Vaccinations should be both individual and societal choice

Many Americans are confused by the 44 percent of their fellow countrymen who have yet to be vaccinated. After all, COVID-19 vaccination is free and the only cost to the individual is the time it takes to obtain the shot. For most people the opportunity cost of that time is minimal, and the cost of catching COVID-19 is potentially quite high, so why would anyone pass on a shot?

There are those who maintain that the vaccine was developed too quickly and that the research on the long-term effects of the vaccine is incomplete. They believe that it is better to contract COVID-19 and gain immunity that way rather than by a vaccination. However, those that refuse the shot neglect the costs they impose on society by their actions.

Those societal costs vary with the severity of the infection but can be significant. Early in the pandemic Healthcare Finance News' associate editor, Mallory Hackett, calculated that the average cost of a COVID-19 hospital stays for patients less than 21-years-old without insurance was $51,289. The average cost of patients 41-years-old or older, without insurance, rose to $78,569. Total costs have only increased since April 2020 when these calculations were made.

Even at these rates the cost of care for a COVID-19 patients are not fully covered by the patient or their insurance carrier. Much of the fixed costs of operating a hospital must be covered by income derived from a variety of services they provide. High among those services are "elective surgeries," which are "crowded out" when a hospital must increase the space and the personnel needed to treat COVID-19 patients. To make up for the loss of income hospitals increase their charges for other procedures. Insurance companies also must cover increased costs, so insurance premiums are raised to cover their increase payouts.

There are many "social costs" incurred when individuals choose to forgo vaccination and as a result become infected. Their decision increases by many times the probability that they will also infect others thereby heightening the personal and governmental cost spiral of COVID-19. And there are the also institutional social costs incurred by businesses and organizations which lose efficiency because sick employees are unable to work for long periods of time.

Finally, there are the future costs associated with the fact that so many students of all ages have missed valuable classroom time during the pandemic. UNESCO reported that in April of 2020, 90 percent of the world's learners: almost 1.6 billion children and young people were impacted by closed schools. UNESCO estimates that ten percent in additional future earning is realized for every year of school. Using this calculation and applying it to the 76 million school children in the U.S. the cost of lost school time for only one semester equates to $2.5 trillion in future earnings. Of course, some students missed no classroom time, but the majority did and for much longer than a semester. In any event, lost time in school is an actual cost of the pandemic that we cannot overlook in ascertaining the cost society incurs because of the non-vaccinated.

The decision not to get vaccinated carries many costs, some of which are born by the individual making the decision, but many are incurred by all of us. The argument that individual rights are tread upon by government mandates for vaccinations has some basis in truth. If there were a way for those who decide against vaccinations to suffer the full costs of their decision than it might make sense for society to excuse people to refuse the shot. Some have tried to do just so. Delta Airlines has made a rational decision in that direction by charging non-vaccinated employees $200 a month more for their health insurance. But if a Delta employee becomes a COVID-19 patient the $200 a month he/she paid will hardly cover the full cost of treatment.

Americans have traditionally revered the rights of individuals to make their own decisions. However, when society suffers physically and financially from the decisions of a few at the expense of many then there is a role for institutions and government to make decisions that benefit all. Such seems to be the case with the requirement that individuals get vaccinated.

MacDowell is president emeritus of Misericordia University in Dallas.