Among all the ways that COVID-19 affects our lives, the pandemic confronts us with a profound moral dilemma:

How should we react to the deaths of the unvaccinated?

On the one hand, a hallmark of civilized thought is the sense that every life is precious.

On the other, those who have deliberately flouted sober medical advice by refusing a vaccine known to reduce the risk of serious disease from the virus, including the risk to others, and end up in the hospital or the grave can be viewed as receiving their just deserts.

That's even more true of those who not only refused the vaccine for themselves, but publicly advocated that others do so.

It has become common online and in social media for vaccine refusers and anti-vaccine advocates to become the target of ridicule after they come down with COVID-19 and especially if they die from it.

Witness the subreddit HermanCainAward, which Lili Loofbourow of Slate identified in September as "a site for heartless and unrepentant schadenfreude."

The site is named for the former Republican candidate for president who became one of the first political notables to succumb to the disease after publicly defying social distancing measures.

Like another site,, the subreddit hosts snippets and photographs of anti-vaccine advocates, often taken at their deathbeds.

The issue of how to think about the deaths of unvaccinated has been thrown into high relief in the Los Angeles area by the case of Kelly Ernby, a prominent Orange County Republican and deputy district attorney who advocated against vaccine mandates and died of COVID around New Year's Day, unvaccinated.

Some online commenters greeted her demise with glee, provoking her political friends to push back against what one official called "bigotry and hate" directed against her.

My Los Angeles Times colleague Nicholas Goldberg lamented eloquently the rift in the social fabric that this species of callous commentary represents. "Mocking anti-vaxxers when they get sick has become a bit of a sport," he wrote.

I have a slightly different take.

To begin with, let's stipulate that not all people unvaccinated against COVID are alike. Some have remained unvaccinated for legitimate medical reasons — they may be children for whom the COVID vaccines haven't yet been officially ruled safe, or people with genuine medical reasons for avoiding the vaccine.

Some may have legitimately faced obstacles in getting to a vaccination site and receiving the full series of shots before becoming exposed to the disease.

Others may have refused the vaccine because they've been deceived by the misinformation and disinformation spread by the anti-vaccine crowd such as anchors on Fox News.

The deaths of all those victims are truly lamentable.

Finally, there are those who have voiced public opposition to the vaccines — not all of whom are unvaccinated themselves. Some have couched their opposition in policy terms. Ernby fell into that category — she asserted opposition not to the vaccines as such, but to vaccination mandates.

"I don't think the government should be involved in mandating what vaccines people are taking," she said during a livestreamed town hall on Nov. 3, 2019, during an unsuccessful campaign for the state assembly. "If the government is going to mandate vaccines, what else will they mandate?"

That town hall predated the pandemic; the mandate Ernby opposed then was a law tightening the immunization rules for California schoolchildren by eliminating exemptions based on "personal belief."

But Ernby made clear that her opposition extended to the COVID vaccines. In August, she posted a statement on her Facebook page supporting firefighters who were opposing a vaccine mandate.

"The vaccine is not the cure to Covid, and mandates won't work," she wrote.

It should be clear that opposing vaccine mandates as a substitute for opposing vaccination itself is a fundamentally incoherent position. It's little more than the garden variety small-government Republican ideology. That's what it was in Ernby's hands.

"I want small government, I want lower taxes, I want to protect our freedoms," she said during her discussion of vaccine mandates at that town hall.

Contrary to Ernby's assertions, however, mandates do work. Requirements that people provide evidence of vaccination before attending public events or entering restaurants or bars have been associated with heightened vaccine rates abroad. Employer mandates in the U.S. have raised vaccination rates at workplaces, as United Airlines has shown.

As for whether a vaccination mandate is a slippery slope to more government control, as Ernby maintained, government mandates have been with us for untold decades. We require drivers to wear seat belts, cars to be equipped with air bags and drivers to observe speed limits and avoid pedestrians. We ban smoking in public places.

Vaccine mandates themselves have been part of the educational system for longer than anyone can remember in every state in the Union. California, for instance, requires K-12 pupils to have as many as 20 doses of immunizations against polio, measles, mumps, rubella, whooping cough, diphtheria, hepatitis and chicken pox.

Obviously, the mandates exist because these diseases threaten not only infected persons themselves, but the community, meaning anyone they come in contact with. That's the folly of the anti-mandate argument: It places a perverse conception of individual "freedom" in opposition to the communal interest.

What's especially iniquitous about the anti-mandate and anti-vaccination arguments is the damage they are doing to America's public health system. Republicans like Ernby used COVID vaccines to turn public health into part of their partisan culture war.

The consequences are pernicious. They can be measured in overwhelmed emergency rooms and intensive care units, in hospital staffs burned out or rendered missing in action because they've been infected.

Some who object to the tone of the commentary about anti-vaxxers are merely voicing a variation on the "civility" argument that was commonly raised against critics of the intemperate and inhumane policies of the Trump administration. As I observed then, pleas for "civility" are a fraud. Their goal is to blunt and enfeeble criticism and distract from its truthfulness. Typically, they're the work of hypocrites.

So what, then, is the proper response to the deaths of anti-vaxxers or other determined foes of public health? First, we must acknowledge that the enemies needing to be stamped out are the misinformation, lies and stupidity being injected into the fight against COVID.

Second, we must view every one of these deaths as a teachable moment. They demonstrate in the most vivid way imaginable the folly of vaccine refusal and of flouting responsible public health measures. They underscore the dire consequences of turning public health into a partisan football.

It may be ghoulish to celebrate or exult in the deaths of vaccine opponents. And it may be proper to express sympathy and solicitude to those they leave behind.

But mockery is not necessarily the wrong reaction to those who publicly mocked anti-COVID measures and encouraged others to follow suit, before they perished of the disease the dangers of which they belittled.

Nor is it wrong to deny them our sympathy and solicitude, or to make sure it's known when their deaths are marked that they had stood fast against measures that might have protected themselves and others from the fate they succumbed to.

There may be no other way to make sure that the lessons of these teachable moments are heard.

Michael Hiltzik is a columnist for the Los Angeles Times.