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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.

Posted on by rjonakait · 1 Comment

The Covid-19 Vaccine and Transgender Sports: A (Plausible?) Trumpian Connection (guest post from the spouse)

On February 5 President Trump signed an executive order barring transgender student athletes from playing in girls’ sports. On March 19, the National Institutes of Health told grant seekers across the country to remove any reference to mRNA vaccine technology from their grant applications. What do these two things have to do with each other?

Maybe nothing. However, it is also possible that the Trump administration is trying to kill two birds with one stone and is using the University of Pennsylvania as its target. On the same day that the NIH promulgated its directive to remove mRNA vaccine technology from grant applications, the Trump administration “paused” $175 million in grant funding to the University of Pennsylvania. The grants are being “paused,” the administration says, over Penn’s failure to exclude the transgender student Lia Thomas from the women’s swim team. Is it a coincidence that the most notable research team in mRNA vaccine technology, Katalin Karikó and Drew Weissman, work at the University of Pennsylvania Medical School? Oh, and by the way, in 2023 they won the Nobel Prize after their work led to saving an estimated 3 million lives from the scourges of the Covid-19 epidemic.

Whatever you may think about transgender women participating in women’s sports, it’s a very bad precedent that such an executive order pre-empted cases that were before the courts (Penn swimmers are suing the university), and it’s equally bad that Penn is being punished for a “failure” that is long past (Lia Thomas has graduated). But by targeting Penn, they are also targeting a Nobel Prize-winning team of scientists who are working on one of the most promising technologies currently available for treating dangerous viruses and cancer. One only hopes that those proposed $175 million cuts do not affect their research effort (they are heavily funded by NIH), but that remains to be seen.

Continuing my effort to explain the devastation being wreaked on American science, here is another effort to describe the incremental steps that led up to the Covid-19 vaccine and that Nobel Prize.

As before: some basic science information is worthwhile.

1) Basic molecular biology: DNA, the famous double helix, unwinds and provides a template for RNA. This is called “transcription.” RNA, which comes in both double and single strands, then codes for proteins. This is called “translation.” Proteins make up just about everything in the body…muscles, bones, nerves, everything.

2) Basic immunology: When a virus invades the human body, the immune system recognizes it, and, if we’re lucky, mounts a response to destroy it. How does it “recognize” it? Molecules (called Toll receptors) on or within immune system cells match up with certain age-old molecular patterns on pathogens. When those receptors meet their match, the cells go into action by producing antibodies and/or other components of the immune response.

3) Basic vaccine biology: The protection afforded by vaccines has been known since 1796 when Edward Jenner realized that small doses of smallpox protected people from getting the full-blown symptoms of the disease. It took another hundred years (1890) before the concept of antibodies was promulgated and another 70 years after that (1958) before the structure and function of antibodies were known. And many years after that before the understanding of the immune cascade that produces them in the first place. Understanding how vaccines work to create antibody protection has been the focus of a massive research effort ever since. The National Institute of Allergy and Infectious Diseases provides about $6.5 billion annually to support that research.

4) How are these things related? That’s what took some time to discover.

That DNA had something to do with heredity was discovered in the 19th century, but its structure was not known until 1953. This discovery is famously described in the book by James Watson, The Double Helix. Watson, Francis Crick, and their male collaborator (Maurice Wilkins), but not their female collaborator (Rosalind Franklin), were awarded the Nobel Prize in 1962. Not surprisingly, then, the 1950’s and 60’s saw an explosion of research in DNA technology leading to an understanding of protein biosynthesis as described above.

In the meantime, work on the immune system progressed apace. While it was clear from research going back 100 years that certain molecules were able to stimulate an immune reaction, the mechanism by which this occurred was largely unknown until Toll receptors were discovered in 1985. They were discovered in embryos of Drosophila, i.e., fruit flies (another Nobel Prize for the team), but their role as the triggers of immune system function did not come for another ten years. Research on these basic elements of immune system activation flourished, and by the early 2000’s, nine different Toll-like receptors had been identified, some of which recognize RNA.

The plot thickens.

So. What if you could engineer a specific RNA to enter an immune cell, translate a small portion of an ugly virus…say, the “spike” surface protein of the Covid virus…then have that surface protein expressed by a non-viral cell? Since the surface protein by itself is harmless without its viral host, such production would not constitute a full-blown viral infection. The RNA would, of course, need to be modified so that it translated the protein but didn’t cause an overwhelming inflammatory response via those pesky Toll receptors. This necessary modification was the genius of Karisó and Weissman at Penn. The modified RNA would then stimulate intracellular Toll receptors to produce a more modest immune response. Would the immune system simultaneously recognize the surface protein and the modest Toll receptor response and mount a reaction that included the production of antibodies against the surface protein? Would that be the equivalent to a vaccine against Covid-19? And the answer is…well, yes. But how to get that RNA into the cell in the first place?

Another discovery, beginning in the 1960’s, showed that tiny lipid (fatty) droplets (nanoparticles) could encapsulate molecules like RNA and “squeeze” it into cells. Hence, they provided a delivery system for the RNA. And this observer has not a single idea about how one gears up the production of this entire apparatus to enable the vaccination of millions of humans. Enter the technology of the pharmaceutical giants….way beyond the scope of this humble essay.

In short, several strands of research over many decades had to come together in order to beat the Covid virus. But questions remain. Can we use this technology to fight cancer? Autoimmune diseases? As-yet-unknown pathogens? Well, we won’t know if the Trump administration bans funding for anything smacking of the pernicious “mRNA technology.” Call your Congress person…NOW.