By Keymanthri Moodley
The debate about mandatory vaccines has reached fever pitch as efforts to contain Covid-19 accelerate.
Compelling scientific, ethical and legal arguments have been advanced around whether or not people should be forced to get vaccinated.
Some countries have already introduced mandates that require people to produce proof of vaccination to access certain public places.
President Cyril Ramaphosa recently announced that the government had set up a task team to advise on vaccine mandates. Vaccine mandates that have been successfully implemented have shown a marked increase in the vaccine status of employees.
The private health insurer Discovery Limited is a case in point. Since introducing a mandatory vaccine policy, vaccine uptake among employees increased from 22% in September 2021 to 94% in November 2021. Several countries have introduced mandates.
They include France, Austria, Greece, the Netherlands and the US. The mandates were initially applied to healthcare workers who have an obligation to protect patients and colleagues from harm.
Now, vaccine passes are also required to access museums, restaurants, bars, gyms, public transport and shopping malls. In my view, there is a strong ethical case to be made for a vaccine mandate.
I agree with Jeffery Gerber and Paul Offit, paediatricians and epidemiologists, who wrote in an editorial in Science: A choice not to get a vaccine is not a risk-free choice; rather it’s a choice to take a different and more serious risk …
To date, only 36.8% of South Africa’s adult population has been fully vaccinated – with either a single dose of Johnson and Johnson or two doses of Pfizer. The aim was to cover 70% of the adult population by December 2021.
Clearly, the country has fallen far behind on this target. The key requirement of any mandate should be that a vaccination certificate is produced for access to high-risk public spaces where harm to others could occur. These include entry to all high-risk congregate environments. This would include gyms, restaurants, bars, nightclubs, indoor shopping areas, theatres, lecture halls, hospitals, clinics, conferences and trade shows.
Domestic flights ought to have similar requirements because the risk is similar, especially where inter-provincial travel can spread the virus from one hot-spot province to another with low incidence. This risk is being shown by Omicron.
But mandatory vaccine policies must include exceptions, such as someone having a severe allergic reaction to a first vaccine dose or having an allergy to a specific component of a vaccine.
The question of allowing religious objections is more difficult. However, most major religions have not specifically outlawed Covid-19 vaccines. South Africa is continuing to deal with the economic fallout from the pandemic, with fresh blows being felt in the tourism sector, in particular, as the result of a new wave in the wake of the Omicron variant announcement.
This makes the issue of a vaccination mandate all the more urgent. Clinical reports about Omicron suggest that people who are vaccinated are experiencing mild versions of the disease, while hospitalisations are predominantly of people who haven’t been vaccinated.
A vaccine mandate would achieve a number of objectives. It would improve vaccine uptake. Second, it would protect health and health systems. Third, it would allow the economy to revive and stay open. Fourth, tourists would be more inclined to visit countries with vaccine mandates because the countries would be perceived as being safer. This, too, would result in economic growth.
A win-win scenario for all.
* Moodley is a Distinguished Professor in the Department of Medicine, and Director, The Centre for Medical Ethics & Law, at Stellenbosch University.
** The views expressed here are not necessarily those of Independent Media and IOL.
