Fauci vs. DeSantis: Is vaccination for your own benefit or for the community's?

DeSantis is taking a beating today, including in local media, for something he said a few days ago about vaccination: “It’s about your health and whether you want that protection or not. It really doesn’t impact me or anyone else.”

That was Fauci bait for CNN, which had the doctor on this morning and found time to ask him about DeSantis’s comment but not to ask him about that other news story circulating today in which Fauci himself is a key player. DeSantis has worked hard the past few months to position himself as the GOP’s foremost Fauci foil. The news that NIAID was apparently funding gain-of-function research in Wuhan will help make that strategy pay off.

But on this topic, Fauci has the better argument:

DeSantis was asked today about his earlier comment and clarified. In the age of Delta, he said, the vaccines are working to prevent severe illness and hospitalization, which is great. But clearly, with breakthrough infections happening, they’re no longer a pathway to herd immunity. Both the vaxxed and unvaxxed will go around infecting people, in which case vaccines are now chiefly a matter of personal protection:

Is he right?

He is not. Or rather, he’s right that herd immunity probably won’t come from vaccination anymore (at least until we get a new vaccine tailored to Delta) but he’s wrong that any person’s decision on whether to get vaccinated “doesn’t impact me or anyone else.” In the last post I cited data from Seattle showing that the unvaccinated part of the population there became more likely to get infected as the new variant spread this summer than the vaccinated part did. And if the unvaccinated are more likely to get infected, odds are very good that they’re more likely to spread the virus to others.

And intuitively, we all understand that. If you, a vaccinated person, had to spend an hour in a crowded room with 50 vaccinated people or 50 unvaccinated people, which would you choose? The answer is obvious.

A stranger’s decision whether to get immunized does impact you, then.

The unstated assumption in DeSantis’s comment is that, thanks to Delta, the vaccinated and unvaccinated are now equally likely to transmit the virus but I don’t know where he’s getting that. The CDC has never said so. What they’ve said is that vaccinated people who get infected can have the same viral load as the unvaccinated do. But it doesn’t mean they always do. And it doesn’t mean the vaccinated are as likely as the unvaccinated to get infected. And it doesn’t mean, if they are infected, they’re as likely to transmit the virus to others. And it doesn’t mean, even if they’re transmitting it to others, they’re transmitting it for as many days. A study from Singapore shows that the vaxxed clear the virus more quickly than the unvaxxed do.

Ironically, we got a study from the CDC last week on the same day that DeSantis made his initial comment that shows the importance of community vaccination. Kids in states with lower vaccination rates were more than three times as likely to need hospital care for COVID than kids in states with higher ones. An unvaccinated child who’s around vaccinated adults seems to have less of a chance of picking up the virus than a child who’s around unvaccinated adults does.

The vaccinated adult’s decision to get immunized impacts the child’s risk, in other words.

And of course, there’s another way that someone’s choice to get the shots or not affects others. As Danny Wilkinson’s family could tell us, having hospitals overloaded with COVID patients means people who need intensive care for other reasons might not be able to get it. A senior citizen in Florida who’s had heart trouble this summer or a stroke has certainly had higher odds of not receiving timely treatment because the state’s hospitals are needlessly crowded with unvaccinated coronavirus victims. Herd immunity would be nice but keeping ICUs functioning is essential. DeSantis seems to be prioritizing the former over the latter in his calculations about vaccine mandates.

One of his spokesmen is hitting back at Fauci this afternoon, but this is weak sauce:

Fauci said that before Delta became dominant. A hyper-contagious new variant was obviously going to raise the threshold for herd immunity to a much higher number, potentially making it unattainable. But Lamb’s missing the point. Just because the vaccinated can transmit the virus now doesn’t make vaccine mandates “pointless.” Vaccination can reduce transmission, which will ease the crowding in hospitals, protect more kids until they’re eligible for their shots, and maybe spare some vaccinated yet vulnerable senior citizens from a nasty infection that they’ll struggle with. This is another case of Team DeSantis looking to ingratiate themselves to the anti-vax segment of the national GOP primary base in 2024 by taking an irresponsible anti-mandate position in all cases. There’s no policy reason public-school teachers and nursing-home workers, at a minimum, shouldn’t have to be vaccinated as a condition of employment. But there is an electoral reason.