Should We Be Worried About Mandatory Vaccines Or Government Coercion?
Over the last few weeks we have heard a lot of talk about Covid-19 vaccine(s) potentially being mandatory. While UK government officials, including the prime-minister himself, have contended that this is simply the fantastical thinking of ‘anti-vaxxers’, comments from Health Secretary, Matt Hancock, have still left a great deal of doubt for many people about the governments future actions.
However, is a mandatory vaccine what so called ‘anti-vaxxers’ should be worried about, or might there be a set of policies that seek to coerce the public into receiving a vaccine without using brute force?
Ultimately, we can only speculate how the British government might attempt to achieve its goal of vaccinating 70% of the UK population by examining how other governments have attempted to do so in recent history. However, it appears – through an analysis of Public Health (Control of Disease) Act 1984 & Schedule 21 of The Coronavirus Act 2020 – that there may already be elements in place to halt those who do not take the vaccine from potentially infecting others.
Will The Vaccine Be Mandatory?
On November 16th, Health Secretary Matt Hancock was asked by Julia Hartley-Brewer of Talk Radio (see below), if the vaccine would be compulsory for people to take. Hancock would initially respond to this question by stating the following:
Well it’s complex because there’s some people, who for medical reasons, can’t have a vaccine and so it’s a complex question. Of course, I want as many people as possible to take it and we won’t allow it […] and the regulators wouldn’t let it happen until it is both effective, which we know on the BioNTech and Pfizer one, and safe.
Matt Hancock
Unsatisfied with this response, in which Hancock had completely dodged the question at hand, the Talk Radio host would interject, exclaiming: ‘it’s not that complex a question is it. Are we going to force people to have the vaccine or not?’
Well we’re not proposing that it’ll be mandatory and I thought, partly for the reasons that I set out, that some people can’t have it, for instance for medical reasons. But we do want a very large proportion of people to take it.
Matt Hancock
After some more bureaucratic bumbling around the question, the Health Secretary was asked for a third time whether he would ‘categorically’ rule out the possibility of making it compulsory to take, at which point he would respond by stating that:
Honestly, I’ve learned not to rule things out during this pandemic because you have to watch what happens and you have to make judgements accordingly.
Matt Hancock
Downing Street would later state that they are not proposing to make the Covid-19 vaccine mandatory. However, they have not seemed to rule out the possibility of coercion, on some level. When asked whether there could be restrictions (i.e. a public transport ban, or preventing individuals from returning to work) placed on those who refused a vaccine, the spokesperson would comment that: ‘we are not proposing to make it mandatory.’ Read between the lines here, and you might well assume that penalties are likely to be put in place for those who do not voluntarily take the vaccine.
How Might The Government Convince People To Take The Vaccine?
A great deal of scepticism has risen around many aspects of the covid-situation. People have started to question the effectiveness of lockdown procedures, the wearing of masks, and the claims and data of scientific experts.
A study by King’s College London and Ipsos MORI has shown that one in six people (16% of 2,237 interviews with UK residents) are ‘unlikely to’ or ‘definitely won’t’ take a vaccine for Covid-19. Of these individuals, 37% believe that ‘face masks are bad for people’s health’, while 34% think that they ‘do not reduce the spread of COVID-19’ and that ‘the government only wants people to wear them as a way of controlling the public.’
While a distrust for a Covid-19 vaccine is still relatively low within the UK, it appears that such sentiments are much more established in the United States. The Kaiser Family Foundation (KFF) published a study (Sep 10, 2020) on the approval of a Covid-19 vaccine in America. They would find that 54% (of 1,199 interviewees) of Americans would not want to get vaccinated for Covid-19 even if it was freely available.
If governments wish to hit their predicted vaccination target of 70%, then it appears – in the US at least – that they will have an upward climb to achieve this. While debates are raging on the pros and cons of a mandatory vaccine, it appears what is more likely to occur is either positive or negative coercion.
Potential Forms Of Positive Coercion:
An Oxford University Professor, Julian Savulescu, who researches the ethics of various emerging technologies, released a paper titled: Good reasons to vaccinate: mandatory or payment for risk?
Savulescu argues that governments should employ a ‘payment for risk’ policy, whereby citizens can voluntarily take the vaccine and are encouraged to do so through either a payment of cash or in kind.
The advantage of payment for risk is that people are choosing voluntarily to take it on. As long as we are accurate in conveying the limitations in our confidence about the risks and benefits of a vaccine, then it is up to individuals to judge whether they are worth payment.
However, with the Institute for Fiscal Studies (IFS) predicting a budget deficit of £345 billion (16.7% GDP) to £376 billion (18.9% GDP) for 2020/21, it seems unlikely that the UK government will begin a program for paying each of its 67 million citizens a cash prize for taking on the vaccine.
