Compulsory COVID-19 vaccination is the issue that refuses to go away.
According to the minutes of its meeting in mid-December, it is under consideration by the National Public Health Emergency Team (Nphet). Nphet will discuss the issue “at a later date” in conjunction with a paper from the Department of Health on the ethical and legal considerations included in these notes.
Across Europe, this issue is a hot topic. In Italy, people over 50 are obliged to get vaccinated against COVID-19. Austria is planning to introduce compulsory vaccination for all citizens from April. A belligerent French president, Emmanuel Macron, says he wants to “urinate” unvaccinated people.
This trend reflects a growing frustration among some policymakers that overburdened health systems are having to dedicate themselves to treating unvaccinated patients. In countries historically disposed to compulsory vaccination schemes, this has resulted in harsh proposals.
Ireland, however, has different traditions, is in a different position and is unlikely to follow these examples.
The wording used in the Nphet minutes of 16 December about compulsory vaccination is the same as used at their meeting last month, and was reported by The Irish Times at the time.
The same wording also appears in the minutes of a meeting on 2 December, where members “voiced the need to exercise caution regarding compulsory vaccination”, noting its potential impact on social solidarity.
So while this issue is still under consideration, it is not being given priority. Agenda items have been moved from meeting to meeting, probably because officials were more immediately preoccupied with the increase in cases.
|confirmed cases in hospital||confirmed cases in ICU|
Barring a major drop in the pandemic – something that is within the bounds of possibility but not currently on the horizon – Ireland is not going to have mandatory vaccinations.
The main reason is outlined in the minutes cited above. Any attempt to force people to be vaccinated risks harming the solidarity that has “been the basis of Ireland’s response to COVID-19 to date”. Unlike other EU states, we have no vaccine mandate for children, for example.
But another reason is that so many people are already vaccinated. So far, 95 percent of our adult population and 92.4 percent of those 12 years of age and older have been fully vaccinated; 57.9 percent of adults have received a booster. The resulting “vaccine wall” is keeping the ICU relatively empty, despite record case numbers.
So less than 5 percent of the population has not been vaccinated – and a proportion of these will have some degree of immunity through prior infection. It is hard to see how society would benefit from forcing this small group to receive a vaccine in their arms against their will. It’s easy to see how much damage we can do by going down this divisive path.
We are making life difficult for already unaffiliated people. They have been kept out of many areas of the public sector, from restaurants to cinemas and gyms, as COVID-19 passes have been given wider and longer usage than originally envisaged.
There could be a strong case for compulsory vaccination if available vaccines work better to prevent transmission of COVID-19. AstraZeneca and Janssen. Preliminary research suggests that Omicron provide minimal protection against infection by variant, although Pfizer and Moderna seem to perform somewhat better.
Some studies have shown that vaccines have halved transmission of previous types, but this time they do not have much effect given the size of the omicron wave.
Vaccines continue to protect people from serious disease, but if they don’t prevent one person from passing the virus to another, should we punish people for the risk of infection just because they weren’t vaccinated? Is?
Even in health care, Irish policymakers have opted not to require mandatory vaccination of employees. Instead, individual employees are removed from frontline duties after a personal risk assessment; Managers may release them in their clinical roles if it is believed that their absence would pose a greater risk than COVID-19 transmission.
There are far bigger issues for Nphet to solve around our vaccination policy. Officials are already concerned about the short duration of protection provided by booster shots against Omicron, which could be as short as five weeks.
The head of the UK’s Committee on Immunization and Immunization, Prof Andrew Pollard, recently noted that vaccinating the planet every four to six months is not sustainable or affordable.
While Irish pockets may be deep, it’s not really even an option for us until perhaps vaccines can be developed that protect against all forms of COVID-19, present and in the future. And do we really want to give continuous medicine to healthy people at such short intervals?
For the foreseeable future, we are likely to hear again about ideas that were conveyed earlier in the pandemic, such as personal responsibility and protecting the vulnerable. Each of us must decide what level of vaccine protection we want, when to wear a mask, which mask to wear, and what other steps to take to reduce exposure to the virus. This would leave resources to focus on those who need protection the most.