Although much of the U.S. has enjoyed a summer dip in new COVID-19 cases and hospitalizations due to the roll out of highly effective vaccines, the Delta variant’s rapid spread is once again bringing uncertainty and fear for billions of people worldwide. At the time of writing, Southeast Asia is seeing its worst wave of the pandemic to date, deaths surged by 80% in Africa in July, and Latin America is again becoming a global COVID hotspot. The U.S. is seeing a dreaded uptick in cases, particularly in states with lower vaccination rates. Alarmingly, many new cases are concentrated among young people, and as students come back into classrooms with a varying degree of COVID measures in place, cases among young kids are on the rise too. Florida recorded its own record number of over 21,000 new cases on July 31. 

Scientists are still working out the implications of the Delta variant, but what we know is that it’s more, perhaps twice, as transmissible as the original virus that hit the U.S. in 2020. It also matures and becomes contagious several days faster. It is not on average more deadly, but these two factors allow it to infect more people faster.

The political and social responses to Delta are changing on a day-by-day basis. It seems as though every day we are inundated with new, and often contradictory, information. The lack of an integrated, scientifically-based, and people-centered response by the U.S. ruling class has hampered our ability to counter the crisis, leaving thousands more dead. Globally, the situation is even worse with many countries worldwide still without access to vaccines. As we’ve pointed out since the beginning of the pandemic, equitable access to vaccines globally was going to be directly cut across by big pharma’s hunger for profit. Despite the development of these vaccines being publicly funded, their manufacturing and distribution has taken place on the free market — meaning the rules are determined by billionaires rather than ordinary people. Because of this, new and more dangerous COVID variants have emerged. 

We need a working-class program to handle COVID and its effects. We need universal access to vaccines which can be accomplished by removing all patent restrictions on vaccine technology, allowing poorer countries to manufacture them at home. We need community-driven education programs aimed toward overcoming vaccine hesitancy. Workers should be guaranteed time off to recover from the side effects of the vaccine with no loss of pay, and unions should fight for this demand in both union and non-union workplaces. We also cannot see the vaccines as a silver bullet as the global ruling class has tried to do, allowing them to in many cases end widespread testing, contact tracing, and mask mandates, which will all continue to be necessary tools to fully curb the pandemic. 

Vaccine Hesitancy

The U.S. has enough vaccines to inoculate every American, yet full vaccination rates hover around 50% of the eligible population in most states. The new surge due to the Delta variant has convinced some holdouts to become vaccinated, with the country reaching 70% of the eligible population with at least one shot on August 2

Vaccine hesitancy, however, poses a major problem for ordinary people in the U.S., especially frontline workers who have now been asked to return to work (often with no increase in pay or protections) and are face-to-face with unvaccinated customers. It also poses a major problem for the U.S. ruling class who bet on vaccination as the pathway to normalcy, especially as social distancing and mask mandates were undermined in many states. Many ordinary people are understandably angry at vaccine holdouts still refusing to get the shot. The science is quite clear that universal vaccination remains our best protection against a constantly mutating and spreading virus, and new hospitalizations and deaths are overwhelmingly among the unvaccinated. However, in order to identify any path out of this crisis we have to first understand why it is that “vaccine hesitancy” is so widespread in the U.S. and what the best means are to overcome it.

The term “vaccine hesitancy” is a tremendously unspecific phrase and obscures the variety of reasons someone may not be vaccinated. Those who remain unvaccinated in the U.S. can be divided into two rough groups: those who want the vaccine but have yet to get it, and those who refuse it. 

For those who want the shot but have yet to get it, this could be for any number of reasons. Whether they can’t get time off work to recover from the side effects, can’t find childcare while they go in for an appointment, or live too far from a vaccination site and don’t have reliable transportation — there remains a question of access for many unvaccinated Americans.

Then there are those who have access but are refusing the shot. The high rates of vaccine hesitancy in the U.S. exists against the backdrop of a completely mangled COVID response by the U.S. ruling class, where open feuding between politicians and health experts became a daily occurrence. More broadly, it exists in the context of deep distrust in our for-profit healthcare system. 

For Black Americans in particular, vaccine skepticism can come from a long history of lack of access to adequate healthcare, and mistreatment in the healthcare system itself. Add to this a brutal history of medical abuse from forced sterilization to the Tuskegee Syphilis Study, an abusive biomedical study where Black Americans were infected with syphilis, studied, and denied treatment. For others, it’s likely informed by decades of personal experience with misdiagnosis, shoddy treatment, and overpriced prescriptions. This distrust, and even disdain, for the American healthcare system is not unfounded. As millions across the country received a vaccine from Johnson & Johnson, the company settled a lawsuit with 15 states in which they will pay $5 billion for its role in the opioid epidemic that has swept the poorest regions of the country.

Despite being publicly funded, the entire COVID vaccine operation was privately driven. Already disliked big pharma corporations competed against one another in a race to the finish line. Then, distribution, like testing, was contracted out in many areas to corporations like Walmart, CVS, and Walgreens. Even Facebook groups sprung up as an informal information source for the public to get vaccinated. For many, the speed with which the vaccines were developed is enough to prevent them from getting it. Though for many people in that category, they’ve signaled once the FDA gives its full approval to the shots they’re more willing to get it.

