People have a right to refuse vaccine. But when exercising any rights, the decision must weigh the potential benefit against the potential harm both for the person and for their neighbours.
Covid, now in the form of the Omicron variant, continues to challenge the institutions and values of Western and other democracies, particularly concerning freedoms and their curtailment in the quest to keep people safe. The degree to which freedoms are to be denied to the unvaccinated is a dilemma of immense significance. Once again, as in the Summer, the UK, particularly England, is a crucible taking informed risks, but risks nevertheless, backing judgement against modelling pressure in its reluctance to impose draconian restrictions too quickly. The UK Government is also showing itself to be an outlier in its non-discrimination against the unvaccinated, or at least not rushing to discriminate unless the data and facts seem to make freedom denying measures unavoidable. At least in the run up to Christmas there was sufficient uncertainty over the ability of Omicron to defy vaccines and cause severe illness and death in the vaccinated population. Even the most vocal critics of any Covid decision made by UKGOV are conceding that it may be worth waiting before moving to a next level of restrictions which will be damaging and expensive, in both general health and economic terms, but which may also shine a spotlight more on the unvaccinated element of the population. This is certainly the case in Europe and the USA.
THE GROWING RESENTMENT TOWARDS THE UNVACCINATED
If in the UK and other Western countries 100% of the population was double vaccinated and rapidly getting a third booster, it is reasonable to say that the health services would be considerably less troubled by Covid patients and at low risk of being overwhelmed. It is the risk and so the fear of overwhelming health services which justifies in Government minds the imposition of extreme restrictions such as lockdowns. But everywhere an excessively high percentage remain unvaccinated: in the UK perhaps 10% of those eligible are unvaccinated, some 5-6 million people.
Perhaps75% – 90% of Covid hospitalisations today are of unvaccinated people. These hospitalisations absorb beds, staff and other resources which could otherwise be available to non-Covid patients with severe conditions. While the vaccinated can be infected by and carry Covid, the unvaccinated are considerably more likely to do so. There are suggestions that NHS staff are increasingly frustrated that avoidable cases are seriously adding pressure on medical workers and that the queues of the untreated public are unfairly growing. Perhaps there is a growing body of public opinion that the unvaccinated are the prime cause of disruption to society’s way of life as well as the economic damage and uncertainties restrictions cause. Are families dividing between the vaccinated and the refuseniks? Tony Blair, among others, refers to those eligible for vaccine who refuse it as “idiots”: hard to disagree some may say but all deprecation such as that fuels the fire of divisiveness. Evangelical anti-vaxxers have sought to deter children from vaccination, and it is reported are booking vaccination appointments and not taking them up to stop others getting vaccinated, as well as spreading misinformation on social media: growing animosity against anti-vaxxers could translate into growing animosity against the unvaccinated in general. Is anti-vaxxer behaviour almost treacherous given the country is fighting an unseen enemy with war comparisons not uncommon?
Getting the unvaccinated to get the jabs, as well as delivering the boosters, is the strategy to contain Omicron. Leaders, the media and influencers must employ all available means to persuade and cajole to implement the strategy urgently. As well as being socially disastrous, it could be highly detrimental to the strategy if the unvaccinated become an underclass, pilloried, the new “lepers” or “pariahs”.
The vaccinated v unvaccinated discussion threatens also to set region against region, particularly if more severe nationwide restrictions are contemplated. There are huge variances between regions as to the proportion of unvaccinated people. Why should a region where the people have been “good” and taken the jab suffer due to other regions where the unvaccinated make up a large percentage of the populace?
London is the epicentre of Omicron infection. It is also the least vaccinated part of England: over 30% of those eligible are said to be unvaccinated. And so, 15 out of the 18 Council areas of England where over 20% of over 60s have not had a booster are in London. What are the reasons? Is it that London has a more itinerant population, people less connected with GPs or the rest of the health system? Is it that London has the highest percentage of ethnic minorities with an aversion to vaccine? London hospitals are most at risk of being under excessive pressure, with NHS staff numbers being depleted by a high rate of infection of them as well as so many unvaccinated being hospitalised. It is arguable that the most unvaccinated areas such as London should be more restricted than other parts of England which are properly vaccinated. Though regional divisiveness is dangerous, circumstances now are different and perhaps a region-by-region approach should be back on the table, if more extreme measures such as lockdown get considered.
RESTRICTIONS VERSUS FREEDOMS
The imposition of relatively innocuous restrictions such as the mask- wearing and social distancing guidelines has become easy to do. Whether there is strong adherence is unclear, especially as even requirements to isolate for those with the virus are not believed to be strongly observed. Arguably now people tend to make their own decisions as to risks and the mitigations appropriate for themselves. While a body of mainly Tory MPs oppose any restrictions, most seem to kowtow to them. Those who oppose are accused of party politics and ignorance of public health, but perhaps it is a healthy democratic sign that there are people for whom individual choice and liberty are paramount. The debate on that front must never die. Even lockdowns are being imposed relatively easily in certain countries. Nobody disputes that such events can have severe adverse health as well as social and economic consequences, with the worst affected being the most deprived in society. They should only be a last resort, and some would say they should be off the table entirely.
