In recent weeks, President Biden has largely abandoned social programs, like expanded unemployment insurance and the child tax credit, aimed at helping people weather the pandemic, and has vowed to avoid public safety measures, like temporary stay-at-home directives during Covid surges, that defined earlier periods of the crisis. Instead, he is turning towards vaccines as his key strategy for fighting the virus, alongside urging Americans to wear a mask and pledging to unroll test reimbursement programs (while telling people to use Google to figure out where to take a test). This approach appears rooted in a belief that the spread of the Omicron variant is inevitable, a turn evidenced by the Centers for Disease Control and Prevention (CDC) declining to recommend higher quality masks, like N95s, and cutting its 10-day isolation guidance in half as Omicron swept across the United States in early January.
Vaccines are certainly a powerful tool against the pandemic, and should be encouraged by political leaders and public health officials. But the president’s turn to a vaccines-only approach has come hand-in-hand with an ugly, and even vindictive, tone of scolding the unvaccinated. This approach is especially egregious in light of the fact that President Biden bears tremendous responsibility for profound global inequities in vaccine access. Only 9.5% of people in poor countries have received at least one dose of a vaccine. In Nigeria, the largest country in Africa, just 2.26% of people are fully vaccinated. How do these people, deprived of vaccines thanks to lack of donations and patent sharing, factor into President Biden’s newfound strategy of “blame the unvaccinated”? Do they even register at all?
People in the Global South should not be left to die due to a lack of vaccine access. And this stunning American chauvinism puts everyone at risk: As long as the virus spreads anywhere, it will give rise to new and more dangerous variants that will inevitably show up in the United States. By embracing a vaccine strategy in which vast swaths of the globe are left with insufficient access, Biden is prolonging the pandemic and ensuring more deaths, and doing so with a sanctimonious wag of the finger.
One of the most alarming comments came from Jeffrey Zients, White House coronavirus response coordinator, at a December 17 press briefing, just as Omicron was beginning to surge in the United States. In remarks clearly aimed at scaring the unvaccinated into getting their shots, he said, “For the unvaccinated, you’re looking at a winter of severe illness and death for yourselves, your families, and the hospitals you may soon overwhelm.”
This was not a one-off. The Biden administration has embraced a messaging strategy replete with such themes. “This is a pandemic of the unvaccinated. Not the vaccinated, the unvaccinated. That’s the problem,” President Biden told Ohio’s WHIO-TV 7 station on December 14. “Everybody talks about freedom, about not to have a shot or have a test. Well guess what? How about patriotism? How about you make sure you’re vaccinated, so you do not spread the disease to anyone else.”
There is a conversation to be had about the best strategies for convincing the vaccine-reluctant in the United States to get the jab. As Melody Schreiber argued for The New Republic in August, “shaming and blaming individuals, and assuming they have made a selfish, considered decision not to get vaccinated, overlooks the largely hidden inequalities that still serve as barriers to vaccination. Unvaccinated people are more likely to be lower-income, uninsured, from marginalized and neglected communities, and have lower levels of education. All of these factors contribute to another, less-noted phenomenon: information inequality.”
If we merely frame vaccine hesitancy as a moral failing, we will not address these institutional barriers, which include predatory media and political figures who market in false information about vaccines, and the fact that people without access to regular healthcare do not have a trusted medical professional in their life to provide information and resources, or to preserve their confidence in the medical system. And what of those who are unable to take off of work to deal with the side effects of the vaccine? As The Lancet noted in August, CDC director Dr. Rochelle Walensky’s remarks that “your health is in your hands” undermined “the idea that fighting COVID is a ‘public’ health responsibility that requires the support of institutions and communities.”
And as long as we’re only talking about individuals, we are not talking about the failures of the current administration responsible for enacting the broad policies that are making the pandemic worse, from the lack of meaningful hazard pay to failure to decarcerate people trapped in Covid hotbeds, as Abdullah Shihipar recently argued in Teen Vogue. While it may seem reasonable to respond with anger toward those who are declining to get the vaccine, when vaccines are such an important component of countering the deadly effects of the pandemic, Biden has an incredible incentive to frame this as an individual problem, rather than reflect soberly on the shortcomings of his own administration.
But the president’s remarks raise another critical question: If Biden identifies lack of vaccinations as the single biggest impediment to overcoming the pandemic, why isn’t he using the entirety of his political capital to vaccinate the world? Why doesn’t he examine why his own administration has failed to meaningfully change the fact that huge swaths of populations around the world cannot get a vaccine when they want one? Of course, the administration would never indict itself, but its “blame the unvaccinated” approach is an important occasion for the rest of us to ask some basic questions about equity.
