CareTalk Podcast – Should the COVID Vaccine Be Mandatory?

John and David debate whether or not the US can reach herd immunity without mandating the COVID vaccine.

David Williams:

Well, John, we both got our COVID shots. Now, should we make everyone else do the same?

John Driscoll:

Well, yes we should.

David Williams:

But it’s kind of complicated. I’m going to have to disagree with you there John.

Welcome to CareTalk, America’s home for incisive debate about healthcare, business and policy. I’m David Williams, president of Health Business Group…

John Driscoll:

And I’m John Driscoll, the CEO of CareCentrix.

David Williams:

Well, John, I got my shot. You got your shot. Should everybody get their COVID-19 vaccination?

John Driscoll:

Well, look, everybody really should. I mean, the vast majority of vaccines that people have already in their arms, they don’t have a choice. Mumps, measles and rubella, polio. There’s a lot of vaccinations that people have already got where they implicitly or their parents trusted the health care authorities to get it right. And in America we kind of have, and it made a lot of these diseases and viruses non-existent. The notion that we should be fighting it is with vaccines is just profoundly simple. But I don’t know that we can actually dictate that to people, David? What do you think?

David Williams:

John, I think you’re getting soft or staying soft just to confirm that. So, we need to get 85% plus probably vaccination order to get to herd immunity. I don’t see it happening without a mandate. I did my part. You did your part. We don’t want the variants to run wild and get after people who’ve already been vaccinated. And I say mandate now, John.

John Driscoll:

Well, David, I think as is typically the case, you don’t bother trying to communicate your point. You just want to dictate them. So let’s slow down there, big boy. How did all those mask mandates work and did they actually build public consensus or undermine it, even when that was brain dead obvious. Let’s step back a little bit. We’ve got an exhausted country that is looking for those green shoots of health.

Maybe we lean on persuasion as opposed to sort of public demands. And you might actually find, David if we spend the time communicating with people that we’ll get to, and I don’t think it’s 85% plus. It’s probably closer to 80% based on the most recent models. And then you got to add the number of people who are immunized or the number of people who’ve got the neutralizing anybodies in their bloodstream because they’ve had COVID. So I don’t think it’s an either or. I think we can get there incrementally and that’s the only way we’re going to convince this United States of America around vaccines to actually increase the number of vaccinations. I’m not sure that dictating is going to work.

David Williams:

Well, John, I’m not sure we’re going to persuade anybody. I do believe you. It wouldn’t have made sense to have a mandate two months ago when there weren’t enough vaccines. Now there are enough and you can have a mandate. John, remember when we were hearing people that were complaining that they don’t want the MMR vaccine and so on. And we said, “Well, that’s because the reason that this is happening now is because people forgot what these childhood illnesses were like and nobody remembers when people had trouble with measles and people died or had lifelong disabilities from that, or when they had polio and they were paralyzed from that. Well, guess what? We’ve got COVID right here in our face. And people are still saying that it’s a nothing burger. I don’t need to persuade anybody, John. I just need to persuade them. “You get it or you’re going to go to prison and there you’re going to get COVID.”

John Driscoll:

I don’t think that’s going to work. First of all, David let’s let’s step back a second. We’ve got these vaccines. They’re incredible technologies, but we are in the emergency use authorization phase. We haven’t gone through all of the… it’s going to happen soon. Maybe we’re at EUA, Emergency Use Authorization plus space, but realistically, there is a reasonable question, I think, if they’re sensible about whether the vaccines have even gotten to where the FDA wants it. Having said that, these vaccines are incredibly safe. There’s almost a nil chance of bad outcomes. They’re being extremely carefully managed and they’re an extraordinary win for society, but I don’t think you get to your end result faster by telling people that aren’t likely to get the vaccine that they should or have to. I mean, what are you going to give people traffic [inaudible 00:04:56] ? So you’re going to creep them off to the overcrowded jails?

David Williams:

All right. All right, John. All right, John. So, usually you’re like a black and white argument type guy. But I see you’re willing to be drawn into the nuances. So let’s get a little bit nuanced here. So-

John Driscoll:

You’re going to demand that people-

David Williams:

Hold on, hold on John. So here’s what I would say. Okay. There’re some subtleties to it and for example, you’re right. It’s on the EUA. So maybe people who are really low risk, like kids what’s not approved for anyway, but maybe it’s not time for mandate there, but let’s talk about, for example, certain professions. Okay. So nursing home staff have been people… Some people that have been, hesitant to get the vaccines.

John Driscoll:

Oh now you’re moving the goalposts.

David Williams:

No, no, no. John, I would say hold on-

John Driscoll:

You can require people in healthcare institutions to get vaccinated. You can require people by employment category to get vaccinated. Now you’re playing on my turf.

David Williams:

Sure. So John, okay. So which way, so, okay. So I would think the mandate should be for certain professions. Yes. Colleges, to be a student there. It’s happening. I think students, young students once it’s approved for them, yes. Also, although the bar should be higher because they don’t necessarily personally benefit as much, the kids. And then how about like a customer? Someone can come into my store. It says, “No mask, no service.” “No vacs, no service.”

John Driscoll:

Well, I think you have that [inaudible 00:06:11] that you can lean on if those rights of privacy and enterprise, the needs of the group, particularly in smaller scale of whether it’s a cop or a teacher or a school. And I definitely think we’re definitely thinking of CareCentrix that we’re not going to mandate and require vaccines as a condition of employment, but we may require it and are likely to require it as a requirement to actually come back to a workplace because you want people to feel safe.

