As America heads into month 19 of “fifteen days to flatten the curve,” the great hope remains that mass vaccination will allow the world to return to something resembling normalcy. In America, that means a massive campaign to compel the millions of as-yet unvaccinated people to get the jab. The federal government and the medical community are urging people to get vaccinated. Local governments like New York City are requiring proof of vaccination as a condition of venturing into most public venues. California business organizations are begging the state to enforce vaccine mandates. Employers are beginning to demand that employees be vaccinated as a condition of employment.
With tens of millions of Americans now vaccinated, and many more around the world, it would be useful to step back and reflect on the fruits of these endeavors. What effect has vaccination had on the number of cases and fatalities? How have vaccinated and unvaccinated communities fared overall? What can we therefore conclude about the efficacy of mass vaccination against COVID-19?
Fortunately, not only is there an embarrassment of data riches on the subject, we are also far enough into the process of mass vaccination where we can begin to see how vaccination is playing out around the world, and close to home. We have examples of communities with high vaccination rates, and others with relatively low vaccination rates, so we can identify useful points of comparison.
On one end of the spectrum lies Gibraltar. A British Overseas Territory at the western end of the Mediterranean, Gibraltar sits on a peninsula at the southern tip of Spain. Gibraltar boasts a vaccination rate of 100 percent; virtually every eligible person in the territory is fully vaccinated against COVID-19. During the spring and early summer of this year, Gibraltar was touted by numerous media outlets as a model of a successful vaccination campaign, and a succession of pieces was published on the beauty of being able to reopen the whole society.
On the other end is Hillsdale County, Michigan, a rural community in the south central part of the state that borders both Ohio and Indiana. Tiny Hillsdale has made news repeatedly in relation to COVID-19. In 2020 Hillsdale College held an in-person commencement for its graduating class, drawing national media attention and criticism. In April 2021, Julie Appleby of Kaiser Health News wrote a hit piece on the community and the college for their attitude toward the virus, which was picked up and reported as news by the Los Angeles Times, PBS, and Salon. Last month the Times published an article identifying the county in each state with the lowest vaccination rate, and in Michigan, Hillsdale is that county, at only 30.3 percent.
Gibraltar and Hillsdale share several similarities that invite a comparison between them. Both are modern, Western communities with access to modern medicine, sanitation, hygiene, and nutrition. Both are somewhat, but not extremely, isolated. Gibraltar and Hillsdale are both small communities. Gibraltar has a population of 34,003, while Hillsdale County is slightly larger, at 45,605. Gibraltar was one of the first jurisdictions to “reopen”; Hillsdale is noteworthy for its resistance to shutdown measures, almost from the very beginning.
So what do we find when we look at these two communities? As of September 1, 2021, Hillsdale County has had 4,768 recorded cases, or slightly less than 10.5 percent of the population, while experiencing 99 total deaths, which represents 0.217 percent of the county. Meanwhile, an ocean away in Gibraltar, the territory had reported 5,371 cases, 15.8 percent of its total population, while suffering 97 deaths, which is 0.285 percent of its total population. In other words, the difference in coronavirus fatalities is insignificant, while relatively unvaccinated Hillsdale has seen a much lower case rate, both in terms of percentages and raw numbers, than fully-vaccinated Gibraltar.
One might plausibly object, however, that these statistics include data from the beginning of the pandemic, and therefore don’t accurately depict the effects of the vaccine on cases and deaths. This is a reasonable objection. From July 1 to September 1, 2021, the number of deaths in both jurisdictions has, mercifully, been very small: three in Gibraltar (0.009 percent of the population) versus five in Hillsdale County (0.01 percent). The case numbers over the same period, however, tell a different story. In Gibraltar, 1,019 cases of COVID-19 have been identified, equivalent to three percent of the population, while Hillsdale County has seen only 343 cases during the same period, or 0.75 percent of the county’s population.
These numbers do very little to bolster the case that vaccination is the key to ending the pandemic. Since Gibraltar has a 100 percent vaccination rate, it is reasonable to conclude that all, or nearly all, of the 1,019 cases noted in the previous paragraph are vaccinated persons. Even if all the cases in Hillsdale County are among unvaccinated persons, it is still true that the case rate since July 1 is 400 percent higher in vaccinated Gibraltar than in unvaccinated Hillsdale.
Gibraltar’s numbers are so jarring that the territorial government has recently begun re-imposing some of the restrictions that were lifted as the territory approached full vaccination. The U.S. Centers for Disease Control now lists Gibraltar as a level 4 travel risk, indicating the highest level of risk. The idyllic picture of fully vaccinated Gibraltar, along with the hope it presented to other nations, was a mirage.
There is also growing evidence in recent weeks that Gibraltar is not an outlier. Another nation which has garnered praise for its vaccination program is Israel, which has hit the 80 percent threshold touted by Anthony Fauci, and is a world leader in booster (third) vaccinations. Israel, however, is now experiencing a surge of new infections and currently boasts the highest level of new infections in the world. Highly vaccinated Iceland has also experienced another surge. Israel and Iceland are also both rated at level 4 travel risks by CDC.
In a rational world, one might expect that all of this would cause peoples and governments to pause to consider whether a mass vaccination program, backed by public pressure and even coercion, is the best way to deal with the problem. If the last 18 months have taught us anything, however, it is that we do not live in a rational world.
*Editor’s note: An earlier version of this article included a mathematical notation error that has since been corrected. The error had no bearing on the overall point of the article.