It’s going to be a long time before a vaccine for the new coronavirus is available. But when it is, there’s no guarantee that it will be affordable for all Americans, according to Health and Human Services Secretary Alex Azar.

Azar, a former drug company executive and pharmaceutical lobbyist, told Rep. Jan Schakowsky (D-IL) during a congressional hearing on Wednesday that, although he would want to make it affordable, he won’t promise that it will be. “We can’t control that price because we need the private sector to invest,” he said.

Unfortunately for Azar, the new coronavirus doesn’t care about profit margins or returns on investment at drug companies. During an outbreak of an infectious disease, that attitude doesn’t just put the poor at risk by making it harder for them to access a protective drug — it puts everyone at risk.

Here's the clip of Azar not assuring Rep. Schakowsky a covid-19 vaccine will be affordable to all. pic.twitter.com/Z8aNd4wLWj — Michael McAuliff (@mmcauliff) February 26, 2020

Vaccines work best when everyone in a community gets them, and herd immunity kicks in when enough people are immunized against a disease. When the proportion of vaccinated people is below a certain level, it’s more likely that someone who hasn’t received the vaccine will come into contact with someone who has the disease, which allows it to keep circulating and cause more outbreaks. That’s what we saw when rates of measles vaccination dropped in New York in 2019: hundreds of people caught the preventable illness.

Measles is far more infectious than the new coronavirus appears to be, but the same principles apply. There is no coronavirus vaccine available yet, and there won’t be for at least a year to 18 months. But when it is, widespread vaccination is the best way to protect everyone, poor and wealthy alike.

Vaccines are just one example of the way cost-prohibitive health care may make it harder for the US to contain the spread of the new coronavirus. People with no insurance or bad insurance might be reluctant to seek care for something they suspect might be COVID-19, the illness caused by the virus, because they’re concerned about the price tag on testing.

Osmel Martinez Azcue, for example, went to Miami’s Jackson Memorial Hospital when he came down with a flulike illness after returning from a trip to China. He wouldn’t have normally gone to the hospital for the flu, he told the Miami Herald, but he didn’t want to put his family and the community at risk if he had COVID-19. As it turned out, he did not have the new coronavirus, but he was still charged thousands of dollars for the testing and care given at the hospital. Thousands of others in the US, if they thought there was a chance they could have the virus, might have to choose between taking precautions that could protect the community and avoiding a massive bill.

Companies that offer only a limited number of sick days — like many the service industry, for example — also put the broader community at risk, not just their employees. People who work in those positions might not be able to afford to take time off if they’re sick.

Vulnerable communities always see a disproportionate impact of disease and aren’t able to take the same precautionary measures as people who have more money and flexibility. That, on its own, is an enormous public health problem. But it also makes it easier for the virus to keep spreading, which impacts everyone, even those people who can afford a certain level of protection. When it comes to infectious disease, health isn’t individual; it’s collective. And the cost of profit-driven care is simply too high for us to pay.