Should vaccination be made mandatory?

News: It has been approximately one year since the introduction of vaccines. Despite many achievements there are still numerous challenges to be tackled like vaccine hesitancy and shortage in supplies. 

In this light, calls are being made to make vaccination mandatory.

We need to understand that in public health, the education and service approach works much more than the legal approach.

At the same time, legal measures could be used appropriately — by restricting entry, incentives or disincentives — to convince people to get vaccinated. 

What have been the positives in the Indian vaccination program? 

There is reasonable vaccination coverage across the country and many issues in vaccine supplies and logistics have been rectified now.  

Transparency in reporting adverse events: Reporting of adverse events is systematically done at the primary, sub-centre, block and district levels. There are various committees that include specialists who go through the reports. 

What are the challenges that still remain? 

Vaccine coverage: Although many eligible people are getting vaccinated. But the last mile reach has become a challenge, particularly among, the 50-plus population who have either received the first dose but are reluctant to get their second dose or have not received even their first dose yet.  

– Many countries are moving towards booster doses, but we have not completed vaccination of all the eligible persons with even the first dose of the vaccine.

– Almost 23% of healthcare and frontline workers are yet to get their second dose in India.  

Rumours being spread against vaccines: Anti-vaxxers are actively spreading a lot of rumours, pseudoscience and unscientific information. Rumours are spread on social media and through WhatsApp. 

Although vaccines have reached the remotest corners but there is challenge is to reach the population reluctant to get vaccinated. 

What is the way forward? 

Reach out to people who are still reluctant to get vaccinated and educate them about the importance of getting vaccinated. Involve doctors, community influencers such as religious leaders, political leaders, panchayat leaders and other influential groups, frontline and healthcare workers. 

Govt can promote awareness through using example of previous successful vaccination campaigns. Example – How vaccination has eradicated smallpox and Polio is on verge of eradication. 

Governments can focus on particular population subgroups where vaccination is low and take targeted efforts to create awareness.

Incentives for people who get vaccinated. 

Rumour-mongering groups and anti-vaccine lobbies must be dealt seriously, and legal action should be taken against them. Governments can come up with advertisements on television or newspapers.  

Children should be vaccinated, while booster doses should be administered to the eligible population.  

Developed countries should understand the problems faced by developing and low-economic countries. The huge vaccine inequity present in the world should be resolved. 

Some cities have already achieved 100% coverage (first dose). There is need to study such models.  

Is it possible to make vaccination mandatory? 

Although some states have made vaccination mandatory for entry into public places and workplaces while the Central Govt has maintained that vaccination is voluntary.  

Govt can introduce mandatory vaccination by giving more importance to the community health vis a vis Individual’s right for denying vaccination. For Example – Smallpox was eradicated by making vaccination compulsory from 1965 to 1975.

Local health authorities have the power to make vaccination mandatory as COVID has been declared a notifiable disease under different Acts of the States or the Epidemic Diseases Act. If anyone seeks exemption, they will have to approach the Judicial Magistrate.  

Source: This post is based on the article “Should vaccination be made mandatory?” published in The Hindu on 31^st Dec 2021.