This journal article is highly
recommended. It provides a good overview of COVID-19 vaccine mandate
policies across many countries and features
thoughtful discussions about the consequences of those polices. Given
that the authors are well-established, public health academics and
many have been involved in vaccination campaigns, it will be
difficult for people to credibly dismiss this article as the work of
“anti-vaxxers” and
“conspiracy theorists”.
Overall this article provided a reasonable and balanced analysis of
the situations caused by the implementation of COVID-19 vaccine
mandates/passports. There are a few criticisms of this
article, though it provides a good record of a historic departure
from public health, bioethical, and constitutional norms in “liberal
democracies”. If you are looking for one article to use while
informing a friend, family member, co-worker, politician, or
journalist about the damage caused to society by the
mandates/passports, then I strongly recommend you consider sending
them this article.
Published in the BMJ Global Health journal, the article “The unintended consequences of COVID-19 vaccine policy: why mandates, passports and restrictions may cause more harm than good”1 gives an excellent overview of how the COVID-19 vaccine policies were implemented from the perspective of public health academics who were deeply troubled by the approach taken. All quotes are from this article. The authors of the article were Kevin Bardosh, Alex de Figueiredo, Rachel Gur-Arie, Euzebiusz Jamrozik, James Doidge, Trudo Lemmens, Salmaan Keshavjee, Janice E Graham, and Stefan Baral. These authors are from universities in the United Kingdom, United States, and Canada, including some well-known institutions such as the London School of Hygiene and Tropical Medicine, Harvard Medical School, Johns Hopkins School of Public Health, and the University of Oxford. These institutions are the academic heart of public health in the Anglosphere, making this article difficult to dismiss as the product of fringe ‘anti-vaxx’ scholars. According to the funding and disclosure of interest sections in the article, some authors have been funded by the pharmaceutical industry or groups such as the Wellcome Trust and the Vaccine Confidence Project, while another author of the article had received a grant to research “Advancing Anti-Corruption, Transparency and Accountability Mechanisms to Tackle Corruption in the Pharmaceutical System” . Some authors were even involved in local campaigns to administer the COVID-19 “vaccines”. Given the authors and their backgrounds this article could be an effective tool for informing people across your divided society. The authors express their reason for writing this article as…
“Evaluating the potential societal harms of COVID-19 pandemic restrictions is essential to ensuring that public health and pandemic policy is effective, proportionate, equitable and legally justified.The complexity of public responses to these new vaccine policies, implemented within the unique sociopolitical context of the pandemic, demands assessment.”
The article’s authors express deep concern that the COVID-19 policies and the rhetoric of the authorities have caused lasting damage to public trust and confidence in public health campaigns.
“Our analysis strongly suggests that mandatory COVID- 19 vaccine policies have had damaging effects on public trust, vaccine confidence, political polarization, human rights, inequities and social wellbeing. We question the effectiveness and consequences of coercive vaccination policy in pandemic response and urge the public health community and policymakers to return to non-discriminatory, trust-based public health approaches.”
The article features a table of quotes from politicians using some extreme rhetoric against those who did not take the COVID-19-related injections. The authors have done good work gathering and summarising many of these aspects of the COVID-19 crisis, making this article a suitable introduction for those that did not venture much beyond the (often government and pharma funded) corporate media narratives during the COVID-19 crisis. The authors provide insights into what COVID-19 policies and rhetoric has done to societies, with this quote neatly describing the situation where the “unvaccinated” were considered culturally unsafe, not ‘unsafe’ based on solid scientific or medical risk assessments.
“Echo chambers have skewed
the reasonableness of risk assessment of some pro-mandate
individuals, who now fear that unvaccinated people are
‘unsafe’—physically but also culturally—despite the
scientific evidence. Political polarisation and radicalisation—both
anti- mandate and pro-mandate—will increase if punitive vaccine
policies continue.”
There are many well-written parts of the Bardosh et al. article, so it is difficult to avoid quoting the entire article. If you have not already, I highly recommend reading the whole article and archiving a copy. Here is a selection of quotes from the article relevant to various aspects of the COVID-19 saga.
On vaccine effectiveness at protecting others…
“Since early reports of post-vaccination transmission in mid-2021, it has become clear that vaccinated and unvaccinated individuals, once infected, transmit to others at similar rates.”
