DMEJ

   Duke Medical Ethics Journal   

The Politicization of Masks and Vaccines: Who Really Gets Hurt

By: Adetomi Oderinde

From the economy, to the job market, to our personal relationships, the effects of COVID-19 have been felt by virtually everyone. As of November 10, 2021, there have been 46,541,113 COVID-19 cases and 753,564 deaths from COVID-19 in America (Centers for Disease Control). With the rise of the pandemic in March of 2020 and lockdowns that immediately followed, top doctors and public health officials in America had to quickly address the dire situation we were in. The first stage of this plan included mask-wearing. Then, in December of 2020, the U.S. Food and Drug Administration (FDA) issued an Emergency Use Authorization for the first COVID-19 vaccines (U.S. Food and Drug Administration), and now, over 194,700,000 Americans are fully vaccinated (Centers for Disease Control). Though both of these methods have undoubtedly curbed the spread of COVID-19, neither has come without their share of pushback and controversy, especially on the political front. Politics in America are already polarized, but with the spread of anti-mask and anti-vaccine rhetoric from our nation’s top officials, who is really getting hurt? 

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Mask-Wearing

Multi-layer face masks made of cloth can block between 50% to 70% of droplets and particles (​​Cassoobhoy, 2021). Since COVID-19 is spread via airborne particles released when an infected individual is coughing, sneezing, talking, or generally exhaling, widespread mask-wearing was introduced to reduce the spread (Environmental Protection Agency). However, even though the federal government has provided guidance for mask-wearing and physical distancing, state and local governments ultimately decide whether to issue mask mandates (Hubbard, 2021). As of November 10, 2021, ten U.S. states and territories have mask mandates for anyone regardless of vaccination status, while three only have mask mandates for the unvaccinated. The remaining 43 states and territories do not have any mask mandates (Hubbard, 2021). 

The biggest states against issuing mask mandates in public areas are Texas and Florida. When banning local mask mandates, Texas governor Greg Abbott claimed that “Texans, not government, should decide their best health practices, which is why masks will not be mandated by public school districts or government entities” (Spencer, 2021). Likewise, in July 2021, Florida governor Ron DeSantis banned mask mandates, citing a study in which it appeared that masking in schools made little difference with the spread of COVID-19. This study, however, was done before the emergence of the delta variant, and the study’s author supports masking in schools (Spencer, 2021). Together, Florida and Texas make up only 15% of the United States population. In August of this year, they held 28% of the country’s COVID-19 cases (Spencer, 2021).

 In order for it to really end, we must return to more fact-based media coverage with less political input. We must increase transparency and education around masks and vaccines. We must hold politicians accountable for the information they spread about the virus."

Despite these sentiments against masks, many studies have shown that mask mandates decrease COVID-19 cases and related deaths. For example, when the Centers for Disease Control and Prevention (CDC) conducted a study in summer of 2020 on mask-mandates in counties in Kansas, they found that the 24 counties with mask mandates saw a 6% decrease in COVID-19 cases while the 81 counties that didn’t saw a 100% increase in cases (Van Dyke et al., 2020). Similarly, in a study conducted by the Department of Health Policy at Vanderbilt University in October 2021, counties in Tennessee without mask mandates had twice the death toll per capita than counties with mask mandates (Vanderbilt University). Wearing masks has been shown to impede the spread of COVID-19 and have been an integral part of America’s public health response throughout the pandemic. 

The anti-mask sentiments we see in the United States are not unique to our current pandemic. When the Spanish Flu came to America in the spring of 1918, San Francisco implemented an ordinance for mask-wearing in October 1918. However, some citizens viewed this as the government overstepping their rights, and they formed the Anti-Mask League in 1919 (Kahane, 2021). Today, anti-mask viewpoints are rooted in six main arguments: mask requirements do not stop the spread of COVID-19; they give a false sense of security; they restrict personal freedom; they present health risks; they lead to harmful social and societal consequences; and they cannot be enforced effectively (Ballotpedia). These arguments reflect peoples’ views on personal liberty and how much power the government has over their decisions, topics that are inherently tied to political views. 

Anti-mask viewpoints became a political topic very early on during the pandemic, especially since partisan divides between the Democratic and Republican Parties have peaked in the last half century. Bordalo et al. (2020) noted that increased political polarization causes an increase in political engagement among the public and therefore a greater divide between Democrats and Republicans (Bordalo et al., 2020). Former President Donald Trump was known to refuse to wear a mask in public and was against enforcing a federal mask mandate since March 2020. There is a significant negative relationship between mask-wearing and counties that voted for Trump in the 2016 presidential election; this indicates his supporters followed his influence when it came to mask-wearing (Kahane, 2021). This intersection of public health and politics can have a large influence on how people react to health crises. 

Vaccines

In January of 2021, the Pfizer and Moderna COVID-19 vaccines were approved by the FDA and made accessible to essential workers, the immunocompromised, and people living in communities with high COVID-transmission; nearly 4 months later, it was announced that everyone in America was eligible for the vaccine (AJMC). Though scientists and researchers spent several months working toward the creation and mass distribution of COVID-19 vaccines to allow us to reach a sense of post-pandemic normalcy, the process was met with much skepticism and political commentary, creating a muddled intersection between facts and opinions.

