Should the state enforce vaccination?

Published by The i paper (1st March, 2021)

Britain’s vaccine programme has been a stellar success, all the more welcome after the disasters leading to our dreadful pandemic death rates. Twenty million people have been given first doses since Margaret Keenan started the rollout in early December. After I received mine, I walked home with a big smile on my face and bounce in my step; it felt like I was heading back to a world of handshakes, hugs and humanity. Some people dress up to celebrate getting that precious needle jabbed in their arm, while others burst into tears such is their emotional release over an injection of hope.

These feelings are unsurprising. Lives have been shaken and certainties shattered by this bleak year of tragedy and trauma. Even leading pandemic sceptics have found excuses to take their medicine. Now there are signs of tumbling death and infection rates as highest-risk people receive protection. In one sign of the sudden burst of optimism, boosted by the sun’s arrival, summer music festivals have sold out. In Israel, where half the population has been vaccinated, a concert was held last week in a Tel Aviv park after a hiatus on such events for 11 months.

These vaccines were developed quicker and work better than we dared hope. Yet concerns remain when a significant rump of people remain hesitant, fearful what they might be putting into their bodies. This is a major problem if there are millions of potential host bodies left to infect since it will make it hard to suppress the threat, especially with new strains constantly emerging. As one official said, do the maths: if there is 85 per cent efficacy and 85 per cent of people are injected, only 72 per cent of adults are protected along with all the unvaccinated teenagers and children.

This begs the question of compulsion: should the state enforce vaccination?  These are not new concerns: vaccines have long sparked resistance, even rioting at some points. Edward Jenner was mocked in the late eighteenth century when he started using cowpox to inoculate against smallpox. Sixty years later Britain followed Sweden with a law mandating smallpox jabs for children, yet Victorian anti-vax activists raised spurious fears over other sicknesses so a “conscience clause” was later added permitting parents to seek exemption. More recently we have seen the toxic campaign against MMR vaccines, despite their incredible success in slashing infant mortality rates.

Now we live in the digital world, which makes it harder to counter and campaign against scaremongering. Laughable ideas such as Bill Gates implanting us with tracking microchips in vaccines fly around social media, spread on smart phones bought with bank cards that both trace movements. 

Last week I saw the corrosive impact of these rumours, talking to people from ethnic minorities in east and north London who are worried over the vaccine – including a carer who initially resisted a jab after seeing videos purporting to show nurses suffering strokes and dying from them. Previously I have investigated anti-vaccination movements in Italy and the United States after their pernicious activities sparked measles outbreaks.

There seem two distinct groups of sceptics: older people at risk or those working on the frontline, yet still hesitant, and younger folk who think this virus does not affect them. “I won’t have a vaccine as I don’t need it,” said one 21-year-old student firmly, failing to see the collective need for society. Others had rational – if flawed – qualms over speed of vaccine development and, for younger women, impact on fertility. 

Yet it was frightening to find outlandish ideas – such as the belief anyone getting the jab will drop dead or that it is designed to decimate ethnic minorities – taking a grip. Mind you, I spent five weeks reporting on the US election where I frequently found people who fell for Q Anon craziness about Donald Trump’s secret war on elite Satan-worshipping paedophiles in government, business and the media.

These issues expose problems seen before the pandemic. The calamitous breakdown in trust between citizens and their institutions, most notably the government, which let conspiracy theories take root. The sense of alienation felt among some ethnic minorities, dismayed by inequalities and prejudice that still pervade parts of society – seen so starkly with the Windrush scandal or health statistics showing black woman four times more likely to die in pregnancy or childbirth in this country. The hypocrisy of social media firms that preach liberal values yet fail to stop promotion of hate and lies. The self-serving activists who use these sites to build global brands and profit from fear. Perhaps even the widening divergence between different generations.

Such problems must be addressed to build back better. Yet they highlight also why it would be wrong to use the full weight of the state to enforce vaccination. Ultimately, citizens must retain the rights over their own bodies, even if this means they suffer consequences and deny something of benefit to the rest of society. Such informed consent is the basis of medical ethics.

Meanwhile coercion would only fuel fears of those influenced by the fantasists and anti-vaccination activists, who would argue the draconian measure “proves” their absurd theories of global cover-up. Sadly, as one minister said to me, there is no silver bullet to stop vaccine hesitancy. It relies on leadership at every level of the state and in communities, along with individuals getting the jab and telling family and friends. One more reason to give thanks that 20 million Britons and 214 million others have taken this path out of pandemic.

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