Thursday, September 09, 2021

On Politics: Vaccine mandates are a U.S. tradition. So is the backlash.

The roots of American vaccine mandates predate both the U.S. and vaccines.
A group of people observing a doctor as he vaccinates a man in an 1870s  illustration called "Vaccinating the Poor," by Solomon Eytinge Jr.via National Library of Medicine

As disease and death reigned around them, some Americans declared that they would never get vaccinated and raged at government efforts to compel them. Anti-vaccination groups spread propaganda about terrible side effects and corrupt doctors. State officials tried to ban mandates, and people made fake vaccination certificates to evade inoculation rules already in place.

The years were 1898 to 1903, and the disease was smallpox. News articles and health board reports describe crowds of parents marching to schoolhouses to demand that their unvaccinated children be allowed in, said Michael Willrich, a professor of history at Brandeis University, with some even burning their own arms with nitric acid to mimic the characteristic scar left by the smallpox vaccine.

"People went to some pretty extraordinary lengths not to comply," said Professor Willrich, who wrote "Pox: An American History," a book about the civil liberties battles prompted by the epidemic.

If it all sounds familiar, well, there is nothing new under the sun: not years that feel like centuries, not the wailing and gnashing of teeth over masks, and not vaccine mandates either.

As the coronavirus overwhelms hospitals across the South and more than 650,000 Americans — an increasing number of them children — lie dead, the same pattern is emerging. On Thursday, President Biden announced that he would move to require most federal workers and contractors to be vaccinated and, more sweepingly, that all employers with 100 or more employees would have to mandate vaccines or weekly testing. Colleges, businesses and local governments have enacted mandates at a steady pace, and conservative anger has built accordingly.

On Monday, Representative Jim Jordan, Republican of Ohio, tweeted that vaccine mandates were "un-American." In reality, they are a time-honored American tradition.

But to be fair, so is public fury over them.

"We're really seeing a lot of echoes of the smallpox era," said Elena Conis, an associate professor and historian of medicine at the University of California, Berkeley. "Mandates elicit resistance. They always have."

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The roots of U.S. vaccine mandates predate both the U.S. and vaccines. The colonies sought to prevent disease outbreaks by quarantining ships from Europe and sometimes, in the case of smallpox, requiring inoculations: a crude and much riskier predecessor to vaccinations in which doctors rubbed live smallpox virus into broken skin to induce a relatively mild infection that would guard against severe infection later. They were a source of enormous fear and anger.

In January 1777, George Washington mandated inoculations for the soldiers under his command in the Continental Army, writing that if smallpox were to break out, "we should have more to dread from it, than from the Sword of the Enemy." Notably, it was in large part the soldiers' desires that overcame his resistance to a mandate.

"They were the ones calling for it," said Andrew Wehrman, an associate professor of history at Central Michigan University who studies the politics of medicine in the colonial and revolutionary eras. "There's no record that I have seen — and I've looked — of any soldier turning it down, protesting it."

Buoyed by the success of the mandate, Washington wrote to his brother in June 1777 that he was upset by a Virginia law restricting inoculations. "I would rather move for a Law to compell the Masters of Families to inoculate every Child born within a certain limitted time under severe Penalties," he wrote.

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Over the next century, many local governments did exactly that. Professor Wehrman this week tweeted an example of what, in an interview, he said was a "ubiquitous" phenomenon: The health board in Urbana, Ohio, Jordan's hometown, enacted a requirement in 1867 that in any future epidemic, "the heads of families must see that all the members of their families have been vaccinated."

But by the end of the 1800s, opposition was louder and more widespread. Some states, particularly in the West, introduced laws prohibiting vaccine mandates. Others narrowly passed mandates after intense debate.

The reasons for resistance were myriad: Some Americans opposed mandates on the grounds of personal liberty; some because they believed lawmakers were in cahoots with vaccine makers; and some because of safety concerns that were, to be fair, more grounded in reality than the modern equivalent. Vaccines then were not regulated the way they are now, and there were documented cases of doses contaminated with tetanus.

The government's response resembled what, today, are wild conspiracy theories. Contrary to the assertions of some on the far right, the Biden administration has never suggested going door to door to force people to take coronavirus vaccines. But in the 1890s and 1900s, that actually happened: Squads of men would enter people's homes in the middle of the night, breaking down doors if necessary, to inject people with smallpox vaccines.

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Legally speaking, the Supreme Court resolved the issue of mandatory vaccinations in 1905, ruling 7-2 in Jacobson v. Massachusetts that they were constitutional.

The Constitution "does not import an absolute right in each person to be, at all times and in all circumstances, wholly freed from restraint," Justice John Marshall Harlan, known for defending civil liberties, wrote. "Real liberty for all could not exist under the operation of a principle which recognizes the right of each individual person to use his own, whether in respect of his person or his property, regardless of the injury that may be done to others."

In the court of public opinion, there was no such resolution.

The polio vaccine was less controversial, mainly because it wasn't initially mandated and because it had been funded by a widely respected nonprofit: the National Foundation for Infantile Paralysis, now called the March of Dimes. This reduced opposition based on mistrust of pharmaceutical companies, and most parents willingly got their children vaccinated. The measles vaccine, too, was not particularly controversial because mandates were not initially enforced.

