# Why COVID-19 Vaccines Should Not Be Required for All Americans



## Becky1951 (Aug 7, 2021)

Dr. Marty Makary: I’m pro-vaccine but blanket requirements outside of health care go too far.

COVID-19 vaccine mandates have become a hotly contested issue, as coronavirus cases and hospitalizations rebound nationwide, driven by the highly contagious delta variant and unswerving vaccine hesitancy. New York City will soon be the first major U.S. city to require proof of vaccination to enter restaurants, gyms and other indoor public spaces. Dr. Marty Makary, a professor at Johns Hopkins University School of Medicine and editor in chief of MedPage Today, argues that mandating vaccines for "every living, walking American" is, as of now, not well-supported by science. Moreover Makary, author of "The Price We Pay: What Broke American Health Care—and How to Fix It," has concerns about the two-dose vaccine regimen for young people.

As told to Lindsay Lyon as part of Two Takes, a U.S. News series examining opinions about key issues. Responses have been edited for length and clarity.

Should all Americans be required to get the COVID-19 vaccine?​No. As a physician with a lot of experience dealing with patients who don't follow what we ask them to do, I believe you win more bees with honey than fire.

The vaccines are so good at protecting against death from COVID-19 that those who are immune can feel good about living life without having to worry about becoming severely ill. Vaccines downgrade the infection to a mild seasonal virus – one we must learn to live with for years to come.

Those who choose not to get vaccinated are making a poor health decision at their own individual risk. They pose no public health threat to those already immune. Would we be so stern toward people making similar or worse health choices to smoke, drink alcohol or not wear a helmet when riding a bike? Over 85,000 Americans die annually from alcohol, yet we don't have the same public health fervor or requirements to save those lives. Let's encourage vaccination rather than activate the personal liberty culture wars that result in people becoming more entrenched in their opposition.

The notion that we have to vaccinate every living, walking American – and eventually every newborn – in order to control the pandemic is based on the false assumption that the risk of dying from COVID-19 is equally distributed in the population. It's not. We have always known that it's very hard for the virus to hurt someone who is young and healthy. And that's still the case. While vaccine requirements for health care workers make sense, we would never extend those requirements outside of health care for, say, the flu shot. We'd simply state to the public: Those who avoid the flu shot do so at their own risk.

Also: Some people already have 'natural immunity' – that is, immunity from prior COVID infection. During every month of this pandemic, I've had debates with other public researchers about the effectiveness and durability of natural immunity. I've been told that natural immunity could fall off a cliff, rendering people susceptible to infection. But here we are now, over a year and a half into the clinical experience of observing patients who were infected, and natural immunity is effective and going strong. And that's because with natural immunity, the body develops antibodies to the entire surface of the virus, not just a spike protein constructed from a vaccine. The power of natural immunity was recently affirmed in an Israeli study, which found a 6.7 times greater level of protection among those with natural immunity vs. those with vaccinated immunity.

Requiring the vaccine in people who are already immune with natural immunity has no scientific support. While vaccinating those people may be beneficial – and it's a reasonable hypothesis that vaccination may bolster the longevity of their immunity – to argue dogmatically that they _must _get vaccinated has zero clinical outcome data to back it. As a matter of fact, we have data to the contrary: A Cleveland Clinic study found that vaccinating people with natural immunity did not add to their level of protection.

So instead of talking about the vaccinated and the unvaccinated, we should be talking about the immune and the non-immune. Immunity is something people can test for with a simple antibody test. I would never recommend that anyone intentionally acquire the infection in order to get natural immunity, but vaccine passports and proof-of-vaccine documents should recognize it.

Now, if someone _does not_ have natural immunity from prior infection, then they should immediately go out and get the vaccine. I'm pro-vaccine. But the issue of the appropriate clinical indication of the vaccine is not an all-or-nothing phenomenon, as we frequently see in American culture and politics.

I'm perplexed at the vitriol directed at folks who are reluctant to get vaccinated. For some, the biggest driver of their hesitancy is the U.S. Food and Drug Administration, which has failed to issue the long-overdue full approval of the COVID-19 vaccines due to stability testing which has nothing to do with safety.

