If we get a coronavirus vaccine, should it be mandatory?


The WHO last year declared vaccine hesitancy a global concern and amid the coronavirus pandemic, anti-vax voices have become louder. So would it be fair enough to make a COVID-19 vaccination compulsory? Or could that just generate more pushback? The Feed’s Alice Matthews investigates The Case for mandatory vaccination.

The science on immunisation is clear. Thanks to vaccines we’ve eradicated smallpox and suppressed diseases like tetanus and diphtheria to the point we almost forget they even exist. Now in the grips of a global pandemic, the anti-vaxxing voices and conspiracy theories have become louder. But there’s no denying a coronavirus vaccine is the fastest way back to normal life and some, like the chairman of the rugby league have already declared a COVID jab would be made compulsory.

So is an employer or a government right to demand immunisation? Or could that lead to more scepticism and hesitancy?

This week on The Case we’re looking at the three things we need to try and understand when it comes to compulsory vaccination: how a COVID-19 vaccine is different from others, fears over a vaccine vs. a virus and the effectiveness of vaccine mandates. 

How is a COVID-19 vaccine different? 

Vaccine development usually takes 10 to 15 years. In the rush to develop one for COVID-19, scientists are saying that process could be fast-tracked to under two years. So how is that even possible? And are we skipping any steps here? 

Scientists aren’t just working on one vaccine. There are more than a hundred in development.  Some are following traditional methods which can involve growing the virus in a chicken egg, deactivating it and putting it in the vaccine. 

Other scientists are using cutting edge technology that involves taking the DNA information of the virus and using it to genetically engineer the specific protein in the virus that triggers the body’s immune response. That method is so much faster than a traditional vaccine. 

The scientific community is working together to get things done simultaneously too.

“Millions of people are gearing up to ensure these checks and balances all work at every stage,” said Professor Kristine Macartney, the Director of the National Centre for Immunisation Research & Surveillance

“I don’t think people should be concerned about shortcuts. It’s really important to understand that all of the processes and procedures are occurring to make sure the vaccine’s effective, to examine safety,” she said. 

“The scientific endeavour is absolutely remarkable.”

So how much will the COVID-19 have to contend with vaccine hesitancy, an issue which the WHO last year declared a global concern?

Fears over a vaccine vs a virus 

It’s easy to be more afraid of a vaccine against something like smallpox, if we haven’t been around to see what the spread of a disease like polio actually looks like. But what about in the middle of a pandemic when people are dying and our lives are being impacted in front of our very eyes?

“The risk perception is focused more on the disease than the vaccine, so I suspect there won't be as much problem with hesitancy when it comes to the COVID vaccine,” said Professor Raina MacIntyre, Head of the Biosecurity Research Program at the Kirby Institute.

She says the hardcore refusers will still be hardcore refusers. But - and this is key -  those who are hesitant or on the fence could be brought on board. 

It is crucial to address those who, for example, fully vaccinate their children but might have concerns about the COVID-19 vaccine in particular, according to Dr Katie Attwell from the University of Western Australia, who analyses mandatory vaccination policies around the world. 

So what about mandates?

Mandatory vaccine effectiveness

While compulsory vaccination might get rates up, experts say the question is, how do we maintain peoples’ confidence in public health and vaccination programs, both now and into the future? And how do we avoid stoking anti-vax sentiment? 

Just to be clear, there’s no suggestion right now that a COVID-19 vaccine would be made compulsory by the Government. And Dr Attwell says any coercive Government measures should be a last resort.

“I think rather than saying what kind of stick are we going to have to beat people with? It much more needs to be a question of how can we understand what people are concerned about?” Dr Attwell said. 

Professor MacIntyre says that’s important because vaccines have gone wrong in the past, citing the 1950s polio vaccine where some batches became contaminated and gave children polio, or the 1990s rotavirus vaccine that had to be withdrawn due to rare side effects.

“The point is these things do happen sometimes and if you’ve used coercive methods, then you can lose public confidence and trust in vaccines. Once you've lost that it's really hard to regain it.”

But what about when it comes to employers like the NRL who are making their own rules? Dr Attwell says that’s different from a Government mandate. 

“Our employers are allowed to require things of us that are in the interest of being able to do that job, of protecting that industry,” she said. 

For some industries like healthcare, a mandatory COVID-19 vaccination would be expected. But it makes you question if one day we might have to prove we’re immune to coronavirus to work or travel abroad, or access childcare?

The Verdict

The thing is there are so many more questions we need to answer first. Like can we actually find a safe and effective vaccine? Can we make enough of it? Who gets it first? How many of us would need a jab to reach herd immunity? Ipso facto, how many people could society tolerate unvaccinated? 

Look, I will be lining up to get this shot and I think a lot of people are hanging out for this. 

But making a COVID-19 vaccine compulsory from the get go could create more pushback than we need and create further polarisation. Worst case scenario, it could end up alienating the very people who would make the vaccine work for all of us.

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