Should We Mandate COVID-19 Vaccinations? Lessons From The British Virgin Islands

Should We Mandate COVID-19 Vaccinations? Lessons From The British Virgin Islands by @marcstrausbooks #vaccinations #COVID19 #COVID

In One-Legged Mongoose: Secrets, Legacies, and Coming of Age in 1950s New York, my memoir to be published this September, I recount the sudden onset of polio when I was 11 years old. It was a hot June day, and as I attempted to walk downstairs in our Long Island home, my legs couldn’t hold me up. The diagnosis in 1954 couldn’t be made with certainty, but there was little doubt as to what was happening.

I was bedridden for two months before slowly regaining my strength. Thankfully, the Salk vaccine would come soon. With that vaccine and a worldwide effort, polio was eradicated. Mumps, measles, and chickenpox are rarely seen now — those vaccines work.

Vaccinations – Where We Are Now

As I recently wrote in a blog post, the side effects of those earlier vaccines were far worse than with the COVID vaccines. A few hundred died of the polio vaccine. Science is far different today, and the side effects of the COVID vaccines have been negligible.

In the best-case scenario, everyone over the age of twelve (or perhaps younger) would be vaccinated. The U.S. has the supply to do it. If we were able to do that, new cases would be rare and variants such as Delta, which is far more infectious, would have little chance to become dominant.

Dr. Anthony Fauci of the N.I.H., a lightning rod for vaccine dissenters, stated recently that if we had had such vaccine resistance to polio or measles, those diseases would still be prevalent today. He’s right. The Delta surge and uptick of deaths is alarming — so much so that Fox News has mostly changed its tune, with several of its hosts urging people to get vaccinated.

Gov. DeSantis of Florida, running hard for his party’s presidential nomination, has now strongly advocated vaccination. Yet he still strongly resists mandating mask-wearing and social distancing. The latter, too, would help in many situations. It’s surely not foolproof, but vaccination confers a high degree of protection against becoming infected and getting very ill.

Because the virus has infected so many, and because there are so many unvaccinated hosts, COVID variants have increased and dominated. The most infectious variants will dominate if it gets sufficient traction. That means that until the vast majority of us are vaccinated, ongoing boosters will be needed. (Assuming they continue to work.)

Today, there is a different mindset in the U.S. compared to decades ago when almost the entire population followed guidelines. Social scientists and political scientists will be writing about this for many decades to come. I have no special insight except to point out that the January 6, 2021 insurrection at the Capitol would not have likely happened in any prior decade going back to the Civil War.

Anger and frustration at our political and economic system are stronger now than at any other time in my lifetime.

In One-Legged Mongoose, I write about listening to the McCarthy hearings, a dark time in our history when one divisive politician led a witch hunt, and almost no other politician stood up to him. The disparity in wealth has grown enormously in the past thirty years. This has fueled anger, riots, and civil disobedience. The loss of fair-paying jobs has increased rapidly. I can’t suggest how to repair this fairly, but it must be repaired.

COVID is a far different kind of crisis than wealth disparity. It is immediate and deadly. It’s also easier to fix: Vaccinate every eligible person.

The reality, of course, may prove to be more difficult than it sounds. I’d expect 20 to 30 percent of our population will resist vaccinations indefinitely. No data or advice is likely to change their minds.

Which leads to the question: Can we impose mandatory vaccinations?

Let’s say in the next two or three years, waves of outbreaks continue and another half-million (or more) people die. Three years from now we may need two more booster shots for optimal safety. There will come a time where we may have no choice but to mandate universal vaccinations.

Is there the political will to do so? My savvy son says it can never happen here. I think it can when we are worn down by tragedy and it becomes evident that universal vaccinations can stem this pandemic. We have imposed quarantines in the past, and we routinely jail people who don’t pay their taxes or break other laws that don’t cause immediate damage to other people.

Those who refuse vaccination are harming others, and eventually, I expect the common good principle will prevail.

Vaccinations in the BVI

I recently visited the British Virgin Islands (BVI), home to about 30,000 people. They scrupulously protected their border entry, and as a result, had few COVID cases. I had to bring proof of full vaccinations, a recent negative PCR, and on arrival, I took another PCR. However, once the Delta variant appeared in the BVI, more than 1,500 residents tested positive for COVID in about two weeks, overwhelming the healthcare facilities.

In the BVI, the majority of the citizens did not want to be vaccinated. Why? It’s hard to get an accurate answer, but we expect it’s for similar reasons as in this country — a widely held belief that the U.S. and other large democracies are not being truthful.

There is a 7 p.m. curfew in BVI. No restaurants are open, no large gathering permitted, and the border is virtually shut. Vaccinations are picking up, but the government can impose further restrictions and mandates on this small population. They have to. Right now, there is no tourism, which produces the majority of the country’s income. Deaths are also increasing quickly.

What Happens Next?

If tens of millions of Americans continue to refuse vaccinations, mandates will happen here as well, in one form or another. Time is running out for a resolution that relies solely on public information and voluntary action. California is instituting a policy that requires state and municipal workers to either be vaccinated or tested weekly for the virus. New York City announced today that all municipal workers, firemen, cops, teachers, must be vaccinated in order to work. States that are hit hard again will eventually demand public compliance.

Our leaders and clergy must step in. In Israel, a large portion of the ultra-orthodox refused vaccination until their Chief Rabbi ordered them to do so. Here the FOX news naysayers must convince their viewers, and politicians of all parties should deliver a forceful message in favor of vaccination.

Last week, the National Football League ruled that a team could forfeit a game if a COVID outbreak is linked to unvaccinated players. Players won’t get paychecks for forfeited games. A federal judge refused to block Indiana University’s vaccination mandate for all faculty and students. This is the beginning. As unvaccinated people continue to put vaccinated people at risk, health-wise and economically, the majority will insist on further and more rigorous mandates.

I recovered from polio, and countless others were saved because of the vaccine. We’ve lost more than 600,000 people in this country, and many more have residual medical issues, such as pulmonary disability.

Mandates: The impossible to imagine has begun.


Marc Straus, M.D., is an oncologist and former Chairman of Oncology and Professor of Medicine. He’s also an art collector, gallery owner, author, and poet. He has authored some 100 scientific papers and edited three textbooks on lung cancer in addition to three collections of poetry. 

The MARC STRAUS gallery represents 24 artists from 16 different countries. Originally focused on emerging artists not previously exhibited in New York, it is now mixed with a few mid-career and late-career artists from the U.S., Asia, and Europe. See for more info.

Preorder One-Legged Mongoose: Secrets, Legacies and Coming of Age in 1950s New York, which will be released this September. Connect with Marc on TwitterFacebookor Instagram. Sign up for his newsletter here 

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  1. Lydia on August 2, 2021 at 9:01 am

    This was a thoughtful post.

    I’ve lost one relative to Covid-19 so far and have two others who have Long Covid. Many more of us caught Covid but seem to have fully recovered.

    I’m 100% in favour of making this vaccine mandatory for school, work, attending large events, etc. I do not want anyone else to suffer the way my family has….and we’ve honestly been pretty lucky so far considering how much harder other families have been hit by it!

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