The goal of our pandemic response should be to reduce death, illness and disability, but instead what you're seeing is a movement that has morphed from being pro-vaccine to vaccine fanaticism at all costs.

We have very strong population immunity in most parts of the U.S. – and these areas are resilient to the delta variant that's driving severe illness right now. This stems from a combination of natural immunity and vaccinated immunity. Roughly a third to half of Americans who are unvaccinated have natural immunity, based on an analysis of California residents. So it does change the outlook.

For example: One study conducted by the state of California this spring found that 38% of Californians and 45% of Los Angeles residents had natural immunity. And this was at a time when vaccine rollout was still too early to account for those numbers. So we're potentially talking about a large portion of the U.S. population who may be immune to COVID and not know it. They should be tested to find out, and we should concentrate our vaccination efforts on people who are not immune.

Right now, we do have a group of susceptible, non-immune Americans among whom the delta variant is raging. That's where we need to focus our attention. We have to work on making the vaccine more available – and easily available – to the non-immune in the U.S. That means going to them: Having walk-up vaccination appointments at routine points of American life.

When it comes to vaccinating healthy kids – and you could argue young people up to 25 – there is a case for vaccination but it's not strong. The COVID-19 death risk is clustered among kids with a comorbid condition, like obesity. Of the more than 330 COVID-19 deaths in kids under age 25, there's good preliminary data suggesting that most or nearly all appear to be in kids with a pre-existing condition. For kids with concurrent medical conditions, the case for vaccination is compelling. But for healthy kids?

The risk of hospitalization from COVID-19 in kids ages 5 to17 is 0.3 per million for the week ending July 24, 2021, according to the Centers for Disease Control and Prevention. We also know that the risk of hospitalization after the second vaccine dose due to myocarditis, or inflammation of the heart muscle, is about 50 per million in that same age group.

It may be that the standard two-dose regimen is a dose too high and is inducing a strong inflammatory response causing these complications. A single dose of the vaccine may be highly effective in kids, as reported by Tel Aviv University. Researchers there found that one dose was 100% effective in kids ages 12 to 15. For now, until we get better data, I recommend one dose for healthy kids who have not already had COVID-19 in the past.

I'm concerned the CDC hasn't considered whether one dose of the two-dose shots would be sufficient – and safer – for young people. The agency's Advisory Committee on Immunization Practices has vigorously recommended the two-dose vaccine regimen for all children ages 12 and up regardless of whether kids already have immunity. I take issue with that. The data the CDC used on which to base its recommendation is incomplete at best. The agency is using the Yelp of vaccine complications as a data source: a self-reported database of vaccine complications, which haven't been fact-checked by authorities. So the agency may not be fully capturing the extent of vaccine complications from the second dose in some young people.

I wish the CDC would tell us more about the deaths of Simone Scott, 19, and Jacob Clynick, 13, both of whom died shortly after getting a second vaccine dose and developed heart inflammation. There have been 19 other deaths in youth under age 25, according to the CDC. Since the clinical trials were not powered sufficiently to detect rare events like these, I want to know more about those deaths before making blanket recommendations.

Researching these events is important when issuing broad guidance about vaccinating healthy kids, including students, who already have an infinitesimally small risk of dying from COVID-19.

https://www-usnews-com.cdn.ampproje...ines-should-not-be-required-for-all-americans


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## chic (Aug 7, 2021)




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## Shalimar (Aug 7, 2021)

With respect, I find the inclusion of a person suffering from morbid obesity to be fat shaming, however unintentional.


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## chic (Aug 7, 2021)

Shalimar said:


> With respect, I find the inclusion of a person suffering from morbid obesity to be fat shaming, however unintentional.


So it's okay to force a vaccine on someone with medical issues who could die or be permanently disabled by it or confine them to something akin to house arrest for life when they cannot comply but it's not okay to compare this to someone overweight who could get surgery, lose weight and become healthier thereby building a strong immune system so these vaccines and all the restrictions and mandates would not be necessary.


