Dr. Aragon,

We are physicians who write to you in response to State Public Health Officer Order of July 26, 2021 regarding mandatory vaccination of health care providers in California.

Specifically, we write to document that the California mandate completely ignores the basic principles of immunology and is in direct conflict with all clinical and epidemiological studies demonstrating that persons with pre-established acquired immunity to SARS-CoV-2 are at least equally, if not better immune than most fully vaccinated persons.

In many California communities, 30%-50% of healthcare workers have declined to get vaccinated against COVID-19 on the basis of recent prior natural infections. These providers understand that their exposure to the virus has resulted in them having immunity against reinfection, as is the case with every transient viral infection we routinely manage using vaccination.

The serious clinical and ethical error in imposing mandated vaccinations on Americans with robust pre-established natural immunity to COVID-19 is two-fold: 1) it ignores the principle of medical necessity in imposing a medical treatment, with no added clinical benefit to the already immune vaccine recipient and 2) it risks harming any recently or concurrently infected persons undergoing a mandated vaccination.  

We are signers not only from California but also physicians and allied health care workers from across the United States.  We understand that if the public health officers are successful in imposing unscientific and unethical mandates against physicians and healthcare workers in California, these baseless mandates will rapidly spread across the United States.  Most of the signatories on this letter are up to date on our vaccinations, as are our children.  Many of the signatories on this letter are fully vaccinated against COVID-19.  A notable group of the signers are physicians who have had COVID-19 and therefore have immunity and do not stand to benefit from vaccination against SARS-CoV2. We are not “Anti-Vax.”

We are united as a community of physicians and health care workers to stand up for ethical public health conduct and the sound principles of immunology and clinical practice which are being ignored or violated by your mandate.  Vaccinated against COVID-19 or not, we all understand that COVID-recovered individuals are at extremely low risk of reinfection.  Exposure to and recovery from COVID provides immunity that is at least equivalent to, and likely superior to, the level of protection afforded by full effective vaccination.  This is consistent with worldwide data indicating that reinfections with the Delta variant in COVID-recovered individuals remain exceedingly rare.  

There is no medical reason to subject COVID-recovered people who have strong immunity against SARSCoV2 and its variants to twice-weekly screening medical procedures which carry their own risks of injury and false-positivity.

To impose this draconian mandate on already immune members of the California medical community and the citizens of California is vastly unreasonable and unsafe.  Please note that we are providing you with this letter of warning in order that you have the opportunity to reverse your error by revising your mandate to exempt already immune healthcare providers from mandated vaccination. To not do so will very certainly be judged by history and by many reasonable and ethical physicians as unreasonable and corrupt.

Respectfully,