Ben Roback is Head of Trade and International Policy at Cicero Group.

“The nine most terrifying words in the English language are: I’m from the Government, and I’m here to help.”

President Ronald Reagan’s words have been immortalised over time by conservatives who consider the government an irritating source of interference. Too often governments get in the way when they should be structural facilitators of growth and development. Cut red tape and let businesses/people thrive, don’t flood them with a tsunami of requirements, regulations, and checks.

But what about when any given central government is the only viable solution to a truly existential problem? In the case of the Covid-19 pandemic, there appears to be no alternative to a centrally driven vaccine rollout programme.

Trump started it, Biden is finishing it.

The response to the pandemic and the vaccine rollout has been conducted entirely under a Conservative government here in the UK. It gives less cover to those whose mistrust in the government might be centred on an opposition party being in power.

On that basis, in the United States, the Republican position on the vaccine remains curious. After all, the vaccine programme owes its creation and early development to the Trump administration. The former president does not get enough credit for Operation Warp Speed, the public–private partnership initiated by the United States government to facilitate and accelerate the development, manufacturing, and distribution of Covid-19 vaccines, therapeutics, and diagnostics. The US Government sprung rapidly into life and showed how it can be a friend, not the kind of foe described by Reagan.

Donald Trump rightly boasts about the achievement. In a recent speech, he said: “Our operation warp speed was absolutely breath-taking…the Trump administration deserves full credit, which we do.”

Given Mr Trump remains at the political and philosophical heart of the Republican Party, why do so many Republican politicians and the party base itself remain so hostile to the vaccine?

Consider the evidence. Arkansas’s Republican Governor Asa Hutchinson was booed on stage after he said that the Covid-19 vaccine doesn’t affect fertility. Fox News has begun to roll out a new out a new public service announcement to encourage viewers to get a vaccine. “America, we’re in this together,” one presenter said. “If you can, get the vaccine,” another added. Meanwhile, its star presenter, Tucker Carlson, continues his perennial campaign against Covid restrictions and inferred hesitation towards the vaccine programme. Analysing why the American vaccination programme is stalling, The Economist wrote that ‘populist conservatives are to blame’.

Mr Trump is not consistent on the matter. On the one hand, he boasts in speeches about shattering records for vaccine manufacture, approval, and deployment. On the other, he kept his own first vaccination silent for weeks initially. That has created a framework for elected Republicans at all political levels, flanked by conservative commentators through their social and mass media platforms, to continue to decry the vaccines as part of a liberal ploy to control their brains and bodies. That would be strange given the vaccines were approved and rolled out initially by a Republican president, would it not?

The pursuit of freedom is an admirable goal and one that we should encourage, not suffocate. But is freedom an absolute outcome or an aspiration with occasional practical limitations? In the case of the vaccine rollout in the United States, it is clear that health guidance designed to protect Americans from a deeply infectious and all too often deadly virus, has been caught up in enflamed cultural tensions deep-rooted in an inherent mistrust of “the Government” – whether at the local, state or federal level.

One step forward, two steps back

The United States made an impressive start in getting federally approved jabs into arms. For the Biden administration, the weather ahead looks troubling. Fully vaccinated Americans have had the taste of freedom in their mouths since May, when the Centres for Disease Control (CDC) announced that masks needn’t be worn following vaccination. This week, in the face of rising Delta variant case numbers, the CDC reversed its guidance and recommended that Americans wear masks indoors again, particularly in crowded indoor settings. For many, it will feel like a prisoner being released from jail, and then being asked to return through no fault of their own.

The new mask mandate comes at a particularly troubling time for southern states like Louisiana, Alabama and Missouri. These three are suffering from a killer combination – literally – of sudden spikes in Covid-19 cases and weak vaccine uptake. The causal evidence? More than 95% of the patients hospitalised nationwide are unvaccinated, according to state public health officials and the CDC.

The Trump administration deserves credit for initiating the vaccine programme. The Biden administration deserves praise for ramping up its rollout. For the health and prosperity of all Americans, the country has little choice but to come together and recognise that vaccination is the only way out of this Covid-19 nightmare which we have all endured for far too long. Freedom can be pursued at all costs, but in the case of the campaign against the vaccines, is it worth dying for?