Canadian Prime Minister Justin Trudeau has invoked emergency rule in response to “Freedom Convoy” protests. Even as Trudeau unapologetically paints anyone and everyone who supports protestors’ as swastika-brandishing Nazi sympathizers, police have begun to arrest truckers, who have occupied Capitol-area streets since mid January in a bid to end to COVID-19 restrictions. Elsewhere in Canada and across much of the United States, political leaders have begun to acknowledge that COVID-19’s well-established propensity to mutate faster than vaccines can keep pace with calls for a smarter strategy.

Acknowledging that COVID-19 is here to stay (endemic) does not mean wholesale surrender. It will remain necessary to protect the vulnerable, in part by adopting CDC’s recently updated mask recommendations. Endemic COVID-19 also pushes to the forefront the necessity for early home treatment options to prevent infections from becoming severe enough to require hospitalization. Endemic COVID-19 also signifies that government reliance upon expanded emergency authority is an unsustainable response to a virus that Moderna’s CEO described to investors a year ago as something we must learn to live with “forever”.

Although COVID-19 waves may continue to break over us, rule-by-executive fiat cannot — providing we do not want our respective representational democracies to become the ultimate pandemic casualty.

Promising research is underway on vaccination via a different route — inhalation — which may offer a significant improvement over intramuscular COVID-19 jabs because the immune response will instead begin in the upper respiratory tract where infections such as cold, flu and coronaviruses get their start. Unlike current vaccines, which favor an immune system response once the virus has established itself well enough to impact the bloodstream, inhaled vaccines may one day do a superior job slowing the spread.

At present, however, vaccine mandates/passports make less sense with each passing day. For one, 2020 COVID-19 vaccines are outdated. A “notably lower” capacity for vaccine-induced antibodies to neutralize COVID-19 infection was first observed last year upon the emergence of Delta variant. While vaccines continue to reduce risk of hospitalization — although that assumption has been challenged, too — faced with Omicron vaccines are no longer highly effective at preventing infection. This matters because without the capacity to dramatically reduce infection and thus break transmission chains, mandates are of limited public health utility. Even more salient to the mandate debate, however, is the matter of “herd immunity“.

Herd immunity is the point at which a sufficient portion of a population — through naturally-acquired infection, vaccination or a combination of the two — are no longer vulnerable to illness, thus choking off a virus’ ability to spread. A high-functioning vaccine will perform well enough that the risks of interacting with unvaccinated individuals are of little consequence to non-immunocompromised people for much the same reason the vaccinated do not lose sleep for fear of contracting measles, mumps or polio.

Unfortunately, COVID-19 vaccines do not yet meet this high bar in spite of reports that attempt to imply otherwise.

We have little choice now but to face reality: Mass vaccination, even under idealized circumstances in which COVID-19 vaccines do not provoke hesitancy and are not also perilously “leaky”, has always been an uphill battle in a world ~7B people strong. Reduced COVID-19 transmission demands not only better vaccines but vastly improved access throughout the Third World. The latter has not happened and it is unlikely to happen within our lifetimes. Perhaps this is why Dr. Larry Brilliant, who is credited with helping eradicate smallpox, disputes the notion that mass vaccination was ever the best approach. In news that went largely unnoticed by U.S. media, Dr. Brilliant urged a COVID-19 vaccine “rethink” to make smarter use of the jabs.

There are additional reasons why it no longer makes sense to circle the mandate bandwagon. COVID-19 vaccines are first-of-their-kinds for a coronavirus. Even if they followed on the heels of a successful coronavirus vaccine predecessor, which they do not, mRNA/DNA vaccines for widespread use in any infectious disease is also unprecedented. No one knew, as Dr. Anthony Fauci told WebMD in March 2021, if these novel vaccines would stop the spread of COVID-19. When cracks in the mass vaccine strategy began to emerge last year with the onslaught of Delta variant, a frightened public was assured that breakthrough infection was rare but nonetheless to be expected — the only thing that really counts is/was the ability of these vaccines to prevent hospitalization and death. And yet this was never entirely true. Mass vaccination was never a public health objective solely to reduce symptom severity.

Herd immunity is the pot of gold at the end of the vaccine rainbow. If our immune systems can be trained to “remember” how to fight this virus in such a way that the risk of variants, too, sharply declines we will be home free.

Some viruses result in lifelong immunity following illness. Similarly, childhood vaccines do not require boosters throughout adulthood. Unfortunately, some types of illnesses — such as malaria and HIV — do not result in lasting immunity. Vaccinating successfully against viruses that do not yield durable immunity following infection is difficult, if not also risky, for similar reasons. Does SARS-CoV-2 fit this difficult-to-vaccinate-against category? For now, the answer would appear to be yes. This is not merely because COVID-19 mutates too rapidly (although it has). And it is not because vaccination rates remain too low (highly vaccinated countries such as Israel and the UK have been slammed by successive COVID-19 waves to no avail). The sticking point, rather, is that peak protection wanes within four months, an oddly-timed interval that creates challenges for timing boosters. Collectively, this explains why scientists concluded that herd immunity via vaccination is not in the cards.

The dominant political-media narrative that we can vaccinate our way out of this pandemic is not only misleading — it has been understood as a long shot by the scientific community for nearly a year.

Best-case scenario COVID-19 vaccines will continue to reduce the risk of hospitalization and death. (Although there is no guarantee of that, either.) Still the issue remains: If vaccines fail to further the herd immunity gold standard, then the decision to vaccinate or not to vaccinate in 2022 must be like any other pre-pandemic medical treatment: a personal choice between patient and physician.

Many things about the future remain uncertain. But one thing is clear: We must not allow COVID-19 to permanently derail our economies, undermine Western democracies through unending emergency rule and upend our personal lives. Sooner or later everyone will come around — dare, I say, even Justin Trudeau.

The big question: How much more damage will we inflict upon one another in the name of this virus before we find ourselves on the same page?

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