"Nobody was enforcing vaccination, and so it simply didn't elicit that mistrust," Professor Conis said. In the smallpox era, by contrast, "skeptical people said, 'Well, why are we doing this? It just benefits the companies making the vaccine and the doctors administering the vaccine, and why should we trust any of them?'"

But the fear and anger came roaring back with the introduction of childhood vaccination mandates in the 1970s. By 1980, all 50 states required schoolchildren to be vaccinated against an array of diseases.

None of it is new, but one thing distinguishes today's anti-vaccination protesters from those of the past. The opposition was always political. It wasn't always partisan.

"There are plenty of echoes today: There are liberty claims, there are strong sentiments about parental rights, there are concerns about the science, there are concerns about the profit involved," Professor Willrich said. "But this party divide in terms of who is most likely to be hesitant or refuse a vaccine mandate is really, I think, something of our own 21st-century moment."

Callaghan O'Hare for The New York Times

What Texas' abortion law says

Last week, I wrote about the Supreme Court's decision to let Texas ban almost all abortions. This week, I read the full law, Senate Bill 8, to identify provisions you might not be aware of.

Here are a few of the things I found:

  • The burden of proof is reversed. Normally, the person making an allegation — the prosecution in a criminal trial or the plaintiff in a civil trial — must prove it is true. The defendant doesn't have to prove it is false: innocent until proven guilty. Not so under S.B. 8, which says those accused of performing or abetting abortions have "the burden of proving an affirmative defense."
  • The law's exception for medical emergencies is vague. Some health situations aren't clear-cut, like a cancer patient who can't receive chemotherapy while pregnant and whose disease could become untreatable within a few months. Doctors must decide whether their patient qualifies, knowing they could be sued by anyone who disagrees.
  • People can be sued for intent even if they never act. The law doesn't specify what counts as intent, leaving open the possibility that a person could be sued for, say, researching the locations of abortion clinics or viewing an advocacy group's donation page.
  • There are no geographic limitations. Residents of other states can sue someone who helps a Texan get an abortion, and they can also be sued for helping a Texan get an abortion.
  • The law puts financial burdens on defendants. A defendant who loses will have to reimburse the plaintiff's legal fees. But courts are forbidden to order reimbursement of the defendant's legal fees, meaning a person who is falsely accused will still be on the hook for the cost of their defense.
NEW YORK TIMES EVENTS

Kara Swisher Live: A Times virtual event

After a summer of budget negotiations, a sweeping infrastructure bill and a surge in coronavirus cases, what will fall bring? What stories will matter the most in politics, media and tech? Where is power changing, and how do we make sense of it?

In a virtual event on Sept. 14, Kara Swisher, the host of the "Sway" podcast and the author of a new subscriber-only newsletter, will discuss the latest political news with the Times reporter Maggie Haberman as the Senate returns.

Swisher will also interview Representative Cori Bush, the first-term Democratic congresswoman from St. Louis, whose summer sit-in on the steps of the Capitol helped lead to a new federal eviction moratorium before the Supreme Court rejected it.

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Tuesday, September 07, 2021

In Her Words: ‘It’s trial and error’

Setting boundaries between work and life
Virginia Gabrielli

By Raksha Vasudevan

"There's nothing wrong with loving your job. But it should not be at the cost of developing other parts of our life."

— Ellen Ernst Kossek, a professor at Purdue University, studying work-life boundaries

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When Janie Sayavong's office reopened at full capacity in June, she was clear on what she would do to feel safe: wear a mask "the entire time," she said.

"I am comfortable with my own ability to say, 'Hey, I really prefer you wear a mask,'" said Ms. Sayavong, who works in human resources at a Denver-based oil and gas company. "And if others say they're vaccinated, that's great. But I don't know if we can transmit so I'm going to ask you to wear a mask, and I'm very fine with that potential backlash." So far, her colleagues have been supportive.

As Covid surges across the United States, employers are once more struggling to balance the safety of their workers with cultures built around the physical workplace. This has resulted in a shifting patchwork of fully in-person, fully remote and hybrid models.

But just as women bore the professional and personal brunt of the first wave of office and school closures, they are likely to do so again, on top of what is shaping up to be another uncertain school year. However, after nearly two years of the coronavirus pandemic, one thing is clear: Women are setting their own physical, emotional and cultural boundaries between work and life.

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Perhaps the most striking example of this comes from South Carolina, where the ACLU and Deborah Mihal, the director of disability services at a public university, filed a discrimination lawsuit in April against the governor for mandating that all nonessential state employees return to the office full time with just a few weeks' notice. Ms. Mihal, the lead plaintiff, did not have child care for her 9-year-old son, and she worried that whatever option she could find on short notice would increase his risk of exposure to the virus.

"The governor's order forces me to choose between protecting the safety of my family and a paycheck," she said in an ACLU statement. The suit argues that the executive order discriminates against women, who disproportionately bear caregiving responsibilities, as well as people with disabilities or those who are immunocompromised.