The United States has pledged 1.1 billion vaccine donations globally, a number significantly higher than pledges by other wealthy nations. But according to data from Duke Global Health Innovation Center, just 32% of those pledged donations have actually shipped. This poor performance is in keeping with trends among other rich countries: A report released in October by People’s Vaccine Alliance, a public health coalition, found that rich nations were falling far short when it came to delivering on vaccine pledges. Meanwhile, the Biden administration has allowed Pfizer and Moderna to maintain monopoly control over the production of mRNA vaccines, which appear most effective against the Omicron variant, defying calls from activists to pursue government-controlled, publicly-owned models for increasing manufacturing.
In light of these shortcomings, people in the Global South simply do not see pledges as a reliable means of equitably distributing vaccines; promises are voluntary, and rely on the benevolence of nations that have already proven themselves willing to abandon the rest of the world to the virus. A separate program, COVAX, which was supposed to address vaccine inequity based on a pledges model, has been a dismal failure. The United States is 62.3% fully vaccinated, and is already well into its booster program, while only 10% of people in Africa are fully vaccinated. “Other countries go ahead and vaccinate zoo animals, people are going on second and third boosters. We’re still in the situation where we’re just over 7%,” Tian Johnson of the African Vaccine Delivery Alliance recently told Yahoo Finance.
U.S. Trade Representative Katherine Tai said in May that the Biden administration supports the temporary waiver of intellectual property rules for Covid-19 vaccines, giving hope to activists around the world who have been urging the World Trade Organization to suspend patents. But this rhetoric has not been matched by on-the-ground action. At the WTO, the Biden administration has been ambiguous about whether it supports the proposal put forward by South Africa and India in October 2020 to temporarily lift patent rules, in order to enable Global South countries to produce cheaper, generic versions of the vaccines. My reporting has shown that at closed-door meetings at the WTO, the Biden administration has been dragging its feet, a reality that, along with outright opposition from the European Union and United Kingdom, has so far prevented the proposal from passing.
It is a travesty that eight months have passed since the Biden administration said it supports a patent waiver, because there are signs that Global South countries could start producing mRNA vaccines, if Pfizer and Moderna would only show them how. In December, healthcare researchers identified 120 manufactures in Asia, Africa and Latin America that have the capacity to make mRNA vaccines, but are prevented from doing so by pharmaceutical monopolies. A separate New York Times investigation identified 10 facilities in India, Brazil, Thailand, South Africa, Argentina and Indonesia that would be strong candidates for making such vaccines. On January 10, India urged a virtual ministerial conference to convene with the hopes of moving the intellectual property waiver forward at the WTO. Biden could act now by throwing his unbridled support behind the proposal, a move that would be consequential in light of the considerable power the United States wields at the WTO.
It is important to note that the Biden administration’s “blame the unvaccinated” approach has implications far beyond these global inequities. Children under 5 years old in the United States are unable to get the vaccine: How do they factor into the Biden administration’s seeming acceptance that the spread of Omicron is inevitable? (Their risk of death and serious cases is lower, but not zero.) The same goes for those who are immunocompromised and therefore at considerable risk from infections, even if they do everything they are told regarding vaccines. How does the Biden administration account for their wellbeing?
The Biden administration’s implicit disregard for the disabled was made explicit on Friday, when the CDC’s Walensky was asked by a Good Morning America host, “I want to ask you about those encouraging headlines that we’re talking about this morning, this new study showing just how well vaccines are working to prevent severe illness. Given that, is it time to start rethinking how we’re living with this virus, that it’s potentially here to stay?”
She replied, “The overwhelming number of deaths, over 75%, occurred in people who had at least four comorbidities. So really, these are people who were unwell to begin with. And yes, really encouraging news in the context of Omicron. This means not only just to get your primary series but to get your booster series, and yes, we’re really encouraged by these results.”
This remark, in which Walensky implied that the lives of disabled or immunocompromised people are dispensable, was rightfully skewered. “Not only is this message from the head of the CDC abhorrent, it perpetuates widely and wrongly held perceptions that disabled people have a worse quality of life than nondisabled people and our lives are more expendable,” the Disability Rights Education and Defense Fund said on Twitter.
The Biden administration cannot scold or shame or dehumanize its way out of the pandemic. There is no shortcut to providing robust social programs to help people survive the pandemic, including meaningful vaccine manufacturing and distribution on a global scale, alongside the sharing of vaccine recipes so that other countries can make the vaccines themselves.
If the Biden administration’s strategy is to just let the virus spread, how will this affect people in Yemen or Iraq or Sudan who cannot get vaccines if they want to? The administration should start from the principle that no life is expendable, a principle that is correct in itself, and also acknowledges that all of our fates are connected. As the World Health Organization warns, “the virus that causes Covid-19, will continue to evolve as long as it continues to spread. The more that the virus spreads, the more pressure there is for the virus to change. So, the best way to prevent more variants from emerging is to stop the spread of the virus.” The cruelty of Biden’s “blame the unvaccinated” strategy will harm us all.