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NO JAB, NO PAY

Australia won’t be the last country to wrestle with a mandatory coronavirus vaccine

Reuters/ Kai Pfaffenbach
Mandatory vaccines often lead to public pushback.
  • Olivia Goldhill
By Olivia Goldhill

Science reporter

Mandatory coronavirus vaccines make cold logical sense. At least 70% of a population needs to be inoculated to create herd immunity, and governments could easily achieve that rate of coverage if they demanded vaccines for all.

Australia discovered the pitfalls of this rationale after prime minister Scott Morrison announced a coronavirus vaccine would be “as mandatory as you can possibly make” earlier this week (Aug. 18). The policy, which granted exemptions on medical grounds, was backed by his minister for industry, science, and technology.

One day later, Morrison had changed his mind. “There will be no compulsory vaccine, but there will be a lot of encouragement and measures to get as high a rate of acceptance as usual,” he told 2GB radio. Australia typically has a high rate of vaccine acceptance.

His backtracking reflects both the legal and social difficulties in enforcing coronavirus vaccination in a population. Though Australia is the first country to publicly grapple with such tensions, similar dynamics are playing out internationally.

Long before Covid-19 emerged, the public health benefits of vaccinations had pushed several countries to make certain immunizations mandatory for their populations. European Union countries including Italy, France, and Germany have compulsory vaccines against diseases like measles, tetanus, and polio.

But other countries explicitly protect citizens from enforced state health interventions.

Australia, for one, grants a right to bodily integrity, meaning everyone must consent to medical treatments. The country allows for public health exemptions if someone has an infectious disease that puts others at harm, but this exemption applies to treatments rather than preventative vaccines. There would have to be an amendment to enforce vaccinations for the public health good, which could well face legal challenges.

Similar concerns affect many countries: “[A mandatory coronavirus vaccine] would be unenforceable and not appropriate,” Anthony Fauci, director of the US National Institute of Allergy and Infectious Disease (NIAID) said yesterday (Aug. 19.) during a video talk organized by George Washington University.

Legislative obstacles are further reinforced by public pressure. The threat of mandatory vaccination has been a focal point for those with vaccine fears, both pre- and post-coronavirus. A Facebook group with more than 150,000 members called “Stop Mandatory Vaccinations” was last year revealed to be one of just two organizations responsible for the majority of anti-vax ads on Facebook.

In the face of such public fears, some public health experts warn mandatory vaccination programs could increase vaccine hesitancy. This is especially true before scientists have completed coronavirus vaccine trials, Julie Leask, a researcher on vaccine refusal at the University of Sydney and the National Center for Immunization Research and Surveillance, told the Guardian. Access to data showing that a vaccine is safe and effective can build up public trust, she says, while government coercion risks building anger and pushing away those who are uncertain.

If mandatory vaccinations carry the counterintuitive risk of decreasing uptake, governments must find other ways to achieve herd immunity.

In Australia, Morrison says uptake will be “encouraged” if not mandatory. He didn’t provide specifics but, as social services minister, he rolled out “no jab, no pay” policies in 2015 that ruled families that refused to vaccinate their children according to government recommendations would lose several tax benefits. In Victoria, Australia “no jab, no play” policies demand children must be vaccinated to attend school or kindergarten.

Until a coronavirus vaccine is successfully developed and released, there’s no way of knowing if such measures will be necessary. In May, UK health secretary Matt Hancock said he expects a “huge proportion” of the country to take a vaccine because of its “obvious benefits.” Though enforced vaccination may represent an infringement on freedom to some, the chance to be vaccinated and return to normal life carries a promise of freedom for many others.

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