A few days ago, as we went for a stroll along the 19th century avenues of Trieste, a beautiful Adriatic city, we encountered a sizable protest against vaccination mandates and other government measures to subdue the pandemic. Perhaps this should have no surprise – a large banner hangs in a window above the same piazza proclaiming the Free Territory of Trieste, a separatist movement to return this multilingual multiethnic city and its borderland environs to the special status it enjoyed, at least formally, between 1947 and 1954, when most of the territory was returned to Italy. Resistance to the national government here draws on a deep well of local sentiment, a sense of uniqueness that impersonal administrative structures do not comprehend.
In recent weeks, Italy and France have leapt ahead of the United States, both in the percentage of the adult population vaccinated and in the way new rules are to be imposed on adults who choose to avoid being vaccinated (or who, for exceedingly uncommon reasons, cannot be), despite widespread access. Their model, it seems, is Israel, where a Delta-driven surge has shown that high rates of vaccination alone cannot liberate us from the hold of the virus.
In these countries, as before, vaccination is to be combined with social measures; the difference now is that solidarity with the as-yet-unvaccinated has been sacrificed, or, at least, limited. If you want to take a long-distance train or go to a restaurant in France, for instance, you will soon have to demonstrate either vaccination or a recent negative test. While that may seem lax as a mandate on its own, free voluntary testing is also due to be withdrawn. The result is a genuinely coercive policy to encourage vaccination, and, indeed, in the wake of its announcement, millions signed up to get their shots.

In reading these developments, my sympathy lies almost entirely with government leaders aiming to secure the common good, which, though it cannot be reduced to the salus populi surely includes it. I doubt anything like it will happen in the US. Even mandating vaccination for air travel – surely within President Biden’s authority – has seemingly been ruled out in advance. Convincing even hospital and nursing-home workers to get vaccinated has been difficult in the US. I read a recent ProPublica report with horror, learning that the vaccination rate nationally for nursing home workers is, at best, on par with all adults, and this despite their direct witness of countless deaths among the elderly in their care.
It is, I suspect, difficult for vaccinated residents of wealthy countries to think about the current state of the pandemic without some quantum of despair. In these countries, we could likely vaccinate our way to safety – with a little more time and a little more urgency – even as the poorest countries in the world remain at grave risk. But if 30% of adults refuse, while suffering no consequences for endangering others, pandemic purgatory is the best we can manage.
My own feelings of despair have begun to harden into frustration and anger. I wrote some months ago about the courage we need to overcome the pandemic, the courage to get vaccinated and the courage to reclaim the goods of social life after a period of heightened awareness of danger. I see now that we also need a kind of temperance, the restraint of unmerited passion. (Aristotle calls the right relation to anger gentleness or mildness and distinguishes it from the other virtues; Aquinas treats it as related to courage, since anger pertains to our competitive inclinations and aversions, not to pleasure and pain directly.)
But, then, what passions are merited in this case?
A persistent question in any examination of my own attitudes has been this: is there an imperative for empathy? Empathy with those who choose not to be vaccinated has sometimes been described as aiming to understand the reasons or world-pictures behind this choice. But one can be angry and dismissive and very much concerned with understanding these reasons. After all, crafting a successful coercive mandate depends on appreciating what would motivate a group of people.
In fact, empathy excludes taking the diagnostic stance to another. So my question is really: is there an imperative to bring oneself into the point of view of someone whose choices you abhor and lament?
These questions seem more straightforward to me when it comes to, say, opioid addiction, an epidemic that also surged over the past year and a half as the virus split us all up. Those who are addicted make bad choices, ones that harm themselves and also, predictably, harm those close to them. These choices also cost us as a society, certainly in material resources but also in the networks of love and solidarity that addiction tends to undermine. Yet I am convinced that punitive measures have failed to stem drug addiction. And I find it relatively easy to empathize with those with addiction when I consider the sins of the pharmaceutical industry and doctors in driving the epidemic, not to mention the social neglect that tends to characterize the places where addiction is commonest.
Vaccine avoiders are a disparate group, of course. But the petit-Trump sycophants and the cynics whose lies – inevitably concluded by the refrain “I’m just asking questions” – are broadcast on Fox News and echoed on Facebook seem to play a role at least somewhat analogous to Big Pharma in the modern opioid epidemic.
Opioid addiction – which surged after the Civil War – and anti-vaccine sentiment, which dogged Jenner’s efforts to combat smallpox (the first vaccine), are stable parts of modern life. But without the professional pain-pill-pushers, serious addiction would likely have remained an isolated phenomenon. Likewise, the intuitive strand in American culture and thinking (a prominent theme in Tara’s book Strange Rites), which frames individual sentiment as a sure guide to what is good for us, all but entails a refuge for vaccine skepticism. But it is the torrent of lies and deception from right-wing media and politicians that have begun to harden hesitancy into refusal. (To some extent, this phenomenon is surprising, since the sort of anti-medical-establishment intuitionalism most common in American life tends to be left-leaning – think of RFK, Jr.)
Where does my comparison lead us? Can we – must we – see ourselves on a par with people who are vulnerable to these forces of disinformation? Admittedly, I struggle to do so. But the separatist ideal I mentioned earlier – a person or collective’s sense of uniqueness set against an impersonal bureaucracy – comes from a desire for individual recognition that modern life frustrates. (By the logic of sovereignty and citizenship, people cannot be Triestine first, but must be standardized as members of a wider Italian or Slovene polity.) Perhaps empathy can find a foothold here.
The bureaucratic talk of many vaccine avoiders – of human rights (invoked by many of the posters in that Triestine piazza) and HIPAA violations – covers over a more fundamental demand: to be seen as a person. That is something impersonal institutions and government agencies cannot, by their nature, offer because of their hierarchical form, their address to us as subjects. While this underlying demand to be seen as a person is a genuinely important one, its expression in a refusal — saying no to the urgency and the pleas of others — is, in a way, empty of further significance. It is only in the sharing of life that recognition is made possible.
The solidarity we need now, and the courage and the temperance such solidarity in turn requires, is reciprocal not hierarchical: it exists, in however frayed a form, between citizen and citizen, neighbor and neighbor. I pray that we have enough of it left to survive. We need those who have not yet been vaccinated to choose solidarity over fear or willfulness. And we need to be able to live with one another, even to love one another, once this is all over.
on empathy
Thank you for writing these essays. This substack has been a reliable source of joy, distraction, and reflection for me, a rare thing in what feels an increasingly bleak and despairing time. Thanks for making my life better.