On media and political portrayals of opposition to the mandates and vaccine passes…
“Mandate and passport policies have provoked community and political resistance including energetic mass street protests. Much of the media and civil debates in liberal democracies have framed this as a consequence of ‘anti-science’ and ‘right-wing’ forces, repeating simplistic narratives about complex public perceptions and responses.”
On the actual cause of most opposition to COVID-19 policies…
“...population-wide adult mandates, passports, and segregated restrictions are unprecedented and have never before been implemented on this scale. These vaccine policies have largely been framed as offering ‘benefits’ (freedoms) for those with a full COVID-19 vaccination series, but a sizeable proportion of people view conditioning access to health, work, travel and social activities on COVID-19 vaccination status as inherently punitive, discriminatory and coercive. There are also worrying signs that current vaccine policies, rather than being science-based, are being driven by sociopolitical attitudes that reinforce segregation, stigmatisation and polarisation, further eroding the social contract in many countries.”
Violations of medical ethics and lack of informed consent...
“Current vaccine policies may erode core principles of public health ethics. As some of those supporting mandates recognise, and contrary to the media portrayal that ‘the unvaccinated are entirely free to decline’, many COVID-19 vaccine policies clearly limit choice and the normal operation of informed consent. This has placed medical professionals in an awkward position, blurring the lines between voluntary and involuntary vaccination. It is clear that many who are vaccinated did so because of the serious consequences of refusal, such as loss of employment and livelihood or access to social events and travel. We should pause to consider the extent to which current policies, and how they are implemented in clinical settings, sets a precedent for the erosion of informed consent into the future and impact the attitude of the medical profession to those who are reticent to undergo a specific medical procedure.”
Secrecy and rapid deployment of novel technology…
“Governments have refused to disclose the details of contracts with manufacturers, including for additional doses or ‘next-generation’ vaccines. Vaccines are typically not approved until 2 years of follow-up data are gathered, but given the urgency of the COVID-19 pandemic and international harmonisation of new agile regulations, the novel mRNA COVID-19 vaccines were placed into emergency use in Europe and North America in late 2020. There is concern that, in the fog of crisis, vaccine policy is being driven by vaccine manufacturers rather than independent scientific and regulatory review.”
Concerns about regulatory capture and censorship...
“In September 2021, an FDA advisory committee voted 16–2 against boosting healthy young adults in the USA but was over-ridden by the White House and CDC, leading to the resignation of two top FDA vaccine experts. Such efforts have only increased the perception that regulatory agencies are ‘captured’ by industry and would conveniently ignore a higher than usual adverse effect ratio to control the pandemic. Concerns have been raised about the lack of due process in vaccine injury compensation claims for the COVID-19 vaccines, which are to be borne by governments and not pharmaceutical companies. A video of a US congressional roundtable on COVID-19 vaccine adverse events with medically confirmed vaccine-injured individuals from the original clinical trials, a US military clinician and Peter Doshi (senior editor of the BMJ) was permanently removed by YouTube. These practices do not reinforce confidence that authorities are being transparent or applying optimal standards for regulatory safety, efficacy and quality for these novel vaccines—standards which should arguably be more stringent given the legal precedent for mandates and passports.”
Violation of norms around proportionality and damage to public trust in institutions…
“Mandates imposing unconditional vaccination, those ignoring the role of prior infection, and those ignoring a shifting risk/benefit balance depending on specific populations, should be considered suspect from a legal proportionality perspective.
When members of the public perceive mandates to be ethically and legally problematic and in violation of established norms of informed consent and proportionality, this will erode trust in public health and scientific institutions and even courts that endorsed or actively promoted such policies. This presents a challenging paradox for experts and authorities: will pro-mandate scientists and organisations come to acknowledge that mandates and passports were disproportionate policy responses? One key aspect of building trust in science and public health involves the open acknowledgement of when experts are wrong and when policies were misguided; however, it appears that many officials have doubled down in their narratives.”
Setting of precedents and concern for the future...
“COVID-19 will not be the last public health emergency and it remains critical that we understand the reasons these approaches were adopted and provide robust evidence to improve future policymaking in times of health emergencies. If not, the proclivity for mandates, passports, restrictions, fines and punishments is likely to become an accepted policy response for the next pandemic irrespective of whether such policies are truly effective, ethical and socially harmful.”
