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To Vaccinate or Not To Vaccinate. Lessons from Lackland

Flu has recently swept through the Lackland Air Base. About 160 troops training there have been sick. This outbreak comes only two months after Pete Hegseth, the Secretary of Defense, ended the longstanding requirement that American troops have flu vaccinations. He stated that it was an “absurd, overreaching” mandate that had served to “weaken our warfighting capabilities.” The flu vaccine is now voluntary in the military. Hegseth again: “Under the disastrous Biden administration, this Pentagon waged an unrelenting war on our warriors on many fronts, including when it came to denying them simple medical autonomy and the freedom to express their religious convictions.”

Perhaps peer pressure tells trainees that it is unwarriorlike to get vaccinated. (The notion that “real” warriors don’t get vaccinations does not seem to be undercut by Trump’s having had flu and Covid shots.) Perhaps the trainees think diarrhea, vomiting, and fevers are manly. Whatever the reason, only 40% of trainees had the flu shot. Well, that was true before an exception to the voluntary vaccine policy was imposed at Lackland. Flu vaccinations are now required.

Hegseth did not explain how mandatory flu shots weakened our warfighting capabilities, but I assume that is because about 8,700 armed forces personnel quit or were discharged when they refused to get vaccinated when it was mandated. (Now they can be reinstated, but only thirteen have sought reinstatement.) That loss, however, only harms fighting prowess if those who quit could not be replaced with vaccinated warriors, and nothing indicates they weren’t. Instead, Trump boasts that our recruitments have never been better. Sorry, Mr. Hegseth, but vaccinated warriors lead to military strength. It is hard to fight effectively with diarrhea, vomiting, and fevers. Removing the vaccination requirement does the opposite of strengthening our military forces.

Hegseth gave medical autonomy as a reason for rescinding the vaccine mandate, but, of course, autonomy has limits. For example, the decision whether to have an abortion is one of medical autonomy, but that autonomy is lacking in much of this country. Moreover, vaccinations are not simply questions of personal medical autonomy. Flu vaccines reduce the likelihood of getting sick, but they do not totally prevent the illness. If I get the flu, others in contact with me are more likely to get the flu, too. My decision whether to get vaccinated affects the people around me, and that would seem to be especially so when I sleep in barracks and eat communally. Those others require consideration.

I own a quarter acre in Pennsylvania. Often in the autumn when it has been dry, the county bans open burning. The government is telling me what I can’t do on my property, which seemingly infringes my rights. (The Constitution has explicit provisions protecting property. It does not have any provisions for medical autonomy.) The ban protects me from myself, just as a vaccine mandate does. I am less likely to burn my property if I don’t openly burn in the dry spell. But the burn ban also protects my neighbors as well. Other properties are also less likely to be destroyed if I don’t openly burn. With an open burn ban, more than my property rights should, and are, considered. With a vaccination requirement, more than an individual’s medical autonomy should be weighed.

Hegseth also said that the military should have “freedom to express their religious convictions.” These stem from the scripture that says, “The Lord said, ‘Verily, do not permit your holy body to be jabbed so as to prevent liquid bowels, upchucking, and chills and sweats. The path to the Lord is an uncomfortable one that should not be lessened.’” Oh, wait. There is no such passage.

Even so, religious objections to vaccinations have existed for hundreds of years. Puritan Minister Cotton Mather learned about smallpox vaccinations from his West African slave Onesimus and employed the technique in the 1720s when Boston suffered a smallpox outbreak. Objections to the inoculations were strong. Although Cotton Mather was hardly lax on the religiosity front, the method was said to be ungodly because it was not mentioned in the Bible. Furthermore, it affronted God’s right to determine who was to die and how and when they should meet their Maker. But experience showed that the vaccinations prevented deaths from smallpox, which, surprise, surprise, both the godly and the ungodly wanted. The practice spread in colonial America, and in 1775 George Washington required the vaccination of the Continental Army. It soon gained general acceptance in the larger cities and towns of the United States.

The practice, however, did have dangers, but those were lessened when Dr. Edward Jenner learned a safer way to vaccinate. Mandatory vaccinations ensued. Boston was the first American city to require school children to be vaccinated against smallpox, and other states and cities adopted the policy and added similar requirements as other vaccines were developed. Over a century after Jenner’s discovery, Cambridge, Massachusetts, in response to an outbreak and pursuant to a state law, required adults to get smallpox vaccinations.

Henning Jacobson said that forcing him to be vaccinated violated the liberty guaranteed by the Constitution and that no one should be subjected to the law if they objected to vaccination no matter what their reason. The issue made its way to the United States Supreme Court. In 1905 Jacobson v. Massachusetts held that individual liberty could be restrained by reasonable laws for the safety of the general public and that “real liberty for all could not exist under the operation of a principle which recognizes the right of each individual person to use his own liberty, whether in respect of his person or property, regardless of the injury that may be done to others.” The mandatory vaccination requirement for adults was upheld.

 In 1922 the Supreme Court extended its Jacobson ruling. Zucht v. King upheld the San Antonio, Texas, school district’s rule that excluded children from both public and private schools if they did not have a smallpox vaccination. Since then lower courts have found many different vaccination requirements to be constitutional.

Since the development of the smallpox vaccine, other vaccines have prevented much human misery, but in spite of what the Supreme Court held more than a century ago, many claim they have a constitutional right to refuse a mandated vaccination. Today the assertions often conflate a personal belief with a religious one. Many people seem to feel that their strong belief must be ordained by their God. Since the Covid pandemic, we have seen an increasing number of claims that mandatory vaccinations violate people’s religious convictions when the belief really seems to come from anti-government feeling or their own misinformed views of vaccine’s dangers.

