I'm generally pro-vaccine.  I've had every vaccine available and we've vaccinated our kids.  I'm also not anti-vaccination for COVID-19.  In fact, there are people I know who I wish would get the vaccine.  (More on that later.)

What I am very much against is the government mandating this particular vaccine for this particular disease.  Let me give you three reasons why:

The main reason to mandate any vaccine would be to stop its transmission.  If we could make COVID go away by just sticking shots in people's arms, then a vaccine mandate would make total sense.  Unfortunately, the current vaccines are doing a terrible job stopping transmission of omicron.

We all know people by now who are vaccinated and boosted who have the virus.  One of my business partners is quadruple vaccinated and he's currently sick.  I can think of several other people I know personally who are boosted and sick with Omicron. 

But who needs anecdotes when you have statistics?  Portugal is the third most vaccinated country in the world (after UAE and Cuba) at an over 90% fully vaccinated rate.  Despite this, COVID is exploding in Portugal right now and they are getting more than 10,000 positive tests a day (with a population smaller than Massachusetts).   Israel is another one of the most vaccinated countries on earth and is mandating a fourth shot to even buy food in a restaurant, but recent data out of Israel shows that the boosted are something like 3x more likely to get COVID than the unvaccinated.

So it's not stopping transmission.  Even the CDC and Fauci have stopped saying that vaccination stops transmission.  What they say is that it will protect you from severe outcomes.

So the argument has shifted from "get the vaccine so you don't spread COVID" to "get the vaccine to avoid hospitalization and death and to not overrun the health system."

And that brings me to my second reason why I am against vaccine mandates:

While it is certainly true that far more unvaccinated people have been hospitalized than vaccinated people, vaccination status is far from the biggest predictor of severe COVID outcomes.  We have known from very early on what the biggest predictors of severe COVID outcomes are, and they are advanced age and obesity.

Only 6% of those who died from COVID in 2021 were under the age of 50.  The vast majority of that 6% (and many of the older people) had obesity and diabetes.  You also have to factor in prior infection.  Almost no one under the age of 65 has recovered from COVID, got the disease a second time, and died from it (again without severe comorbidities).

So focusing a mandate on the unvaccinated in order to prevent hospital overload doesn't get to the root of the problem.  In order to have the most impact, we need to identify the people with the following criteria:

- Above the age of 50.
- BMI above 28.
- Unvaccinated or unrecovered.

Those are the people who are at greatest risk of overrunning our hospital systems.  Not young, healthy people who are avoiding this particular vaccine.

Put another way, I,  as a healthy and active 38 year old, who has already recovered from COVID, have a near zero risk of being hospitalized with COVID.  I am not going to overrun the hospital system.  Neither is my recovered wife or my healthy and recovered kids.  

So if we are truly concerned with not overburdening the hospital system, wouldn't it make more sense to impose a mandate tethered on age and BMI?  I mean, sure, it would make for some awkward conversations, but no more so than the completely not a risk dad who has to explain to his kids why he lost his job.

There are people I know who I really want to get vaccinated.   They are wonderful people in their early seventies who have diabetes and are on the heavy side.   They haven't dealt with COVID yet.  I'm concerned that when they do, they have a very high risk of hospitalization and death.

Why can't we focus our efforts on these people and people like them instead of a mass rush to vaccinate all the ten year olds on my swim team and the previously recovered marathon runners?

A third reason why I think these particular vaccine mandates are a bad idea is...

A month after I had COVID, I experienced weird issues with my heart that I think might have been myocarditis.  I would be doing something completely ordinary, like walking around a grocery store, and suddenly feel faint and need to lean on a shelf or sit down.  This despite the fact I was running nearly every day and eating healthy.  Thankfully this passed quickly after a few episodes.

I was already not keen on getting a vaccine for something I had already recovered from and my body had little problems with.  But, when I heard that the mRna vaccines were causing severe myocarditis in rare cases, particularly in young men, I decided that the benefit for me wasn't worth the risk.  Is that unreasonable?

Children have less chance of severe COVID outcomes than of drowning or dying in a car accident.  Their risk profile is extremely low.  They also have not been drivers of infection (according to several studies).  What if a parent decides that it's not in the best interest of their child to get the shots, when we don't know how they are going to effect them years or decades from now?  Is that parent unreasonable?

What if a relatively low risk person doesn't want to sign up for what now looks like a twice or thrice annual shot in perpetuity?  Is that unreasonable?

Yes, I know that certain vaccines are required by public schools.  But those vaccines tend to be one-and-done and for diseases with a much higher fatality rate.  In contrast, the COVID vaccines are for a disease many of us have already recovered from, seem to be needed every 4-6 months, and use a new and untested vaccine technology.  If they blocked transmission it would make some sense to mandate them, but they don't, especially with new variants.  

What would be the harm with, instead of blanket vaccine mandates, focusing our efforts on making sure that those most at risk are ready for their inevitable date with this virus?  What would be the harm in telling people honestly "your weight and habits make this a particular threat to you" and in addition to vaccination, prescribing some serious lifestyle changes?  What would be the harm in getting off the backs of those at extremely low risk of the disease so we can focus on those at great risk?

Instead we have pursued policies that are doing great harm:  They are putting massive strains on our economy.  They are forcing thousands (if not millions) of essential workers to lose their jobs.  They are straining our hospital systems as we are firing nurses when we need them most. They are are encouraging extremely unhealthy and unrealistic ways of viewing the virus and leading us to distrust our government and dislike each other more.

There is a better way, let's jump off the cray train and take it.