Savulescu has therefore suggested an alternative ‘payment’ method, whereby certain normalities (which we once took for granted), are returned in exchange for participating in the vaccination program:
An alternative “payment” model is to pay those who vaccinate in kind. This could take the form of greater freedom to travel, opportunity to work or socialise […] One attractive benefit would be the freedom to not wear a mask in public places if you carried a vaccination certificate, and not to socially distance.
However, as Savulescu himself has admitted, both models have serious flaws. Introducing a pay-to-win scheme may very well increase vaccine uptake (particularly in times which are economically difficult), although it will likely come at a high price. By placing cash into the equation, it will almost certainly raise a red flag in the minds of many; signalling that the vaccine is largely untested and unsafe to take.
Even if this monetary stimulus is substituted for a ‘payment in kind’, in which certain freedoms are restored, it too will almost indefinitely arouse suspicion. People will witness that their so called ‘freedom to choose’ is not that much of a choice at all. Those that take the vaccine will be able to return to normal daily life, while those that remain sceptical are left side-lined and at a distance (quite literally).
Some might object that this represents a form of shaming the non-vaccinators (some of whom might be excluded from vaccination for health reasons), just as presenting those who evaded conscription with a white feather was a method of shaming perceived free-riders.
Potential Forms Of Negative Coercion:
The difference between Savulescu ‘payment in kind’ and forms of ‘negative coercion’ may, in some regards, only present a difference in framing, however, it is nonetheless important to discuss how the government might take more draconian measures, in their attempt to convince the British populous that taking the vaccine is a good idea.
Travel:
UK citizens may be subject to receiving a ‘health passport’ or some form of ‘digital immunity certificate’ in an attempt to ‘provide evidence of an individual’s Covid-19 status at any given time’, as is highlighted in a report by the Tony Blair Institute for Global Change.
This would be used to limit those who have either tested negatively or who have not received a vaccine from travelling freely: nationally or internationally.
While many may contend that a scheme of this sort is necessary in order to halt the spread of the virus, it will pose concerns for those that do not feel it is safe to take the vaccine; limiting their freedom and preventing them from being able to visit their family, friends or have access to certain resources.
Jobs:
During lockdown many people have begun to climatize to the idea of working from home. But as lockdown restrictions relax (at least for those who have taken the vaccine), we could see unvaccinated persons being stopped from returning to their work spaces, in order to prevent infection.
While this may initially appear to be a relatively harmless precaution, it will undoubtedly further isolate those who are already feeling that they are living in a world that is not listening to their side of the story.
Worse yet, employers may be reluctant to keep workers on their pay-role who are unable to take part in routine activities that require a physical presence. Although the workplace has and certainly will continue to develop in the coming months and years, it seems unlikely that businesses will be overjoyed with those who go against the grain of health and safety practices.
In recent weeks, reports have discussed a group of NHS staff who have taken to Facebook, in a group titled: NHS Workers for Choice, No Restrictions for Declining a Vaccine (which has now either been deleted by the hosts, Facebook itself or has been buried by the respective companies algorithm).
The group would include a GP, several accident and emergency nurses, healthcare assistants, lab workers, and private and public care home staff.
With many facilities/areas of the U.S. mandating that healthcare workers recieve a vaccinne, the UK could seek to impliment a similar set of policies for medical professionals once the release of a Covid-19 vaccine occurs.
Benefits:
A No Jab, No Pay scheme may be put in place in the UK if a vaccine for Covid-19 manages to be introduced.
This practice has been adopted in Australia whereby family and childcare payments are withheld from people who claim to be ‘conscientious objectors‘ to vaccination and prohibit their children from recieving certain vaccines.
However, this policy is had very small impact on convicing ‘anti-vaxxer’ parents from immunizing their children as a recent study within the Australian and New Zealnd Journal of Public Health has identified.
The proportion of children aged five to less than seven years who received catch-up MMR1 [first dose measles, mumps and rubella vaccine] vaccination was 13.6% (4,719 of 34,793 unvaccinated children) during the baseline period and 12.9% (4,169 of 32,321 unvaccinated children) during the ‘no jab, no pay’ period,” the study found.
Of 407,332 incompletely vaccinated adolescents aged 10 to less than 20 years, 71,502 (17.6%) received catch-up MMR2 [second dose measles, mumps and rubella vaccine] during the first two years of ‘no jab, no pay’. This increased overall coverage for this age group from 86.6% to 89.0%. MMR2 catch-up activity in this age group was greater in the lowest socioeconomic status areas than in the highest socioeconomic status areas (29.1% v 7.6%), and also for Indigenous than for non-Indigenous Australians (35.8% v 17.1%).