Since then, Ms. Mihal's employer, the College of Charleston, has granted her an accommodation to continue working from home and the ACLU has had to dismiss its original lawsuit. However, fearing that other state agencies might not grant similar accommodations to eligible employees, the ACLU has filed a complaint with the Equal Employment Opportunity Commission. The complaint argues that the governor's order still disproportionately harms women, people with disabilities, caregivers and Black people. It asks the EEOC to carry out a thorough investigation of how the order has been implemented.

Ms. Sayavong, who is recovering from cancer, falls into the category of high-risk women with care-taking responsibilities: She has aging parents as well as young children. But she, like many others whose employers are still following a hybrid model, is already setting new rules for how and when she will work.

"I still have no intention of going back to, like Monday through Friday, 8 to 5. I think that ship has sailed for me," she said. She has no desire to structure her workday around drop-off and pickup times for her children, nor does she miss the stress of running late to the office and having to pull over while driving to take a conference call.

Kristen Surya, a New York-based lawyer in the music industry, is also determined to protect her energy when she returns to the office. As an introvert, she finds the highly social atmosphere of a record label draining at times.

"People love coming and talking to you," she said. "It's very social in a way that, like, makes me die inside," she joked. Her office's initial reopening date of early September has now been postponed indefinitely because of the Delta variant. But Ms. Surya is already thinking about the boundaries she will need to set when the office does reopen. "If I feel like I want to leave at some point in the day, I'm just going to have to let myself do that," she said.

Ellen Ernst Kossek, a professor at Purdue University who is studying work-life boundaries and career equality, says that while employers still hold a lot of power, workers also need to create the post-pandemic workplace they want.

She advises workers to have conversations with their managers about the flexibility they really need and how that will affect their performance. But she also warns: Offering more remote work options and flexible hours in a culture that still expects employees to overwork may actually do more harm than good, contributing to a greater erosion of boundaries between work and personal life. The pandemic has confirmed this: Instead of using time spent on commutes, breaks and socializing at work to rest, most people simply worked more.

A recent survey also found that 39 percent of women fear that taking advantage of flexible work arrangements will negatively affect their career growth — with Black and Latinx women the most concerned. Other research points to some reasons, namely the fear that not having a physical presence will result in being passed over for promotions, and decrease women's influence and informal interactions with decision makers.

Suzi Kang, a quality assurance engineer based in Lincoln, Neb., was given the option to telework at the beginning of the pandemic. But she was very aware of the trade-offs. On one hand, she worried that remote work would make it harder for her to build relationships, especially as someone who started her job only three months before Covid. On the other hand, she often felt like an outsider — as someone who identifies as Asian in an industry dominated by white men. In the end, she decided the trade-off was worth it. "It does help to not have to put on a different persona for work," she said.

But some women are using the blurring of personal and professional life to share more about their identity and life outside of work. In her research, Dr. Kossek has seen women be more frank with their employers about their family's needs, or intentionally letting colleagues see markers of their political beliefs, like a picture of Malcolm X or LGBTQ posters, on video calls.

"Some of the women, particularly those that felt a little more job secure, just revealed and said, 'I don't care. For eight years I'm tired of hiding. We've got to change,'" she said.

This could also lead to more workplace bonds built out of shared identity. A number of women reported coming together with colleagues who shared race, gender or other identity markers to support one another over a difficult year, and to set boundaries with employers on what they need to feel safe and productive at work.

"After the Atlanta shooting, that for me was a real heightened time of concern and worry and feeling invisibilized," said Nimol Hen, who works in academic advising at a Colorado university and identifies as Cambodian American. But the tragedy also mobilized the BIPOC and AAPI community at work, because they were expected to just sort of soldier on like nothing had happened, she said.

Since then, BIPOC staff and faculty members at her institution have formed an affinity group. So far, the group has advocated with university leadership to officially condemn the anti-Asian violence in Atlanta and to take the physical safety concerns of AAPI into account in making back-to-campus plans.

Dr. Kossek said asking for changes at the workplace as a group is a good strategy. "It's easier to say no to one person," she said. But if a team or even two colleagues ask for something — a more flexible schedule or not to be expected to answer emails after a certain hour — employers are likely to consider the request more seriously.

She also warns that some misunderstandings as teams try new modes of working, are inevitable. "It's trial and error," she said. But she believes the attention is long overdue. "We have been acculturated to put work first. And there's nothing wrong with loving your job. It's good for your health, but it should not be at the cost of developing other parts of our life."

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What else is happening

Here are three articles from The Times you may have missed.

Annalena BaerbockLaetitia Vancon for The New York Times
  • "It's about our future." Annalena Baerbock, the Green Party candidate for chancellor wants to change Germany. [Read the story]
  • "Today is a historic day for the rights of all Mexican women." Mexico's Supreme Court votes to decriminalize abortion. The ruling sets a precedent for the legalization of abortion nationwide. [Read the story]
  • "It was time." Camille Miceli once inspired Marc Jacobs, John Galliano and other designers. Now she's Pucci's first female designer. [Read the story]

In Her Words is edited by Francesca Donner. Our art director is Catherine Gilmore-Barnes, and our photo editor is Maura Foley.

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