NEW YORK – Philip J. Landrigan is a strong supporter of COVID-19 vaccine mandates.

As the director of the Boston College Global Public Health Program, it’s his medical perspective on how to keep hospitalizations and death rates down even if cases climb. It’s his theological perspective, too, as a teacher at a Jesuit university.

“I strongly believe that individual rights have to be balanced against a person’s responsibility to society,” Landrigan, a pediatrician, public health physician and epidemiologist told Crux. “You can put it in terms of the second great commandment to love your neighbor as yourself and I think people who choose not to get vaccinated place not only themselves at risk, but they place everybody around them at risk and so they’re not upholding their responsibility to society.”

COVID-19 vaccine mandates have been debated nationwide since they were first introduced. Landrigan, though, argues recent data shows their effectiveness. As of Jan. 4, the four states with the highest daily cases average are New York, Florida, California and Texas in that order. New York and California have some of the strictest COVID-19 vaccine mandates in the country. Florida and Texas, meanwhile, are unapologetically anti-mandate, and are facing far higher hospitalization rates through the present wave of the Omicron variant.

“Vaccines don’t protect everyone against upper respiratory illness, which sometimes can be nasty, but they do an incredibly effective job protecting people against hospitalization and death and so in states like New York and California, like Massachusetts where I am where we have strong mandates in place in many sectors of society, we have a lot of cases but the hospitalizations and death rates are not going up as rapidly as in places like Florida and Texas,” Landrigan said.
What follows is more from a conversation Crux had with Landrigan about the COVID-19 pandemic, the way forward, and specifically the Omicron variant. Landrigan’s roles before his time at Boston College included the Dean for Global Health at the Mount Sinai School of Medicine in New York City, and he also established the environmental epidemiology until at the U.S. Center for Disease Control that is now the National Center for Environmental Health.

Crux: How do you assess the COVID-19 Omicron variant at this point?

Landrigan: When each of the new coronavirus variations emerges there’s three things you have to look at. Number one, is it more contagious? Number two, does it make people sicker? Is it more likely to kill them? And number three, do the current vaccines protect against it?

Omicron has been around long enough now that we have reasonably good answers to each of the three questions. Number one, it absolutely is more contagious. It seems to spread more rapidly even than the Delta variant and so it’s infecting more and more people. Number two, it does not seem to make people any sicker. In fact, the illness may be a tad less severe.

And then number three, the vaccines do protect against serious outcomes. That said, the vaccines don’t do such a good job protecting people against upper respiratory infection, especially people who are four, or five, six months out from their last vaccine. They seem to be at pretty high risk of picking up respiratory infection from Omicron and then even though they don’t get terribly sick themselves they can spread it to other people.

The second big theme is that virtually all of the deaths, and all of the serious illnesses, and all of the hospitalizations, are occurring among people who have chosen not to get vaccinated. I can say that with absolute certainty. What that says to me is we have to continue to use every tool available to us to persuade people who haven’t gotten vaccinated to get vaccinated and to persuade people who’ve gotten one shot or two shots to get a booster.

Where do you expect the nation will be a few months from now?

I see two possible scenarios. One is that this Omicron variant burns through the population, infects a very high proportion of people who’ve escaped up until now, and we come close to herd immunity. That’s the optimistic scenario and I hope it plays out.

The other possibility has to do with the nature of this virus. This is an RNA virus, which means that it has an unstable genome, which is exactly why it’s already mutated several times in the past two years to give us the Delta strain and now the Omicron strain. If it mutates again all bets are off. We’d be back dealing with a new strain, and we’d have to answer the three questions that I posed at the beginning of our conversation.

What have you observed with children and the Omicron variant?

Certainly, kids get the Omicron. Fortunately, children seem to be much more resistant to serious illness than adults. And so far the pediatric hospitals are showing an increased number of cases but they’re not being overwhelmed and let’s hope it stays that way.

What about children receiving the vaccine? What do you say to hesitant parents?

I’d say the exact same thing I said about adults. It’s the same equation. These vaccines have been extensively tested, extensively tested. They’re safe. They do their job. They protect children against serious illness and death. And by protecting children they protect all of the people around them. People who choose not to allow their kids to get vaccinated are endangering their children but they’re also endangering everybody who comes into contact with their children.

Last spring you co-authored a publication, “COVID-19 and Health Disparities: Structural Evil Unmasked” that examined the disproportionate impact of COVID-19 on vulnerable populations, which is something Pope Francis and the U.S. Bishops have talked about. What does the U.S. need to do to help these vulnerable populations?

The quickest most cost-effective thing we can do within the United States is to really work very hard at the national level to get the vaccine out to the people on the margins. People in inner cities, migrant populations, people on the border, prisoners.

Use federal muscle where necessary to get shots into the arms of those vulnerable populations that haven’t yet gotten shots. There’s other things we can talk about like improving access to health care, but that’s not going to happen overnight. But getting vaccines into people’s arms can happen quite quickly if we put the muscle behind it.

How important is getting vaccines to lower and middle-income countries if the world wants to have a chance at getting through the COVID-19 pandemic?

I think the right way to answer that is to think about how the virus behaves. When there’s a large pool of people in some part of the world who are not vaccinated, and the virus gets into that population it spreads like wildfire. I’ve already mentioned that this is an unstable virus, which is prone to mutate and produce new strains.

The more it spreads, the more people are infected, the more the virus is replicating. It’s like a roulette wheel. If you spin the ball enough times you’re going to get another mutation. So the most effective way to keep this thing from mutating is to get shots into the arms of as many people around the world as we can.

What is the responsibility of the American Catholic Church going forward?

There’s a responsibility of church leaders to encourage their congregants, their parishioners, to get the vaccine and to counter the misinformation, which is so rampant out there. I know a lot of priests, a lot of pastors, even bishops have been reluctant to speak out on this because they don’t want to alienate people and that’s a valid concern, but good homilists who put the responsibility for getting vaccinated in terms of the second great commandment do a lot of good.

Follow John Lavenburg on Twitter: @johnlavenburg