Australian and New Zealand Journal of Public Health: ‘Immunisation coverage and socioeconomic status – questioning inequity in the ‘No Jab, No Pay’ policy’
Therefore, if the UK government does seek to impliment this strategy, in an effort to convince people to take a vaccine for Covid-19, then they will likely have to target more than one source of benefit income if they are to have a chance of coercing the 1/6 of the population that are currently dubious.
What Does The Law Say? Public Health (Control of Disease) Act 1984 & Schedule 21 of The Coronavirus Act 2020:
However, the question remains: would it be possible for the government to mandate that its citizenry take a vaccine?
Under current legislation, vaccines are not compulsory. While the government is given the power to prevent, control or mitigate the spread of an infectious disease or contamination, they cannot (under sections 45A-T of the Public Health (Control of Disease) Act 1984) mandate an individual to have treatment or vaccination.
45E Medical Treatment states the following:
- Regulations under section 45B or 45C may not include provision requiring a person to undergo medical treatment.
- “Medical treatment” includes vaccination and other prophylactic treatment.
Additionally, Schedule 21 (Powers Relating to Potentially Infectious Persons) of The Coronavirus Act 2020 does not allow for mandatory vaccinations. However, it does provide extensive powers to public health officials, police, and immigration officers for the period in which the Secretary of State has declared that:
- the incidence or transmission of coronavirus constitutes a serious and imminent threat to public health in England, and
- the powers conferred by this Part of this Schedule will be an effective means of delaying or preventing significant further transmission of coronavirus in England,
This information can be found in Part 2 (Powers Relating to Potentially Infectious Persons in England) 4.1 of Schedule 21.
These powers exist in respect of a person who is potentially infectious which means that:
- the person is, or may be, infected or contaminated with coronavirus, and there is a risk that the person might infect or contaminate others with coronavirus, or
- the person has been in an infected area within the 14 days preceding that time.
Following an assessment (see: summary by Louise Hooper of Garden Court Chambers or the full Schedule 21 document for information about powers related to screening and assessment), if screening confirms a coronavirus infection, powers are granted to a public health officer (§14) to impose further restrictions and requirements for a period of 14 days (§15). There are, however, provisions for an extension on this period.
After the imposition of a restriction to citizen (§14) a public health officer must assess the person within 48 hours (§15.2a) and ‘reconsider which requirements or restrictions’ (§15.2b) are necessary and proportionate to impose on that person.
Following this, the public health officer may revoke the restriction or specify a different period that does not exceed 14 days (§15.3a) or substitute another form of restriction contained within §14 (§15.3b).
However, under §15.4, if ‘the public health officer revokes the requirement to remain or the restriction, the Secretary of State may, if satisfied that the person is potentially infectious, re-impose the requirement or restriction (for the period originally specified).’
Furthermore, a public health officer may extend the period if they suspect that ‘the person will be potentially infectious at the end of that period’ (§15.5a) and/or if they deem it necessary for the for the following purposes (§15.5b):
§14.2: Powers Exercisable After Assessment:
- in the interests of the person,
- for the protection of other people, or
- for the maintenance of public health.
The period by which a public health officer may extend ‘requirements’ is limited to a 14-day period (§15.6) if it is in relation to the following requirements:
§14.3: Requirements:
- to provide information to the public health officer or any specified person;
- to provide details by which the person may be contacted during a specified period;
- to go for the purposes of further screening and assessment to a specified place suitable for those purposes and do anything that may be required under paragraph 10 (1);
- to remain at a specified place (which may be a place suitable for screening and assessment for a specified period;
However, it states in §15.6 that the ‘requirement to remain in isolation’ (§14.3e) is exempt from this rule.
Although the public health officer must review the requirement or restriction ‘at least once in every period of 24 hours’ (§15.7) and ‘a person on whom a requirement or restriction is imposed […] may appeal against it (or against any variation of it or any extension of the period to which it relates) to a magistrates’ court’ (§17).
Albeit this ‘loophole’, in which one can be kept in isolation, for a potentially indeterminant amount of time, is concerning. While mandatory vaccinations may not be legal, there is seemingly an opportunity to keep those that do not take the vaccine voluntarily under ‘house arrest’ (or some other manner or form).
This can be enforced (§16) either ‘by a constable or public health officer removing the person to the place’; ‘by a constable or public health officer keeping the person at the place’; or ‘if the person absconds, by a constable taking the person into custody and returning them to that place or another place a public health officer may specify.’
We may therefore see that, in interests of maintaining public health and for ‘protection of other people’, individuals who decide to not take the vaccine will be kept against their will to slow the progression (or potentially cease) the spread of Covid-19.
