In 1905, the Supreme Court ruled against a pastor, Henning Jacobson, who had sued the state of Massachusetts for requiring residents to take a vaccine after an outbreak of smallpox. “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, whether in respect of his person or his property, regardless of the injury that may be done to others,” the court ruled. “It is, then, liberty regulated by law.”
That ruling, and others after, it have repeatedly reaffirmed this principle. As for private businesses, they can choose to hire, fire and transact with anyone, unless they discriminate based on a protected category.
There is still room for interpretation. Lawyers could argue that prior cases didn’t consider a drug authorized only for emergency use by the F.D.A., as the early coronavirus vaccines will be. Or perhaps a more conservative-leaning Supreme Court would be open to revisiting prior precedent.
With distribution of a coronavirus vaccine beginning in the U.S., here are answers to some questions you may be wondering about:
- If I live in the U.S., when can I get the vaccine? While the exact order of vaccine recipients may vary by state, most will likely put medical workers and residents of long-term care facilities first. If you want to understand how this decision is getting made, this article will help.
- When can I return to normal life after being vaccinated? Life will return to normal only when society as a whole gains enough protection against the coronavirus. Once countries authorize a vaccine, they’ll only be able to vaccinate a few percent of their citizens at most in the first couple months. The unvaccinated majority will still remain vulnerable to getting infected. A growing number of coronavirus vaccines are showing robust protection against becoming sick. But it’s also possible for people to spread the virus without even knowing they’re infected because they experience only mild symptoms or none at all. Scientists don’t yet know if the vaccines also block the transmission of the coronavirus. So for the time being, even vaccinated people will need to wear masks, avoid indoor crowds, and so on. Once enough people get vaccinated, it will become very difficult for the coronavirus to find vulnerable people to infect. Depending on how quickly we as a society achieve that goal, life might start approaching something like normal by the fall 2021.
- If I’ve been vaccinated, do I still need to wear a mask? Yes, but not forever. The two vaccines that will potentially get authorized this month clearly protect people from getting sick with Covid-19. But the clinical trials that delivered these results were not designed to determine whether vaccinated people could still spread the coronavirus without developing symptoms. That remains a possibility. We know that people who are naturally infected by the coronavirus can spread it while they’re not experiencing any cough or other symptoms. Researchers will be intensely studying this question as the vaccines roll out. In the meantime, even vaccinated people will need to think of themselves as possible spreaders.
- Will it hurt? What are the side effects? The Pfizer and BioNTech vaccine is delivered as a shot in the arm, like other typical vaccines. The injection won’t be any different from ones you’ve gotten before. Tens of thousands of people have already received the vaccines, and none of them have reported any serious health problems. But some of them have felt short-lived discomfort, including aches and flu-like symptoms that typically last a day. It’s possible that people may need to plan to take a day off work or school after the second shot. While these experiences aren’t pleasant, they are a good sign: they are the result of your own immune system encountering the vaccine and mounting a potent response that will provide long-lasting immunity.
- Will mRNA vaccines change my genes? No. The vaccines from Moderna and Pfizer use a genetic molecule to prime the immune system. That molecule, known as mRNA, is eventually destroyed by the body. The mRNA is packaged in an oily bubble that can fuse to a cell, allowing the molecule to slip in. The cell uses the mRNA to make proteins from the coronavirus, which can stimulate the immune system. At any moment, each of our cells may contain hundreds of thousands of mRNA molecules, which they produce in order to make proteins of their own. Once those proteins are made, our cells then shred the mRNA with special enzymes. The mRNA molecules our cells make can only survive a matter of minutes. The mRNA in vaccines is engineered to withstand the cell’s enzymes a bit longer, so that the cells can make extra virus proteins and prompt a stronger immune response. But the mRNA can only last for a few days at most before they are destroyed.
Over the past week, I spoke with executives at companies in various industries to see whether they intend to require vaccination of employees or customers. None wanted to speak on the record.
Almost all said they planned to recommend the vaccine, but not make it compulsory. Several said that they have tried to create a culture of trust, and a vaccine mandate would undermine that trust. Others worried about legal liability if an employee had adverse side effects from the vaccine. Some said they would like to mandate the vaccine, but worried that a backlash could spiral into a public-relations nightmare.
This is not a hypothetical thought experiment. When the chief executive of Qantas, the Australian airline, said he would require passengers to be vaccinated — “certainly for international visitors coming out and people leaving the country, we think that’s a necessity,” he said — the backlash was swift. A travel agency in Britain stopped booking flights with the airline, stating that “we feel that bodily autonomy with regard to medical intervention is a personal choice and not something to be forced onto people by businesses.”
It is understandable that executives would be anxious about courting potential controversy, but leadership is about making difficult decisions when the stakes are high. Simply recommending that people take the vaccine may not be enough.