Promoting vaccination is an important goal in public health policy. However, Covid-19 vaccination coverage in the United States is still far below the public policy goal. Vaccination may be discouraged by the incentive to “free-ride.” Referred to herein as “free-riders” in vaccination, these individuals avoid the cost associated with vaccination while benefiting from other individuals’ vaccination.
Vaccination for infectious diseases produces herd immunity, providing indirect benefit to unvaccinated individuals. As the result of herd immunity, the risk of infection for an individual depends on other individuals’ vaccination status; risk of infection generally decreases as the vaccination coverage in a community increases regardless of an individual’s vaccination status.
The free rider problem can crop up when the resource is shared by all and free to all. Like air. If a community sets voluntary pollution standards that encourage all residents to cut back on carbon-based fuels, many will respond positively. But some will refuse to make any change in their habits. If enough follow the standards, the air quality will improve, and all the residents will benefit equally, even the free riders.
Free riders can be forced to contribute to the public good, which is essentially what school-entry immunization mandates do in the case of herd immunity against vaccine-preventable diseases.
People do things for their own selfish reasons, not your reasons. Herd immunity against vaccine-preventable childhood diseases is a public good — one that is created by self-interest but cannot be maintained by self-interest. It is also a “last mile” problem: Vaccine coverage is generally very good but reaching those few who resist is difficult. Indeed, it is the last mile of herd immunity that is the most fragile, where self-interest begins to create free-riding defectors rather than pro-social contributors.
The concern of the government for the health, peace, morality, and safety of its citizens. The preamble to the U.S. Constitution cites promotion of the general welfare as a primary reason for the creation of the Constitution.
What exactly is “the common good,” ability to discern and act on what’s in our common interest depends on believing that we, as Americans, all have something in common. “We the People.”
I would argue that if you are unwilling to make the sacrifice a simple shot or wear a thin mask for the common good “We the People” you are selfish free rider, politically manipulated, misinformed and unconstitutional.