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## Don M. (Aug 7, 2021)

Becky1951 said:


> Dr. Marty Makary: I’m pro-vaccine but blanket requirements outside of health care go too far.



Yes, some of the requirements being initiated, are a PITA for many people....but until the "deniers" begin to face reality, these restrictions will only continue, and probably increase.


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## Shalimar (Aug 7, 2021)

chic said:


> So it's okay to force a vaccine on someone with medical issues who could die or be permanently disabled by it or confine them to something akin to house arrest for life when they cannot comply but it's not okay to compare this to someone overweight who could get surgery, lose weight and become healthier thereby building a strong immune system so these vaccines and all the restrictions and mandates would not be necessary.


Fat shaming is never ok, regardless of circumstance. Should a person wish to prove a point re their stance around vaccines, there are many ways to do so without invoking this type of prejudice.


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## debodun (Aug 7, 2021)

Lately our church prayer list always has 1 to 3 people every week that have had bad reactions to the vaccine.


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## oldman (Aug 7, 2021)

I have both natural and artificial immunity. What does that mean? I really don't know. My doctors are telling me even though I have all of this immunity and antibodies, I can still get COVID again and any new strains that come down the pike. As with any vaccine, there is NO 100% certainty that the patient will not get the disease they are being inoculated for.


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## Pecos (Aug 7, 2021)

chic said:


> So it's okay to force a vaccine on someone with medical issues who could die or be permanently disabled by it or confine them to something akin to house arrest for life when they cannot comply but it's not okay to compare this to someone overweight who could get surgery, lose weight and become healthier thereby building a strong immune system so these vaccines and all the restrictions and mandates would not be necessary.


This view is rather speculative.


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## SeaBreeze (Aug 7, 2021)

oldman said:


> I have both natural and artificial immunity. What does that mean? I really don't know. My doctors are telling me even though I have all of this immunity and antibodies, I can still get COVID again and any new strains that come down the pike. As with any vaccine, there is NO 100% certainty that the patient will not get the disease they are being inoculated for.


And people who get flu shots can also get the flu, however it is less serious and may not lead to pneumonia, etc.  COVID-19 is a killer, I had a family member die from it in the hospital, over 600,000 Americans have died during this pandemic.  I knew before I was vaccinated that there was no guarantee that I wouldn't get coronavirus, but if I do, I should live to tell about it.  And, the only way to put this pandemic under control is to stop spreading the disease, and get vaccinated.


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## SeaBreeze (Aug 7, 2021)

Shalimar said:


> Fat shaming is never ok, regardless of circumstance. Should a person wish to prove a point re their stance around vaccines, there are many ways to do so without invoking this type of prejudice.


I agree about the fat shaming, it's offensive and _never _okay.


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## Shalimar (Aug 7, 2021)

SeaBreeze said:


> And people who get flu shots can also get the flu, however it is less serious and may not lead to pneumonia, etc.  COVID-19 is a killer, I had a family member die from it in the hospital, over 600,000 Americans have died during this pandemic.  I knew before I was vaccinated that there was no guarantee that I wouldn't get coronavirus, but if I do, I should live to tell about it.  And, the only way to put this pandemic under control is to stop spreading the disease, and get vaccinated.


SB, my deepest condolences on the loss of your family member.


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## SeaBreeze (Aug 7, 2021)

Shalimar said:


> SB, my deepest condolences on the loss of your family member.


Thanks Shalimar.


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## John cycling (Aug 7, 2021)

Shalimar said:


> With respect, I find the inclusion of a person suffering from morbid obesity to be fat shaming, however unintentional.



The photo depicts the first person as being HEALTHY.
So you'll have to answer that statement for yourself, since you're the one who's shaming that person.

Personally, I find the irony of calling an obviously out of shape unhealthy person healthy to be so ignorant
that, yes, it is humorous to someone like me who DOES know what being healthy and in good condition is about.

Making *false accusations, false interpretations and personal attacks* appears to be a common happening on this forum.


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## SeaBreeze (Aug 7, 2021)

John cycling said:


> The photo depicts the first person as being HEALTHY.
> 
> So you'll have to answer that statement for yourself, since you're the one who's shaming that person.


