Coercion is the Order of the Day

Virginia colleges and universities, along with institutions of higher learning throughout the world, have faced an unprecedented challenge operating in the midst of the COVID pandemic. No small part of that difficulty has been that there is no response that pleases everyone, and every policy decision has had an unavoidable downside. Recently, however, some institutions have chosen to require that students receive one of the investigational vaccines authorized for emergency use as a condition of enrollment. This decision is qualitatively different from every other policy decision taken in response to the COVID phenomenon. It violates a central tenet of modern medicine, that no medical treatment should be offered unless the benefit is assessed to outweigh the risk. But it is even worse than that because the treatment is not only offered but mandated.

Young healthy people at the very start of their adult life are being coerced into doing something that could pose a serious, even permanent, risk to their health. While it may be true that in some circumstances, coercing individual behavior for the good of a community may be good and necessary, that is manifestly not true in the case of the COVID vaccine mandates. The emergency is ending, with the expiration of Governor Northam's Executive Order #79 on May 28 and the COVID State of Emergency in Virginia scheduled to expire June 30. There is simply no warrant for the level of interference with the bodily integrity and freedom of our students that is represented by these vaccine mandates.

We are advocating for a robust application of scientific knowledge and method to public health policy. Some of us are healthcare workers whose calling is to serve others through the application of medical science. We affirm the critical role that vaccines have played in public health, and we support the continued advancement of vaccine science. The COVID vaccines, however, are novel and insufficiently tested. They are officially categorized as investigational, and that designation is not a mere formality.

While efficacy data reported so far are encouraging (but not without controversy), the safety profile of the vaccines is still coming into focus. Emergency use authorization is based on an assessment that for some persons the risk from COVID outweighs the risk of taking a vaccine whose safety profile is still being determined. But the overwhelming majority of college students are not in this category. Requiring anyone to take an investigational vaccine against their will is wrong. But to require this of young, healthy college students is unconscionable. Not only is their risk of a critical or fatal outcome from COVID statistically minuscule, but the mandate takes advantage of their diminished agency. In the midst of, or starting out on, their college careers, they’re susceptible to coercion because their future is staked on the specific college plans they have made and in which many of them have substantially progressed. To force an emergency-use treatment on a group of people to whom the emergency clearly does not apply is harmful to them, however good the intentions may be.

Repeated assertions that “the vaccines are safe” are meaningless without context. The safety of any medical treatment has always been defined in terms of the risk-benefit trade-off. The risks of the COVID vaccines are not sufficiently understood to justify giving them to people with barely any need for them. Long-term safety data is simply not available, and important sub-groups of people (e.g., the young, those infected with the wild virus, those having pre-existing autoimmune disease) were not included in the trials. But the lacuna in our understanding is amplified by what we do know: the vaccines represent a novel approach, implemented with new, largely untested platforms; and plausible injury scenarios are known which take more time to develop than has currently elapsed in the vaccine trials.

Rather than injecting antigens representing the virus being vaccinated against, the COVID vaccines provide genetic instructions for the body's cells to produce antigens, subsets of the target virus proteins, in much larger quantities than with traditional vaccines. The mechanism for delivering the genetic material is novel as well. Messenger RNA (mRNA) wrapped in a Lipid Nano Particle (LNP) and DNA spliced into a deactivated Adenovirus represent the epitome of novelty. This exciting technology may eventually prove to be a game-changer in disease prevention; but science takes time and requires careful, deliberate advancement steps, especially when the human body is the domain of experimentation and development.

Potential long-term issues with these novel vaccines are identified in the medical literature. Numerous studies uncover significant questions for which experimental or analytical answers are not yet available. Scientists are increasingly coming to suspect that the spike protein of the coronavirus is responsible for many of the severe, critical, and fatal outcomes from COVID that some people experience. And it is this very protein that the vaccines produce by design, and in such large numbers that they routinely overwhelm the immune system. Worse yet, there are indications that the bio-distribution of the LNP wrapper is broader than the virus itself, delivering spike proteins to tissues where they can be especially harmful. There are plausible scenarios discussed in the medical literature wherein autoimmune and CNS diseases (e.g. MS, ALS, Parkinson’s) could be induced by the vaccine in a sub-clinical form that does not manifest until years or even decades after the vaccine is administered. To require the vaccination of young people with most of their life ahead of them while answers to these questions are not yet known is an ethical failure, not justified by the laudable goal of providing bullet-proof assurance that COVID will not once again disrupt the college experience.

Opinions may differ as to the significance of these concerns or how many layers of safeguards against a COVID disruption of the university mission should be applied. But students should be left to make their own decisions on the risk they will take with their own health.

Some may argue that the mandate is not coercive, because students can choose to not take the vaccine if they agree not to enroll (or re-enroll) in their chosen college. The failure of this argument is self-evident. Numerous examples can be produced of students who strongly oppose being vaccinated but are now planning to do so because it is unthinkable that they would choose another school. (And given the legal opinion by the Virginia Attorney General that colleges may levy vaccine mandates on their students, their choices would be sharply limited even if they did decide to switch schools.) The possibility of exceptions accompanying the mandates does not address this concern because they are not available to all and they are accompanied by burdens that will undoubtedly have the effect of inducing students to accept the vaccine against their prior intention. Coercion is best discerned by the one who is on the receiving end of it.

Colleges and universities made a commitment to provide for the higher education of Virginia’s young people, and they and their families made a commitment of trust, effort, and finances in response. Now colleges are abandoning many of their students, requiring as a condition for their continued education that they put their health at risk. That is a dystopian twist never envisioned by the students or their families when they enrolled in their chosen school.

There is a fundamental contradiction inherent in requiring the COVID vaccines. If they are so effective as to justify mandating them for people who don't want them, then they are also effective enough to protect those who choose to get them. The very effectiveness used to justify the mandate serves to prove that the mandate is not necessary. The absurd logic of mandating in the name of safety is that the vaccines are effective for those who do not want them and ineffective for those who do.

The path chosen by Virginia colleges and universities in mandating the use of investigational vaccines is not in the best interest of students and will do real harm to the community these schools sincerely desire to serve. The mandates should be reversed, or delayed until such time when traditional FDA-approved vaccines are available.