The more readily draconian or even less severe measures are accepted, the more devalued become the freedoms which they curtail, and the danger of those in power seeing a precedent for controlling the public in the future is real. There must be a concern that in the Western and other democracies today the speed and ease with which the unvaccinated are being segregated from the vaccinated in terms of their rights is an erosion of liberty that requires real checks and balances:
- In the USA the unvaccinated are mostly barred from working in attendance at federal workplaces; in New York State they are being prejudiced also in the private sector; vaccine passporting is now established.
- In the Netherlands, a lockdown is in place and the unvaccinated are barred from some activities.
- In Germany, the unvaccinated are barred from public life, such as restaurants and leisure facilities. Vaccination is expected to become compulsory in February 2022 – what does that entail for those who refuse? Fines? Prison?
- In Austria the unvaccinated are locked down, and compulsory vaccination is likely.
- France, with the USA supposedly the home of liberty, has created an unvaccinated underclass.
- In some countries there is mooted the possibility that the unvaccinated must pay for hospital treatment if they catch Covid: Singapore, an authoritarian State, has adopted that and In Australia this idea seems to be acquiring traction.
Most European nations are dividing between unvaccinated and vaccinated. This article does not seek to assess restrictions in Asia, but Omicron is driving severe controls there, such as in Thailand and Singapore. The unvaccinated will be finding travel rules for them are more stringent everywhere.
Extraordinarily and embarrassingly perhaps, in Wales, First Minister Mark Drakeford, while critical (perhaps foolishly) of the more relaxed approach in England, has introduced fines for those who should work from home but who are caught travelling to work without a reasonable excuse, and higher fines for employers. The UK needs to beware of those with power at the top of government in national assemblies, as well as Westminster, becoming careless of the liberty of their “subjects”.
IS THE UK A LONE CRUSADER FOR VACCINE FREEDOMS?
UKGOV in England seems still to hold freedoms dear, but not to the satisfaction of all. That restrictions when proposed will be put to Parliament first is healthy. While detractors continue to decry the reluctance of UKGOV to adopt stringent measures without at least data justification, the public are entitled to expect the leaders, especially the Prime Minister, to exercise judgement and not rush to easy lockdowns or vaccine passports generally, depriving the unvaccinated of rights. The requirement for NHS personnel and carers in care homes to be vaccinated is exceptional. If compelling data proves that Omicron is likely to cause the NHS to collapse, tougher measures may emerge but there is a level of optimism that the worst effects of this variant can be mitigated. The idea of mandatory vaccination Is anathema in England, hopefully. Of course, with hindsight detractors may be proved right but this is the world of catch 22 decisions. It is too easy for political opponents and commentators with no responsibility for decisions to flip flop wherever the best political positioning takes them, but is anyone fooled when the leader of the opposition declares he is not playing politics but is guided by public health interest? As a lockdown fan, he surely needs to beware of abusing the unvaccinated.
UKGOV focus is persuasion, persuasion, persuasion of people to get vaccinated. The media and influencers need to align themselves with this message. Nobody is helped when premier league footballers, to whom the unvaccinated young look to as heroes, refuse vaccination. Until but two weeks ago, almost 40% of them were unvaccinated. The number taking the jab is increasing slowly, but their position is doubly galling as Covid infections among team squads cancel matches which are an important public entertainment. Perhaps these role models, so called, should be ambassadors for vaccination, as should all at the top of their sport: don’t they have a special social responsibility? At the other end of the spectrum, it is unhelpful and seemingly unkind that the Archbishop of Canterbury implies that the unvaccinated are “immoral”.
LET PEOPLE CHOOSE THEIR FATE
It is axiomatic that it is time to live with the virus. Sadly, no country can afford to let its health system collapse, but the continuing erosion of personal freedoms is a dangerous cancer which, Covid aside, could easily spread if Governments are too ready to impose shackles on the public. It is good the UK government is loathe to interfere too quickly, and it appears people have become more able to form their own view about risk, self-policing their health priorities. The divisiveness of the vaccinated v the unvaccinated is a peril to be wary of. Tolerance is required, but the unvaccinated surely too must continuously examine their consciences if their exposure to the virus and absorption of limited healthcare resources is damaging the lives of others to an unacceptable level.
The EU should be a bastion of protection of individual freedoms but the haphazard country by country approach to Omicron, with a Brussels silent on human rights of the unvaccinated, is weakening their halo. The nations of the UK must keep protection of liberty at front of mind. The unvaccinated are not and must not be allowed to become the new lepers. However, deciding whether or not to get vaccinated is, like most decisions, one where moral considerations and the impact of the decision are relevant.
This article is directed at countries where there is a choice for the citizen whether to get the vaccine. In their haste to keep their own people safe Western governments have been so inward looking with fine words but little action for developing nations. When considering vaccines, the need to treat the more deprived areas of the world fairly with vaccine availability must keep being emphasised. They are being neglected. Billions of people who have no such choice will be the unvaccinated, and a new global underclass will possibly be created, distinguished not only by their level of poverty but also by their Covid contagion.
See also:
THE CONFLICT BETWEEN FIGHTING COVID AND RESPECTING RIGHTS
VACCINATION PASSPORTS – THE ROAD TO UNLOCKING OR AN AFFRONT TO FREEDOM?
VACCINE NATIONALISM AND VACCINE CELEBRATION
VACCINES – A MIRACLE, BUT A BUMPY ROAD
COVID CAVALRY ARRIVING: A SHOT IN THE ARM? ADVISERS DEPARTING: A SHOT IN THE FOOT?