So, your laughing until you're crying "Like" for that photo had nothing to do with fat shaming, huh? 

 That means you would have had the same reaction if someone like this was in that photo.  Shalimar is not the one fat shaming here, don't try to twist anything, doesn't work.


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## Sassycakes (Aug 7, 2021)

Because of all the Covid has done to my nephew, both me and my husband have gotten the vaccine.


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## ProTruckDriver (Aug 7, 2021)

Because my body is low on antibodies and I cannot produce many antibodies because of my cancer. Why should I get a vaccine that is worthless to me while if I do take the vaccine it may make me sick or have long term or permanent side effects. 
Are people like me going to be punished because we are not going to get this vaccine? 
Am I going to be labeled as an anti-vaxxer?
Is the government going to take away our liberties because the vaccine is worthless to us?
I got the influenza vaccine every year up to last year. I knew the flu vaccine was sort of worthless to me but I still got it. The flu vaccine has been tested for many years.
The technology for the covid type vaccine has been around since the 1990's used on cancer patients:

https://www.curetoday.com/view/-the-next-wave-in-cancer-vaccines

The difference is that the vaccine being used for combatting cancer is custom made for each patient by their bloodwork. It isn't a "One Size Fits All" vaccine like the covid vaccine is. No one knows the long term effects of this "One Size Fits All" Covid vaccine. It may have no side effects for some and then some many side effects. 

I wish the people the best of luck getting the "One Size Fits All" vaccine that is in its trial stage. I hope all turns out well for all of you.


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## SeaBreeze (Aug 7, 2021)

ProTruckDriver said:


> Because my body is low on antibodies and I cannot produce many antibodies because of my cancer. Why should I get a vaccine that is worthless to me while if I do take the vaccine it may make me sick or have long term or permanent side effects.
> Are people like me going to be punished because we are not going to get this vaccine?
> Am I going to be labeled as an anti-vaxxer?
> Is the government going to take away our liberties because the vaccine is worthless to us?
> ...


I'm not a doctor, but I've said many times before that if someone has medical issues, and their doctor advises them not to take the vaccine, then they definitely should not threaten their health by doing so.  I have a neighbor who can't take certain vaccines, and she has not had any for coronavirus.  I lost my sister in her early forties to cancer, and I wish you the best.  My heart goes out to you.


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## ProTruckDriver (Aug 7, 2021)

SeaBreeze said:


> I lost my sister in her early forties to cancer,


Sorry for your loss.  I lost my sister also to cancer. She was in her early fifties. Wish they would find a cure.


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## SeaBreeze (Aug 7, 2021)

ProTruckDriver said:


> Sorry for your loss.  I lost my sister also to cancer. She was in her early fifties. Wish they would find a cure.


Thank you.  I wish they would find a cure too, been a long search. My condolences for the loss of your dear sister, may she rest peacefully.   Hugs.


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## Brookswood (Aug 7, 2021)

I wasn’t aware the vaccine made anybody healthy. Helps to keep one healthier? Yes, for most of us.  Make an unhealthy lifestyle suddenly healthy?  No.

I believe the photos are what is called a Straw Man argument. Setup a false or weak argument and then knock it down.  Big deal. We can all do that nonsense.

Besides my body is much more similar to the  ‘unhealthy‘ guy.  And I’m vaccinated.  

oh, I agree that government ordered blanket vaccine mandates are full of ethical problems.


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## Warrigal (Aug 7, 2021)

chic said:


> View attachment 177540


The two photographs are extremes. 
It is a mistake to think that being fit is the same as being heathy.
There are many unfit people who enjoy robust good health and there are similar numbers of fit althletic people who are susceptible to diseases.

I'm one of the unfit but otherwise quite healthy group.
I have been vaccinated for SARS-cov-2 because I want to stay healthy.


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## oldman (Aug 8, 2021)

My sister has Myasthenia Gravis and cannot take the vaccine, but received a letter from the medical group that her doctor’s office is part of reminding her to get the vaccine. Really?


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