Mandatory vaccination – the great divide
Police officer Vera Moss* insists she’s no anti-vaxxer, nor is she opposed to the COVID-19 vaccines approved by the World Health Organization. After all, she points out, she willingly took the first shot of the AstraZeneca, although she failed to...
Police officer Vera Moss* insists she’s no anti-vaxxer, nor is she opposed to the COVID-19 vaccines approved by the World Health Organization. After all, she points out, she willingly took the first shot of the AstraZeneca, although she failed to turn up for the second jab when it was due.
Vera continues to have questions about the effectiveness of the vaccine and said she was in no rush to take the second shot, although she has not ruled it out altogether.
But there is one thing the law-enforcement official is adamant about: no Caribbean government should force citizens to take the vaccine, despite the high level of hesitancy that has stymied the authorities’ efforts to reach herd immunity, she argued.
“This is ridiculous. I think people should have choices in this thing, man,” Vera told The Sunday Gleaner. “What’s the rush, what do they really have to lose if they don’t want to be vaccinated, why do we have to reach to the point where we have to be forcing people to do this?”
With the highly contagious Delta variant confirmed in a number of Caribbean countries, where vaccine hesitancy remains high, governments of the tourism-dependent states are mulling ways to get people to take the COVID-19 jabs.
In Antigua and Barbuda, where just 31 per cent of the population is fully vaccinated, with 39 per cent partially vaccinated, the Gaston Browne administration has adopted a hard-line approach to the issue. Much to the chagrin of the labour unions, Browne has declared that front-line public sector workers who provide direct services to arriving passengers and tourists must be fully vaccinated or be subjected to twice-monthly testing at their own expense. The government had initially indicated that each test would cost EC$260 (approximately US$96) but has since reduced the cost to EC$50 (approximately US$18).
This policy is a climbdown of sorts from Browne’s previous high of mandatory vaccination unless the twin-island state reached herd immunity by the start of this month.
“This is not a threat. We are struggling on a monthly basis to meet salaries and wages. Antigua and Barbuda is one of the hardest-hit countries, one of the most vulnerable, and you are telling me that we have the luxury of not getting vaccinated?” the Antiguan leader said in early May.
“Well, I want to say definitively to the people of Antigua and Barbuda that we do not have the luxury of not getting vaccinated, and if we do not get the herd immunity perhaps in the next 60 to 90 days, there is going to be weeping and gnashing of teeth in this country.”
There’s not much clarity here on the Andrew Holness government’s position on the issue, with the prime minister stating last week that he would not make “anything mandatory”, even as he suggested that vaccinated teachers would be treated “in some preferential way” that would be different from those who are unvaccinated.
However, with over 1,800 COVID-19 cases in July at a daily average of more than 130 new infections, the health minister, Dr Christopher Tufton, late last month mooted the idea of following the example of France, which last week enacted a controversial law that makes health passes mandatory for access to bars, restaurants, gyms and certain malls. Establishments that fail to enforce the rules will face penalties, and their employees could face pay suspensions – but not firings – if they fail to get vaccinated as well.
The US president, Joe Biden, also announced last Thursday that all federal employees and contractors must now be fully vaccinated against COVID-19 or face regular testing before returning to in-person work.
“There is going to come a point when we will have to give some consideration to some of those measures,” declared Tufton. “We have seen creative measures being deployed, including policy around access to work, to certain facilities [and] legislation that requires persons of a particular age to be vaccinated.”
Much of the regional governments’ vaccine policy is driven by economic considerations and pressure from the business community, which is having a difficult time recovering from the impact of the pandemic.
A debate on the controversial issue is currently raging in Barbados, where less than 35 per cent of the population is partially vaccinated and 26 per cent fully vaccinated. Some private sector enterprises are already demanding that their employees, as well as job applicants, must be double-jabbed. The Barbados Hotel and Tourism Association has also made it clear it plans to lobby the government to have tourism employees who are unvaccinated or those who will not disclose their status to be subjected to weekly PCR tests at their own expense.
