Mandatory vaccination: legal, justified, effective?

Anne McMillan Friday 19 March 2021

[Excerpt]

Vaccine programmes being rolled out around the world have provided hope for many, but are causing concern and opposition among others. Global Insight assesses how governments and medical authorities should respond and whether compulsory vaccination is the answer.

Vaccination against Covid-19 is seen as a route back to normality, an escape from the current restrictions which mean we can’t shake hands, hug loved ones or travel freely. For some people, vaccination promises release from the fear the virus may strike them, a relative or a friend, hope of reinvigorating a moribund livelihood or resuming a child’s disrupted education.

But, while millions wait anxiously, counting the weeks or months (probably years in some low-income countries) until they reach the priority vaccine group, others fear that their refusal to accept a vaccine against Covid-19, regardless of the reason, will isolate them by labelling them unsafe to be around, and may even affect their ability to earn a living.

The controversy over vaccines is nothing new. When Edward Jenner created the first vaccination against smallpox in 1796, it was initially seen as miraculous solution to a disease which was killing millions worldwide. But it wasn’t long before his vaccination began to attract opponents and when smallpox vaccination was made compulsory in the UK by the Vaccination Act of 1853, the legislation only served to increase resistance.

By the late 19th century there was strong anti-vaccination sentiment in parts of Britain. Anti-vaccination leagues were formed and thousands took to the streets to demonstrate against what they saw as an invasive practice. Objections included religious or health concerns, along with the recurring theme of the trampling of individual rights, which resonate in the cries of present-day vaccine objectors. The scale of anger led to the legislation being amended in 1898 to allow for ‘conscientious objection’ to receiving a vaccine.

Now, with the Covid-19 pandemic, the issue has come to a head again and not just in Britain. Around the world the controversy over vaccines seems as fresh today as it was when Jenner first discovered his answer to smallpox. Two centuries later, similar objections are being raised by vaccine sceptics and opponents, some of which merit a hearing. ‘There is a need to recognise that beyond general vaccine sceptics and/or those simply buying into the latest conspiracy theory expounded on social media, many people may hold genuine fears and anxieties about vaccination in general (or relating to specific vaccines),’ says Barbara Connolly QC, member of the IBA’s Family Law Committee Advisory Board.

Beyond general vaccine sceptics and those simply buying into the latest conspiracy theory… many people may hold genuine fears and anxieties about vaccination

Barbara Connolly QC
IBA Family Law Committee Advisory Board

So, what have we learnt since the 19th century? Do arguments for and against vaccination still hold? And if so, how can, and should, governments and medical authorities respond? Perhaps most important, is mandatory vaccination legal and justified from a human rights perspective, or effective given this new threat to public health?

Vaccination fears

What is it about vaccines, one of the most simple and successful medical interventions ever, that attracts so much controversy? One characteristic of vaccination is that it is preventative rather than curative and so is generally rolled out on a widespread scale, thus magnifying any potential risk. As the President of the European Commission, Ursula von der Leyen (a qualified physician), said when justifying the comparatively longer time it took for the European Union to declare early Covid vaccines safe: ‘A vaccine is the injection of an active biological substance into a healthy body. We are talking about mass vaccination here, it is a gigantic responsibility.’

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