I agree with Peter Doshi2, in criticising the article for the use of the word “unintended” in the article’s title. Given the quotes from senior politicians the authors included in Table 2, it is clear that many of the negative consequences (such as inducing inaccurate fear, polarisation, stigmatisation, discrimination, societal division, and scapegoating) were obviously intentional . As detailed in previous writings3, I think that “unintended consequences” is a phrase we need to challenge whenever it is used.
I am also critical of some of the public health attitudes on display in the last three paragraphs of the article.
“If current policies are to continue, public health-associated bureaucracies and society will have to increase coercion to address current and future resistance and, in the process, come to leverage strategies more consistent with policing than public health.”
This passage indicates that due to the increased resistance and trust destruction, caused by the COVID-19 policies, the authorities will need to act more authoritarian and increase coercion to achieve their policy objectives in the future. This could be a chilling warning, though what is more concerning to me is the use of the phrasing “...will have to increase coercion…” which is implying that the use of such measures are necessary and inevitable. Increasing coercion is always a choice on behalf of the authorities. That quote and the following quote also implies that there is a default assumption among public health academics that policy objectives are inherently good. The authors are mainly arguing that more ethical and non-coercive means are a better way to achieve those policy objectives. The authorities and experts imposing their will upon the population appears to be seen as acceptable, with disagreement among public health academics being more about methods and the acceptability regarding the consequences of those methods.
“There are other options to address the pandemic and it is not too late to return to non-coercive public health measures, including pro-social language and community leadership for vaccination, especially to protect high-risk groups. Future investments in public health capacity, especially health providers who build relationships of trust working in communities, will be essential to engage in positive reforms.”
The authors unfortunately enter the territory of identity politics for a portion of the article as they state...
“It is highly likely that mandates and passports have been implemented in ways that discriminate against disadvantaged groups including immigrants, the homeless, isolated elderly people, those with mental illness, specific cultural and religious groups, those in precarious living circumstances, and people with certain political views and values.”
It is true that certain groups in society had a worse time, on average, during the COVID-19 crisis when compared to other groups. However, I would argue that focusing on identity politics is divisive and distracts from the larger issues. COVID-19 policies were not wrong only because they harmed marginalised groups. COVID-19 policies were wrong because they violated the rights of most of society and inflicted damage upon most of society. The policies were also wrong because they were built on lies, deception, faulty reasoning, and dubious evidence. This should be the concern of all.
Another criticism is that parts of the article appear to have been toned-down during peer-review. An early preprint version of article featured a table titled “Incomplete or misleading information by health authorities and the media”4 which was removed before publication. Such a table would be particularly controversial given the widespread use of the terms “disinformation” and “misinformation” by those same health authorities and media organisations. The removal of this table hints at the political nature of the postmodern peer-review process, especially around controversial topics. Given the widespread censorship and suppression of criticism during the COVID-19 crisis, I am surprised that this article made it through the peer-review and editorial process at BMJ Global Health. The authors may have had to make difficult choices to remove some of the more controversial content or risk not being able to get the article published in a well-known and ‘respectable’ medical journal.
Despite these criticisms, “The unintended consequences of COVID-19 vaccine policy: why mandates, passports and restrictions may cause more harm than good”, is highly recommended as an overview of these COVID-19 policies and their consequences on societies. It should function as a suitable gateway article for those still ‘within the system’ who were unaware of how much damage was done with those policies.
There are other aspects of the Bardosh et al. 2022 article which I will cover and expand upon in future writings.
Tara Hanley’s substack features an interview with one of the article’s authors, Kevin Bardosh.
https://tarahenley.substack.com/p/we-didnt-see-enough-honest-critical
1 Bardosh
K, de Figueiredo A, Gur-Arie R, et al, The unintended
consequences of COVID-19 vaccine policy: why mandates, passports and
restrictions may cause more harm than good, 2022, BMJ
Global Health, https://gh.bmj.com/content/7/5/e008684
2 The Unintended Consequences of COVID-19 Vaccine Mandates: Why They May Cause More Harm than Good, UtorontoLaw, 2022, https://www.youtube.com/watch?v=QjUskKTq_Qc
3 https://dismantlingdystopia.substack.com/p/replacement-language-dysfunctional
4 https://odysee.com/@dismantlingdystopia:3/Bardosh-preprint-SSRN-id4022798-27.04.2022:0
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By Dismantling Dystopia