The U.S. healthcare system is notoriously expensive and full of surprise charges that could easily lead to bankruptcy. Despite the vaccine being free, there are a significant number of ‘hesitant’ people who either are not aware of this or are skeptical that it’s true. If we had a system like Medicare-for-All where high quality, free healthcare was guaranteed, people would not be afraid of being charged for a vaccine! 

That deadly pandemics are a money-making opportunity for Big Pharma is why Socialist Alternative calls for the public ownership of the pharmaceutical industry: vaccines and all other drugs should be researched, developed, manufactured, and distributed on the basis of need, not profits. 

Within the broad category of vaccine skeptics, there are those who are without question driven by right-wing, conspiratorial ideas. A dominant line of thinking in this section of society is that the COVID threat has been overblown by the government as a means of controlling individuals. They apply this logic to mask mandates, lockdowns, and vaccinations, claiming that the entire COVID response is an exercise in government control. This thinking has emerged in a political and social environment wherein faith in major institutions was already decaying, which explains how these ideas have been able to grab hold of ordinary people. 

Tucker Carlson, who hosts the highest-rated cable news show in U.S. history, regularly undermines the science of COVID vaccines and has even compared them to frontal lobe lobotomies. Figures like this bear criminal responsibility for the crisis we’re in now. Right wing pundits have doubled down on the argument that vaccination is, above all else, a personal decision that should be made without concern for its impact on broader society. This right wing individualism is at odds with the vast majority of ordinary people who recognize that a certain degree of individual sacrifice is necessary in order to protect society at large. 

Are Vaccine Mandates the Answer?

Most forms of vaccine skepticism could be overcome in the context of a public healthcare system that is run transparently with no hidden costs. If the pharmaceutical industry was publicly owned and run purely in the interests of public health rather than profit, we would very likely see dramatically less skepticism. Even in the immediate term, measures could be taken to alleviate the concerns of ordinary people about getting the shot: guaranteeing paid time off to allow people to recover from the side effects, free transportation to and from vaccination sites, community driven information campaigns to ensure people know the vaccine is free, and a removal of all patent protections to transparently demonstrate the science and technology behind the vaccines.

While we do not support a blanket policy of mandatory vaccination, which could be used as a form of repression, we do support certain measures to protect public health. Most states already require healthcare workers to get certain vaccinations to protect their patients such as vaccines for influenza, measles, and rubella. The same is true for school students and military personnel. We support a similar policy for COVID vaccinations, though we believe that such a policy, in order to actually protect workers, would have to be negotiated with the workers themselves. Rather than being implemented solely by bosses and managers, workers should have the right to negotiate and implement the safety procedures, including proof of vaccination, that they deem reasonable. This could include work-from-home options where applicable for those who are, for whatever reason, not able to get the vaccine. It could also include rigorous testing requirements for unvaccinated workers in a given workplace.

Additionally, while we would thoroughly oppose any measures that prevent the unvaccinated from carrying out necessary tasks like grocery shopping, going to the pharmacy, riding public transit, etc., we would support vaccine requirements in order to attend high capacity indoor events.

We Need More than Vaccines: Fund Public Health!

We know more pandemics will be coming. Yet, a year and a half into the worst pandemic of our lifetimes, the U.S. public health infrastructure is no better prepared to handle the ongoing surge, let alone whatever may come afterward when complacency has long since set in. 

Hospitals remain understaffed. Contact tracing was never fully implemented. Sick pay standards, not just for becoming infected but also for recovery from vaccination side effects, were never standardized and are out of reach for the most precarious workers. Free housing for those needing quarantine and isolation was never provided in a widespread or accessible way. To top it all off, Biden has removed funding for critical pandemic preparedness from his proposed $3.5 trillion “human infrastructure” bill.

Virologist Ian Mackay suggests thinking of pandemic defenses as layers of Swiss cheese: all measures have holes, but when layered on top of each other, those holes are plugged and can block the virus from spreading. Vaccines are only one such layer, yet capitalist governments have placed all bets on it alone. Instead we need many more layers of protection than just vaccines, and they should be fully funded and implemented in addition to the vaccines. 

An example of such a public health measure is the nationwide eviction moratorium. Last year the CDC determined that preventing evictions was a key way to contain the spread of COVID. This has since been contested by Republicans, voicing the concerns of the predatory real estate and housing lobby, as a breach of the Constitution. Knowing that an eviction crisis would undermine the effort to control the pandemic as well as damage the economy, and under pressure from the direct action of Rep. Cori Bush, Biden and the CDC were forced to extend it temporarily to October 3. However, October 3 will roll around and real estate tycoons and slumlords will come knocking on the White House doors demanding an end to these tenant protections. This will put millions at risk not just of eviction, but contracting COVID.

We need to rapidly re-introduce layers of protection like eviction moratoriums, widespread testing, mask requirements, and contact tracing that have been abandoned by most politicians in the U.S. On top of that we need new layers of protection like reliable accommodations for people who need to be isolated from vulnerable people in their household.

Fully protecting society from disasters, whether it be diseases, wars, or climate emergencies, is impossible on the basis of a system that solely protects profit. Fossil fuel companies’ profits are made through unmitigated theft of the earth’s resources, big pharma profits are made by signing off on needless death. Truly protecting ordinary people from calamity means entirely free, high-quality public healthcare, truly affordable publicly owned housing, an end to profit-driven destruction of the planet, and genuine international solidarity rather than reckless competition. All of this demands that we fight for the socialist transformation of society as our only defense against needless disaster.

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