I’m just saying, look, I’d love a world in which everybody sensibly get vaxed into this quickly as possible. I think we’ve got to look at the reality that Americans don’t react well to global mandates. But if you increase the cost of access, whether it’s work or services, or actually honestly access to the healthcare system, or if people see that it is a condition of participation, I think you’re likely to see more people get vaccinated.

And I’m actually more hopeful that with more people, having a good experience and more people being healthy and more data getting out there that there’s a possibility that conversation and experience will help.

David Williams:

John, here’s one that really bothers me. And I’m hoping you can actually explain it a little bit, because I’m awfully concerned and unhappy about it on its face. And that’s where I saw that a very high percentage of our soldiers who are offered the vaccine said, “No,” something like a third said “No,” depending on the branch and I don’t get it. And to me, it’s, if anything, it’s a failure of leadership and it just makes me wonder about first of all, how did this happen? And secondly, I mean, do we have the same view? Like we’re going to have a military operation. We think it’s okay a third of people think, “Well, gee, I don’t think that’s an enemy.” I mean, what’s the story?

John Driscoll:

I can’t explain the profound lack of leadership and clarity around this. It should be a requirement, David. It may have something to do with the E-way stuff, but as a practical matter, having served in the uniform, you’re ordered to do stuff, you do it. And one of the things that will profoundly affect our force posture and undermine the resilience of our military is if we permit people to pick and choose whether they are putting their health at risk, because it’s not just their individual health, although that’s dangerous because they are part of a team that requires their help, the United States military, but it puts other people’s health at risk. Look, when people get sick, we all pay for it. When people get sick in the military, particularly of a viral illness, they’re at risk of making a bunch of other people sick. No, I think I’m with you on that one. That just strikes me as dumb.

David Williams:

I hope that’s going to be going to be corrected. Now, John, one thing, I think that we should go back to some nuances that you’re describing before, which is that there’s a pretty high percentage of people that want the vaccines, lined up for it. We’ve seen it in many states. Then there’s some group that’s really against it, but there’s a bunch of people in the middle that are sort of, they would get. Just has to be convenient. They have to have the right messaging around it. They have to not worry they’re going to miss a day of work if they have side effects. I wasn’t feeling well. I was tired, that is. Doing fine, but tired after my vaccine. And if I had to worry about an hourly job, I would be concerned about that.

So I think there’s a role to be played to making it easier to do it. And John, maybe it’s the same thing. We should take all of the people that have been focused on how to prevent people from voting and get them to turn their [inaudible 00:09:53] in the other direction and say, “Why would [inaudible 00:09:54] all the opposite things and get people to be vaccinated easily?”

John Driscoll:

Well, I think it goes back, David, to the fact that we’ve got a broken and incomplete public health infrastructure. But one of the things I think that both the Trump administration and the Biden administration has gotten right, is by pushing it out through pharmacies, they’re pushing it out through the private sector access point to the healthcare system that’s got the greatest reach in the country, that thousands and thousands of pharmacies. We’ve got a lot of actually, a pretty big excess of pharmacies in the U.S. and now we can actually put them to good use.

David Williams:

John, I know we don’t like to talk about the next pandemic, although I think we may have a guest soon on our show to discuss that, stay tuned listeners, but this pandemic, last one was about a hundred years ago. Now, my concern is that what’s happening… This is like the hundred years-

John Driscoll:

That’s not true. That’s not true. There was a Hong Kong flu in the sixties. There’ve been a number of close calls on pandemics. The last big one was in 1918, but there have been some viral epidemics that were contained, but that harmed and killed many, many people between now and… We don’t tend to track it because it’s not common. It will likely become a lot more common as the zoonotic viruses, those viruses that jump species, the ones that… do you know what that word means?

David Williams:

John, actually, my first question of zoonotic is like, “Does that have three O’s in a row or four?”

John Driscoll:

That’s what I’m unsure about. As we overpopulate the earth and people are traveling a lot more and we have more of a convergence of travel and people living in previously uninhabited habitats, you’re going to see more of them. I think actually, COVID, SARS 3, this is a wave that we will revisit.

David Williams:

Okay, well, John, you are agreeing with my first point, which is that I was going to say, it’s like those hundred year rainstorms that floods, now we have every five years. So what precedent, getting back to our point about vaccine mandates, I mean, what do we need to be thinking about in terms of having a mandate or not about, yeah, what does that mean for the future?

And I think the possibility that this isn’t even the big one. Things that may be even more aggressive in terms of infectiousness and how deadly they may be.

John Driscoll:

I just think it builds on the point that I think that Jason Kelly was talking about last week on our previous CareTalk, where we need to have a different level of infrastructure around our biological vulnerability. Now here’s the good news. We’ve got a vaccine. We’re talking about the back and forth about whether you mandate it, but the reality is, it works and it’s safe. And we actually created the design for the Moderna and the Pfizer vaccine within 48 days of actually unpacking the genetic code of this particular virus. So I think we have the technologies to solve for us, but I think what you’re going to see is, is the COVID shot will be an annual shot or an annual booster and what I worry about is that early warning system of testing that failed so badly that the beginning part of this pandemic, and that it’s unclear whether we’re going to invest in the infrastructure so that we can find it and contain it. Because if we can find and contain these next to new viruses, the current variance, if we could contain them, we’d be a lot less dangerous to society and to people.

David Williams:

Well, John, sign me up for that booster club, at least for COVID, but I hope that they nip these other ones in the bud so I don’t have that. I’ve had just about enough for today, John. So let’s say that’s it for this week’s edition of CareTalk. I’m David Williams, president of Health Business Group…

John Driscoll:

And I’m John Driscoll, the CEO of CareCentrix.

David Williams:

If you liked what you heard or you didn’t, please tell us what you think and subscribe.