When information on vaccines and other public health decisions regarding COVID-19 focus more on politicians and less on scientists, the public may get mixed signals regarding who they should trust. As Hart et al. (2020) puts it, people start to “form opinions in line with political elites they trust and reject information not aligned with this view”. Some American politicians have denounced COVID-19 vaccines or spread misinformation about the vaccines. For example, earlier this year, Texas senator Bob Hall made false public statements about the COVID-19 vaccines, alleging that they contain “fetal parts” and traces of aluminum (Iannelli, 2021). As public leaders, politicians have the responsibility of advocating for public health measures that protect the public, but misinformation and fear about vaccines negatively affect communities that have been hurt most by the COVID-19 pandemic. 

Despite making up only 32% of the United States population, between March 2020 and June 2021, Black and Hispanic Americans were hospitalized at a rate that was 2.8 times higher than for white people (U.S. Government Accountability Office), and mortality rates were 3 times higher in these populations (AJMC). Additionally, health disparities and inequalities, such as lack of access to quality care and vaccine access, affect these groups more than others, especially in lower-income communities that are disproportionately Black and Brown. With America’s history of medical abuse against minorities and the medical mistrust that has arisen in these communities, citizens deserve transparency and factual information, not polarized debates that leave them confused on the choices they should make regarding their health and safety.

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Conclusion

Photo credit to Storyblocks

The result of scientific denial due to political polarization is that instead of being able to make decisions based on personal values and factual information, people’s decisions are being influenced by misinformation and politically motivated opinions that lead to more harm than good (Reiss, 2021). Factual information and reliable sources should empower the public, not fill them with doubt because of what their political party claims. We’ve been told throughout the pandemic to “trust the experts”, but is that really what America has been doing? Media coverage about the pandemic included politicians blaming others for the virus instead of highlighting the dangers of COVID-19, which caused conversations surrounding the virus to reflect tensions between our politicians. Though vaccination rates are rising in America, we cannot leave anyone behind in our public health efforts. Many believe that the end of the COVID-19 pandemic in America is near. In order for it to really end, we must return to more fact-based media coverage with less political input. We must increase transparency and education around masks and vaccines. We must hold politicians accountable for the information they spread about the virus.

Review Editor: Olivia Ares
Design Editor: Kidest Wolde
References

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AJMC Staff. (2021, June 3). A timeline of covid-19 vaccine developments in 2021. AJMC. https://www.ajmc.com/view/a-timeline-of-covid-19-vaccine-developments-in-2021 

Ballotpedia. (n.d.). Arguments against mask requirements during the coronavirus (COVID-19) pandemic, 2020-2021. Ballotpedia. Retrieved November 13, 2021, from https://ballotpedia.org/Arguments_against_mask_requirements_during_the_coronavirus_(COVID-19)_pandemic,_2020-2021#Mask_requirements_are_unenforceable 

Bordalo, P., Tabellini, M., & Yang, D. (2020). Issue salience and political stereotypes. National Bureau of Economic Research. https://doi.org/10.3386/w27194 

​​Cassoobhoy, A. (2021, August 18). Face mask for coronavirus: Types, best filters, how to make. WebMD. https://www.webmd.com/lung/coronavirus-face-masks#5-11 

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Hart, P. S., Chinn, S., & Soroka, S. (2020). Politicization and polarization in COVID-19 news coverage. Science Communication, 42(5), 679–697. https://doi.org/10.1177/1075547020950735 

Hubbard, K. (2021, October 27). These states have COVID-19 mask mandates. U.S. News and World Report. https://www.usnews.com/news/best-states/articles/these-are-the-states-with-mask-mandates 

Iannelli, V. (2021, April 4). An act relating to misinformed consent to immunizations for children. VAXOPEDIA. https://vaxopedia.org/2021/04/04/an-act-relating-to-misinformed-consent-to-immunizations-for-children/?fbclid=IwAR2x4CKNNF_oNgSKJOVDHQbizCxXiQaUkkAisW6XWp8JMsm9V5unb9s5Cas 

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Spencer, T. (2021, August 20). GOP governors, school districts battle over mask mandates. AP NEWS. https://apnews.com/article/joe-biden-business-health-education-coronavirus-pandemic-1aba40b697a210a65356269c916780d4 

U.S. Food and Drug Administration. (2021, August 23). FDA approves first COVID-19 vaccine. FDA News Release. https://www.fda.gov/news-events/press-announcements/fda-approves-first-covid-19-vaccine 

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Van Dyke, M.E., Rogers, T.M., Pevzner, E., Satterwhite, C.L., Shah, H. B., Beckman, W.J., Ahmed, F., Hunt, D.C., & Rule, J. Trends in county-level COVID-19 incidence in counties with and without a mask mandate — Kansas, June 1–August 23, 2020. CDC’s Morbidity Mortality Weekly Report, 69(47). 1777-1781. http://dx.doi.org/10.15585/mmwr.mm6947e2 

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