COVID-19: Should vaccination be mandatory?

Ecuador is as of Thursday the first country in Latin America to impose mandatory vaccination against the coronavirus due to the increase in cases of the omicron variant.

In the region it is now installed a debate that has already caused controversies in several countries where it is required to be vaccinated to carry out various activities of public life.

If you are a doctor in France, a teacher in New Zealand or a government official in Canada, being vaccinated is essential to work.

Indonesia can deny benefits to those who refuse to vaccinate. Greece has made them mandatory for those over 60.

Austria will impose them as an obligation for all from February. There will be exceptions for medical or religious reasons, but the rest of the unvaccinated population will face fines for not going for their doses.

Almost two years after the pandemic was decreed, covid-19 is still among us.

Above, now we face what seems the most contagious variant to date.

And although the first studies suggest that omicron could be lighter than its predecessors, its high transmission capacity continues to be a challenge for global public health.

In this scenario, would vaccination be mandatory the way out of the pandemic?

Vaccines save lives

The main asset of vaccines is that save lives. If you get vaccinated, you reduce the risk of getting seriously ill. Less severity means less death and less hospital pressure.

Historically, vaccination campaigns have been enormously successful eliminating diseases like smallpox or drastically reducing mortality in others such as measles.

“We have very good examples that show a direct causal relationship between requirements (of mandatory vaccination), achieving high levels of vaccination and protecting not just individuals but entire communities,” Jason Schwartz, associate professor of the history of medicine of the United States, tells the BBC. Yale University.

“Vaccines work, they absolutely work and we have a lot of evidence to prove it,” he adds.

Some less stringent mandates such as the one proposed by Austria have achieved the goal of increasing vaccination levels.

In France, the expedition of the health pass, a kind of immunization passport required To access restaurants and other public spaces, it has been linked to an increase in vaccination rates, to the point that the government hopes that this will avoid making them mandatory.

Public resistance

Demonstrations against confinements and restrictions have taken place in London and other cities around the world.

But any government decision will encounter some kind of opposition and making vaccines mandatory would be even a step beyond all the measures taken so far.

“People think very differently when it comes to vaccines,” Vageesh Jain, doctor of public health at the Institute for Global Health at University College London, tells the BBC.

“Anything that is administered to them in the body will not be taken in the same way. Although academics and other experts think that in theory it is just another type of restriction, people have a more emotional reaction“.

There will always be someone who will never be persuaded to be vaccinated, but It is possible to have doubts about vaccines without being precisely an anti-vaccine.

A study in Austria distinguished between the 14.5% of the country’s 9 million people who were not ready to get vaccinated and the 9% who simply doubted.

Governments must weigh whether the benefits outweigh the public reaction. But, as Cathleen Powell, a law professor at the University of Cape Town in South Africa, argues, there are also legal overtones.

“The right to bodily integrity of a person who does not want to be vaccinated, and who wants to make their own decisions about what medical treatment to receive, directly collides with the rights of other people not to be infected with potentially fatal diseases,” argues Powell.

We are running out of options

The coronavirus has been with us for a while, but so have vaccines.

At least in Europe, behind the vaccination mandates hides the frustration that, after months of mass vaccinations, there is still a significant population remains unvaccinated.

The president of the European Commission, Ursula von der Leyen, said a few weeks ago that this was the time to think about mandatory vaccinations, although she insisted that it was a decision that belongs to individual governments.

“We have vaccines that save lives, but they are not being used properly everywhere,” he said.

Is it hasty to force a vaccination?

Several strong health arguments support mandatory vaccination, but it is not the only way to increase levels.

“What’s quite remarkable in the past is how politicians like the idea of ​​mandatory vaccination because it seems to give a quick response to the problem,” says Samantha Vanderslott, a social science researcher at the Oxford Vaccine Group.

“I don’t want the government to neglect other things that need to be done to make sure people really have access to vaccines,” he adds.

Austria will not make vaccinations mandatory until February and is still using other means.

“For those who are afraid, who do not have confidence, for those whose risk assessment is low, it is important for them that they are listened to and that their concerns are taken seriously,” psychologist Barbara Juen told the national radio station ORF. , from the University of Innsbruck in Austria.

In South Africa, the percentage of vaccinated is lower than the European average but it is still higher than the average recorded for the entire African continent.

There is no shortage of vaccines in that country and low vaccination has been linked in part to misinformation.

The government has weighed making vaccines mandatory in some circumstances, but the number of vaccines administered has increased rapidly since the discovery of the omicron variant.

Sometimes governments are not the only ones providing ‘nudges’.

Would vaccines end lockdowns?

Varying in the level of harshness, lockdowns, the closure of some non-essential activities and travel bans have returned to some European countries this winter in the face of the omicron threat.

And is that compulsory vaccinations are not the only form of imposition. The above measures, which we have seen so much in almost all countries these two years, also have a high cost for mental health and the economy.

But in addition to saving lives, mandatory vaccination could spell the end of lockdowns.

“It is not only about disrupting your freedom … it is also about economic, mental and physical health damage,” argues Alberto Giubilini, researcher for the Oxford Uehiro Center for Ethical Practices.

This academic supports imposing vaccination on the most vulnerable to the coronavirus.

“There is no reason to impose the enormous costs of confinement on people when other measures are available.”

Can forcing vaccination be counterproductive?

Some experts are concerned that this type of measure generates distrust of future campaigns.

“Mandatory programs during a crisis can be counterproductive“Dr. Dicky Budiman, a World Health Organization advisor, explained in an interview with Al Jazeera.

“When people have what we call conspiracy theories, false beliefs or misunderstandings, these kinds of shows only reinforce their opinions.”

Dr Vanderslott uses climate policies as an example.

“We have seen, especially in Europe, how some parties oppose compulsory vaccination knowing that it can be a way to obtain votes from a certain section of the population,” he explains.

“We could see more parties, which tend to be on the right, exposing that message in their political campaigns and saying that they want to eliminate mandatory vaccination measures. It is a fear that, once it happens, will leave us without the option of continuing to use it as a measure. politics, “adds Vanderslott.

* Reportería by Thom Poole, BBC News.

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