On the one hand, fine. Who cares? We’ve reached the stage of the pandemic where most adults who want to be immunized have had the opportunity. If Rand Paul’s natural immunity fades in time and you end up being infected by him, well, that’s on you for not getting vaccinated.

We’re all responsible for our own risk now. If you don’t want to get the jab, that’s your right. Take the consequences.

On the other hand, plenty of people who’ve had COVID have gone ahead and gotten vaccinated, including Donald Trump. Maybe Paul’s natural immunity will be as durable as vaccine immunity, but maybe it won’t. Why take the chance?

What’s he trying to prove?

So brave…Such a leader… so manly…

Rand Paul: 'I'm not getting vaccinated' https://t.co/4bVulvSgnA

— Adam Kinzinger (@AdamKinzinger) May 23, 2021

There are two reasons that a person who’s recovered from the disease might choose not to get vaccinated. One is if he believes it’s unnecessary because it would add nothing to his ability to fend off the virus, as Paul seems to:

“Until they show me evidence that people who have already had the infection are dying in large numbers or being hospitalized or getting very sick, I just made my own personal decision that I’m not getting vaccinated because I’ve already had the disease and I have natural immunity,” Paul said…

“In a free country, you would think people would honor the idea that each individual would get to make the medical decision, that it wouldn’t be a big brother coming to tell me what I have to do,” Paul said.

“Are they also going to tell me I can’t have a cheeseburger for lunch? Are they going to tell me that I have to eat carrots only and cut my calories?” Paul continued. “All that would probably be good for me, but I don’t think big brother ought to tell me to do it.”

Is natural immunity as good as vaccine immunity? There are reasons to doubt it. Reinfection may be rare but it does happen. A study of Denmark published in The Lancet in March found that 0.65 percent of people who tested positive for COVID during that country’s first wave also tested positive during its second. Estimated efficacy from natural infection was 80.5 percent — but that dropped to 47.1 percent among senior citizens. Paul is 58 and had part of his lung removed after he was assaulted by his neighbor a few years ago. Reinfection has also been chronicled in Brazil, possibly because of the P.1 variant that’s common there, and it so happens that P.1 is now the second-most common variant in the U.S.

But that’s not all. Another recent study of California found that vaccinated people had higher antibody levels and greater antibody “breadth” than people with natural immunity did. That might be because not all COVID infections are created equal: “In people who are only mildly ill, the immune protection that can prevent a second infection may wane within a few months,” the Times noted back in March. Rand Paul got infected all the way back in March 2020, during the first weeks of the pandemic, and said he was asymptomatic when he first announced that he had tested positive. (It’s unclear if he had symptoms while recovering.) He’s now 14 months removed from what seems to have been a mild bout with the disease.

All of which is to say, there’s no reason for him to think vaccination is unnecessary. He may be in the same position as an average twentysomething with respect to COVID, i.e. unlikely to have much difficulty if he gets infected (again) but possibly capable of transmitting the virus to others if he does. If we’re asking young adults to take one for the team and get vaxxed in pursuit of herd immunity, why shouldn’t we ask Paul?

The second reason to avoid vaccination is if he fears serious side effects, whether known or unknown. If he’s worried about blood clotting from Johnson & Johnson, even though the risk from that is remote, he could opt for Pfizer or Moderna instead. If he won’t do that either because he considers their products some sort of health threat as well, then he’s underselling the vaccines — the same thing he’s spent months accusing Joe Biden and Anthony Fauci of doing. Take off your masks now that you’re vaccinated, Paul has said to them, or else you’re signaling to people that you don’t believe the vaccines work. If he’s holding off on getting immunized himself because of some fear that the vaccines might do him more harm than good then he’s endorsing a bigger deterrent to vaccination than they are.

What is he afraid will happen if he gets the shot, apart from a boost in antibodies? How would it hurt to get an immunization he *might* not need but could only benefit from? He’s thrown enough rocks at Fauci for being a poor vaccine salesman that he should explain his reasoning, especially since having a populist Republican get immunized can only help convince holdouts in red states that it’s safe and worth doing. As of this morning, not a single state won by Trump last year is above the national average of 49 percent measured by the share of the population that’s received their first vaccination dose. Seven red states have yet to reach 40 percent on first doses; by comparison, six blue states have already passed 60 percent.

Any encouragement by Paul or anyone else to the GOP base would be useful. But that’s probably asking too much. Remember that Paul’s Senate colleagues were furious last year that he put them at risk by using the Senate gym and attending GOP lunches even after he knew that several attendees at a fundraiser he was at had already tested positive. He was at the gym the morning after he took the COVID test that eventually came back positive instead of isolating as a precaution until he had the results. He’s always been glib about the risk from the virus. He’s not going to go get vaccinated now just to set a good example, especially knowing how that might damage his populist cred.

I’ll leave you with Scott Gottlieb ushering in the “individual risk assessment” phase of the pandemic.

“People need to make individual assessments of their risk,” @ScottGottliebMD says. “A crowded setting with a very mixed population, you don’t know a lot of the people — that is very different than getting together in a household where you know a lot of people are vaccinated.” pic.twitter.com/wHGrCVl8Up

— Face The Nation (@FaceTheNation) May 23, 2021