Whether the anti-vax belief is truly religious and should be an accepted form of relief from mandated vaccinations is a topic for another day. Today, though, we can focus on the simple lesson from the outbreak at Lackland: Ending the vaccine mandate undercut the readiness of our armed forces. Sick soldiers are not the best warriors. Hegseth has harmed, not strengthened, our military.

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Anti-Vaxxers Should Know this History

          The disease did not originate there, but a preventive measure began in China. The measure spread around the world. Knowledge of it came to North America, where the disease had helped Europeans dominate the land, on a slave ship. The preventive inoculations led to claims of violations of personal and religious liberty. A vaccine was developed, and states began to require its use. Courts were asked to find a law requiring vaccinations unconstitutional, but the Supreme Court upheld the statutes. The vaccine was so successful that widespread inoculations have led to the elimination of the disease. This particular virus is no longer the scourge that killed hundreds of millions.

We don’t know precisely how or when smallpox developed, but we have evidence of it five thousand years ago in Egypt. It endured through the millennia. By the fifteenth century, it had spread to all parts of the globe except the Americas. That changed when Europeans brought it to what they thought of as the new world. Native populations, who had no immunity to the disease, succumbed at perhaps a 90% rate, making it easier for the Spanish and English to colonize what had once been extensively populated lands. Smallpox persisted. Millions of cases still occurred in the second half of the last century.

          People tried to prevent the disease, and by the sixteenth century, China was using an immunization method against smallpox in which powdered smallpox scabs were inserted into scratches made in the skin of the healthy. When this went well, the recipient developed only a mild form of the disease, but one that gave the person lifetime immunity. This inoculation method called variolation (Variola is the virus that causes smallpox) spread to the Middle East and Africa.

          Puritan Minister Cotton Mather learned this technique from his West African slave Onesimus and used it in the 1720s when Boston suffered a smallpox outbreak. Objections to the inoculations were strong. Although Cotton Mather was hardly lax on the religiosity front, the method was said to be ungodly because it was not mentioned in the Bible. Furthermore, it affronted God’s right to determine who was to die and how and when they should meet God. Others raised the non-religious objection that using the product of a disease to prevent a disease did not make sense. But the empirical data overwhelmingly showed that variolation prevented deaths from smallpox. The practice spread in colonial America, and in 1775 George Washington required the variolation of the Continental Army. It soon gained general acceptance in the larger cities and towns of the United States.

          The practice, however, did have dangers. While the inoculation recipient usually got only a mild case of the disease, occasionally it was severe, and deaths occurred. Near the end of the eighteenth century many recognized that a cowpox infection (which is related to, but much less virulent than, smallpox) seemed to protect against the more serious infection. Dr. Edward Jenner vaccinated (the terms vaccine and vaccination are derived from the name of the cowpox virus, variolae vaccinae) people with the cowpox virus and then later showed that this made the recipient immune to smallpox. Jenner is credited with creating a smallpox vaccine–the first vaccine ever. In doing so he is thought to have saved more lives than anyone else in history.

          Even with the vaccine, however, smallpox continued not just in backwaters or “primitive” areas of the world, but also in the United States. In 1827, Boston was the first American city to require school children to be vaccinated against smallpox, and other states and cities adopted the policy and added similar requirements as other vaccines were developed. Over a century after Jenner’s discovery, Cambridge, Massachusetts, in response to an outbreak and pursuant to a state law, required adults to get smallpox vaccinations.

          Henning Jacobson said that forcing him to be vaccinated violated the liberty guaranteed by the Constitution and that no one should be subjected to the law if they objected to vaccination no matter what their reason. The issue made its way to the United States Supreme Court. In 1905 Jacobson v. Massachusetts held that individual liberty could be restrained by reasonable laws for the safety of the general public and that “real liberty for all could not exist under the operation of a principle which recognizes the right of each individual person to use his own liberty, whether in respect of his person or property, regardless of the injury that may be done to others.” Jacobson had offered proof that some medical authorities contended that vaccinations would not stop the spread of smallpox and would cause other diseases and adverse consequences. The Court noted, however, that many other medical authorities held contrary opinions. The Court concluded that legislatures—not the courts– had the authority to decide how to protect the public. The mandatory vaccination requirement for adults was upheld.

          In 1922 the Supreme Court extended its Jacobson ruling. Zucht v. King upheld the San Antonio, Texas, school district’s rule that excluded children from both public and private schools if they did not have a smallpox vaccination. Since then lower courts have found many different vaccination requirements to be constitutional.

          Smallpox vaccinations, of course, have been a huge success. Intensive containment and vaccination efforts in the second half of the last century led to the worldwide eradication of the disease. The last case of it was in 1978.

          Since the development of the smallpox vaccine, many other vaccines have prevented much human misery, but in spite of what the Supreme Court held more than a century ago, many claim they have a constitutional right to refuse a mandated vaccination. The law and the Constitution are not on their side. They will succeed only if the present Court will be activist enough to overturn the settled precedents and find that individuals have a right never before found, a right to place others in peril. If so, society will suffer. And American life expectancy, which took the largest nosedive since World War II under Trump, the Has Been Guy, will drop further. Such a finding will, in fact, MALG–Make America Less Great.