No such decision has been taken by the Private Sector Organisation of Jamaica (PSOJ), although the number of unvaccinated workers is “a real issue” for business leaders, according to Keith Duncan, the PSOJ president, who told The Sunday Gleaner that he didn’t know if any of his members had insisted on workers taking the vaccine.
“We do not have a position on whether vaccines should be mandatory at this time,” said Duncan in a brief exchange. “What we know is that there are many people that are willing to be vaccinated and we are now getting the vaccines. Maybe when we hit the wall with vaccination it may become a consideration.”
With less than 10 per cent of the Jamaican population inoculated against COVID-19, and despite limited access to the vaccines, many are concerned that the efforts at reaching herd immunity have already hit the wall.
There are also increasing concerns among leading experts and authorities, including Dr Carissa Etienne, director of the Pan American Health Organization (PAHO), that the Delta variant, which is currently leaving a trail of tens of thousands of new cases and hundreds of deaths a day in the United States, will cause a new wave in the Caribbean, placing significant pressure on the health systems.
“There are a few things that I am worried about – certainly the low coverage of vaccination. So, when we see transmission at such high levels, it means that there will be significant pressure on our health systems – and we know the capacity of health systems in the Caribbean – and so we will begin to see significant numbers of deaths,” Dr Etienne told The Sunday Gleaner from Washington.
Despite these concerns, the PAHO boss shied away from offering any advice to regional governments on mandatory vaccination, preferring instead to focus on the importance of vaccines in the control of the coronavirus, and encouraging people to get the shots.
“It is clear that vaccines are our only way out of this pandemic. It is therefore important that when it’s your turn, that you do get vaccinated,” she stressed. “We do not get involved in member states’ decisions as to whether vaccines should be mandatory or not. What we do know is that we require a very targeted communications programme, both at the grassroots level, but also on social media, targeting communities, etc, to combat the vaccine hesitancy that is so prevalent across the world.”
Any attempt at mandatory vaccination – or forcing workers to pay for regular tests – will come with its own questions about the violation of people’s human rights and freedoms, and governments’ ability to impose remedies on the population. Already, one trade union leader in Barbados has threatened to take the government to court if it enacts legislation that allows private sector employers to force unvaccinated workers to pay for a COVID-19 test in order to be cleared to work.
Health authorities and supporters of mandatory vaccination have pointed to the fact that countries have taken such actions for centuries to protect their citizens.
The issue was discussed at a recent virtual forum titled ‘Mandatory Vaccinations: Legal, Justified or Effective’, organised by the Organization of Commonwealth Caribbean Bar Associations and the Organization of Eastern Caribbean States Bar Association.
During the forum, Dr George Mitchell, the spearhead of Grenada’s response to COVID-19, referenced the use of chlorine to purify drinking water for the prevention of cholera, laws governing food preparations to protect against food-borne illnesses, and the need for yellow fever vaccination cards to travel to certain countries.
“I must say I think an individual has the right to refuse a vaccine based on his medical condition or if that person does not endanger anybody at all because they don’t interact with anybody,” Dr Mitchell told the forum. “At the same time, I think that the state does have the responsibility and the obligation to protect its population from both physical and biological hazards, and so the question is asked, whether or not contextually, mandatory vaccine is something we need to delve deeper into.”
He said, however, that whatever decisions are taken in this regard, people’s individual rights must be respected.
The preservation of people’s rights is paramount, according to attorney Dr Lloyd Barnett, who said his views on the issue continues to evolve as more information becomes available.
“There are so many factors that need to be considered,” Barnett told The Sunday Gleaner. “It’s a changing situation and what works for one country won’t necessarily work for another, depending on the constitution, the level of incidence of the disease … so it is not anything precise.”
However, the Jamaican attorney said while there was evidence to suggest that the COVID-19 vaccinations were effective, the case for mandatory vaccination cannot be made unless the governments can prove that there are no reasonable alternatives.
“I [am] of the view that … the important thing is to push for the increase of the levels of vaccination and then if the figure that is targeted is not achieved then at that stage you can consider whether it can be made compulsory,” the respected attorney told the recent joint forum on mandatory vaccination. “But the evidence as it exists now, there is no basis on which it can be made universally compulsory; the compulsion would have to target specific groups.”
[* Name changed to protect identity]