyone involved in this activity was vaccinated. The move went off without incident. After moving, I had an enjoyable time with the young men, treating them to lunch and a beer at a local pub as my wife and daughter went shopping for apartment stuff. Weeks later, I learned that the friend (a fine young man) who had helped had not been vaccinated and was not planning to get vaccinated. Basically, I lost my cool in front of my daughter and her boyfriend regarding this revelation and made an ass out of myself. Because I fear this virus, I acted out on that fear. I used unpleasant words to describe my dismay regarding the friend who had made such a non-sensical (my opinion) decision regarding getting vaccinated. Instead of meeting the highest standards of my profession as a physician to use this opportunity to educate someone regarding their health, I became that loud old person too often ignored by those born more recently. I have apologized for my behavior, but more importantly, I have learned something from this experience.
My encounter with an unvaccinated young person apparently is not novel since the under-30 crowd is the main deterrent in preventing the US population from reaching President Biden’s goal of 70% vaccinated adults by July. What is so special about reaching 70%? Most experts agree that this percentage is high enough to impart ‘herd immunity’ to the US population. Herd immunity occurs when the number of vaccinated people in a group is so high that the virus can no longer spread exponentially from person to person, thus ending the epidemic. More importantly, without herd immunity, every unvaccinated person represents fertile territory for the virus to grow and potentially mutate into a new, more nasty variety of this deadly virus. Presently, the most concerning new version of the COVID-19 virus is the Delta variant. This version of the virus apparently is more easily transmitted person-to-person and is more lethal. Fortunately, the currently available vaccines remain effective against this variant. However, this may not remain the case if we fail to achieve high enough numbers of vaccinated people in our population to end the pandemic. Every future individual who is not vaccinated and becomes infected with COVID offers the virus an opportunity to evolve into a new variant that may be resistant to the vaccine. In short, the ‘freedom’ of an individual to refuse being vaccinated has the potential to seriously sicken or kill their family and neighbors. Can I predict this for sure? Of course, I cannot, any more than I could have anticipated the Delta variant. Then again, I can fall back on medical history and our seemingly unending battle with human viral illness. This history would suggest the development of new varieties of this COVID virus will appear as the pandemic wears on.
The protection afforded the individual who is vaccinated is established science. Areas of our nation where vaccination rates are high are enjoying significantly lower COVID hospital admissions than poorly vaccinated regions. The risk of the virus to a person’s health is far greater than the risk of vaccination. These statements are not my opinions; they are the empirical observations of the health science organizations monitoring this pandemic. I have invested considerable time since my miserable performance with my daughter trying to refine my message regarding this pandemic and the importance of the non-vaccinated joining the ranks of the vaccinated. This is not my area of expertise, but I am armed with the education and information needed to explain the best available science as a physician. I have gotten clearer in my explanations, calmer, and my message is far more refined. I feel I can address most of the science questions of those I am trying to influence to get vaccinated. There is one response, though, that I cannot overcome. Too often, in my interactions with those unwilling to be vaccinated, I hear statements similar to, “I should have the freedom to not get the vaccination in this country.”
My understanding of COVID science does not help counter this particular line of reason. This issue has caused me to ponder the meaning of freedom and what it means to be free in America. Freedom, I would suggest, is not the right to do anything one might wish to do. For example, in our free society, we are not free to drive intoxicated, steal another’s property, or commit violence against another. Freedom for the individual is the fulfillment of the expectation that you personally will not be subjected to the drunk driver, the thief, or the murderer. Obviously, sometimes members of our society violate the freedoms of others, and our laws are designed to deal with those who forsake this social covenant. The individual only achieves freedom when the community accepts standards that prevent one individual from impinging on the freedoms of another. In short, to be free, one must act responsibly within a community to ensure their actions do not violate the freedoms of others.
I would suggest that the most freeing and patriotic thing an individual can do in our society today is getting the COVID vaccine. By acting responsibly and accepting the small risk of the vaccination, the individual not only is protecting themselves from COVID, but more importantly, they are protecting their neighbor’s freedom to not become infected by you. Reverend Marshall understood that true freedom can only occur in a society that has established the conditions allowing the individuals within said society to choose to grant their neighbors freedom. To decide to do the right thing for the sake of their neighbors.
I would remind all healthcare providers that our most important responsibility is our role as educators regarding health. We should not be bashful in helping those in our care to understand the benefits and risks associated with COVID vaccinations. As I have learned through interactions with my own family, discussions as complex as COVID vaccinations are something clinicians must work at to become proficient. Knowledge frees us from fear, and I am confident that most Americans, when armed with the facts regarding COVID vaccinations, will choose what is consistent with freedom in this country.