Je suis un pro-vaxxer - mais les vaccinations obligatoires me mettent toujours mal à l'aise | Sean O'Grady

Je suis un pro-vaxxer - mais les vaccinations obligatoires me mettent toujours mal à l'aise | Sean O'Grady
I can well understand why it is being introduced in Germany and elsewhere, but I do fear how far they’ll take the policy – and if it will actually have the desired effect

What is going on in Germany? Even for a militant pro-vaxxer – I’m proud to be such – the idea of a general population-wide “mandatory” vaccination makes one uneasy.

I can well understand why it is being introduced in Germany, and Greece and Austria for that matter, because of their depressingly low coverage; but I do fear how far they’ll take the policy – and if it will actually have the desired effect.

Even in an emergency, you have to hold on to a sense of what will work. It is about drawing a line. At one end, it seems more than reasonable to require people working in health and care settings to be vaccinated, because it may reduce infection and transmission (to a degree) because it adds to a localised herd immunity effect, and of course the national one.

It’s also fair to ask those entering crowded indoor venues, including bars, theatres and restaurants, to produce evidence of Covid status, such as a documented negative test, and a vaccine certificate: a so-called vaccine passport. No one has a human right to get down at the disco. Germany seems to be extending that to “non-essential shops”, which is pushing it, but with some justification.

Reducing contacts reduces infections, après tout. At this point in the argument, it is sometimes still asserted that Covid is no worse than the flu and we have to “learn live with it”.

Maybe Omicron will prove relatively benign, if more contagious, but we don’t know yet. We need to be cautious because by the time we find out it isn’t nicer than the Delta variant, it’ll be too late. Hence the “panic”, which is simply the precautionary principle at work, albeit belatedly.

I’d say the last 20 months have suggested that Covid can be rather worse for more people than flu. It is endemic, but that doesn’t mean it can be ignored. It’s also pointed out that vaccination doesn’t stop anyone catching Covid – or passing it on.

That’s only partly correct. The unvaccinated are disproportionately represented on the Covid wards. Vaccines reduce the incidence of the disease – which is why death rates remain lower than in the pre-vaccine period.

Selon un récent rapport, fully vaccinated people can contract and pass on Covid-19 in the home – but at lower rates than unvaccinated people (which comes froma study of COVID-19 transmission between household contacts, led by Imperial College London and the UK Health Security Agency (HSA) et publié dansThe Lancet Infectious Diseases).

On that same basis, there’s a case for requiring people who work in other settings where they come into closer contact with large numbers of people – say, in schools, hospitality or public transport – to also be vaccinated as a condition of employment (with medical exemptions).

Bien sûr, individuals should also be required to wear masks, because they too help to reduce transmission. As with vaccines, the masks are not 100 per cent effective – far from it – but they add to our collective defences, and this is confirmed in another recent UKHSA survey of the evidence, which concludes that: "Globalement, the evidence suggests that all face coverings are, to some extent, effective in reducing transmission of SARS-CoV-2 in both healthcare and community settings.”

Donc, every little helps, and that includes vaccination. Dans ce contexte, in extreme conditions, it might be reasonable to ask parents to agree to vaccination for older children, provided it is safe to do so – special caution is needed.

It’s true that kids rarely suffer much from Covid, but the older adults they meet certainly do. The evidence in this pandemic of social and educational harm inflicted by sending pupils home from school is also real – so this should really be a very last resort in a pandemic spike and a collapsing NHS. Yet if it saves lives, then it would have to be enforced, as lockdowns have been over these past months.

In each case there is a link between “rights” and responsibilities: the right to a job being balanced with the responsibility to protect those around you. But then what? Instinctively, I used to feel that anyone unvaccinated is a potential killer on the loose, but I acknowledge there are limits to what should (or can) be done to carry public support.

Taking away a driving licence or passport is harsh, because the relationship between those rights and obligations are nothing to do with Covid. Should you instead start fining people again and again just for not being vaccinated? And what do you do if some cannot afford the constant penalties or refuse to pay?

Putting them in jail seems counterproductive, given how quickly Covid can spread in such an environment, so you run out of measures to enforce the law.

If you take health insurance away, they will be left to spread the disease before they die. Quelque, in any case, would welcome having martyr status. A government ought not break the commonly understood link between rights and responsibilities, between an act of behaviour and a condition of some particular act of behaviour.

These are so routine, we hardly think of them. If you have an income, you may be liable for income tax. If you take to the motorway, you don’t exceed 70mph (and you’ll have passed your driving test). If you want to convert your house into flats, you need planning permission.

Making a vaccination a blanket requirement is different, and sadly not understood; so you risk undermining the moral force of the public health campaign – which is about protecting others as well as yourself – and about acting responsibly under your own free will, as with most things we do in society.

Fining a hermit for simply not getting a jab seems absurd, and pointless. The most acute dilemma is that presented by the unvaccinated suffering from Covid and needing hospitalisation. Treat them or leave them?

Some say they ought not be given a bed on a ward, depriving others more responsible, but again that seems to be crossing a line. I’m not one of those who takes pleasure in seeing accounts of anti-vaxxers making literal death bed conversions to the vaccine.

Their illness is certainly self-inflicted – just like (arguably) smokers suffering lung diseases, or a dangerous sports enthusiast in intensive care – but of course, all have access to medical help.

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The unvaccinated Covid-sufferer is different in that it is an infectious disease, and they may well have harmed others – even killed them – along the way because of their antisocial behaviour, but it still feels wrong to withhold treatment simply because of their ignorance or personal choices. It would render them untreated and left in the community, like something out of a medieval plague, harbouring Covid.

Society still has vestigial obligations to them as citizens. Heureusement, Britain’s successful vaccine roll-out and sense of community (and self-preservation) has meant that these tough questions aren’t being asked of us. Encore.

But in other parts of the world – not just Germany with adequate vaccine stocks, but in places with appallingly low rates of take up and very high hesitancy and antivax propaganda, such as Southern Africa – the balance between individual freedoms and community safety is badly out of balance, and is forcing deeply unpleasant choices.

À la fin, mais, the right to life is the pre-eminent human right: a pandemic merely illuminates that truth.

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