Vaccines: Only mandate the ‘mandatable'…or we will shoot ourselves in the foot

As the political momentum grows for vaccine mandates, we need to step back and review what they are, how they could work, whether they could work here and what could happen if they don’t.

Vaccines: Only mandate the ‘mandatable’…or we will shoot ourselves in the foot
© Copyright (c) Daily Maverick , All Rights Reserved

The pace of the Covid-19 pandemic is such that bold leadership is called for, especially when the impact of policy options is uncertain. Evidence of success or failure follows the trailblazers; and it is inevitable that political instinct rather than clear-cut fact will have to drive some major decisions.

In the heat of the moment, however, we could rush into choices that worsen our prospects of reaching critical thresholds of coverage.

In essence,  vaccine mandates are instructions to compel people to get vaccinated. They are premised on the view that high vaccination rates are critical to protect society and restore the economy.

We must start by acknowledging that the twists and turns of this hustler-virus keep testing even these core assumptions. The early optimism of substantially reduced transmission leading to herd immunity through vaccination gave way to a more pragmatic realisation that only extremely high coverage levels can suppress new waves of infection, and even then only to some extent. The European experience of the fourth wave illustrated the “leakiness” of current vaccines — vaccinated individuals still got Covid–  and in South Africa there are already many cases of breakthrough infections by the Omicron variant in “double-vaxxed” individuals.

In time, and should there be a natural attenuation of the virus’s virulence, the public health argument for Covid-19 vaccination may dissipate. There is even the risk that leaky vaccines could lead to more lethal viruses. However, the evidence to date shows exactly the opposite.

The fact of today’s vaccines is that they have substantially reduced the frequency of severe illness and death, turning Covid-19 into a milder disease that is less disruptive to the economy and social life. It is this singular reason that provides compelling evidence for vaccination and a solid rationale for the introduction of national mandates.

The government could introduce one or more of three types of vaccine mandates:

  • The first is compulsory vaccination for all citizens, which Austria has already introduced and will be considered by the German Parliament in February next year.
  • The second is restrictions on access to services, events and facilities. Typically, these are framed as “vaccine passports” facilitating admission, although some countries have made more explicit threats of exclusion.
  • The third is the facilitation of workplace mandates, for which Business for South Africa has sought a clarificatory court order to confirm the legality of implementation.

As government, if you tell someone to do something, you must be able to check that they have done so and compel them to if they don’t. Otherwise, you lose credibility and those in opposition just dig in even further.

A rapid review of the effect of Covid-19 certification introduced across the world in 2020 found little to cheer in the implementation of vaccine mandates and warned of the unintended consequence of public resistance and hardening attitudes. However, that was 2020; in the lifespan of Covid-19, a long time ago.

A more recent study (submitted for publication but not yet peer-reviewed) compared the vaccination rates in six European countries to a simulated counterfactual of what might have happened without mandates, based on the coverage trajectories of other countries which did not introduce them. This simulation showed the strong effect of the Green Pass in Israel, a modest effect of vaccine passports in France and in Switzerland, and a positive but insubstantial effect in Italy. It could not show similar effects in Germany or Denmark and concluded that vaccine mandates are only useful when implemented early in the course of a national vaccination programme.

There will be legal and philosophical debates about the imposition of restrictions on individual rights and the boundaries of state authority, but the basis of my argument is that the government should implement vaccine mandates on one condition — that there is a plausible pathway to their success.

If we were to go on the strength of global evidence alone, the case for mandates is not yet robust enough and advocates will only shoot themselves in the foot if they make it the crux of their argument. At this point, the critical question is not whether vaccine mandates have worked elsewhere, but whether their implementation is both feasible and likely to have an impact here.

The feasibility of vaccine mandates 

Practically, a vaccine mandate only has meaning if vaccination status can be checked and its implementation enforced. Paper-based vaccination certificates are easily reproducible and open to fraud. They would soon rapidly render compulsory vaccination meaningless. Therefore, we have to use a digital solution in the form of QR codes, which require a smartphone.

While smartphone penetration is 91%, according to the Independent Communications Authority of South Africa, this number grossly overestimates the extent of distribution, as they tend to be concentrated in richer households. The latest General Household Survey released by Statistics SA last week found that just under two thirds of people in South Africa have access to the internet via cellphone. In some of the poorer provinces, it is closer to half. Even if they can download the QR code, the code needs to be scanned and verified through a digital link to a central server.

Imagine the scene at rush hour on Main Road, Wynberg. The taxi stops in the driving lane to admit a passenger. The door slides open and the fare-collecting uscabha presses the scanner against the smartphone in the prospective passenger’s outstretched hand. Cellphone reception isn’t great, so there’s a delay in connecting to the server. Meanwhile, an angry cacophony of hooting emanates from the growing line of cars behind the taxi…

Even if we could verify vaccination status, we couldn’t enforce it across society.

More than half (56%) of the 23 million adults who are not yet vaccinated are young people aged 18-34 years. Angry and hungry, over half of them are unemployed and many have expressly demanded “jobs before jabs”. On their stipend of R350 a month, they do not visit museums, hotels, cinemas or even sporting events and will feel no compulsion to come forward just because they are told to do so.

The denial of social grants may be tempting, but with the exception of the special Covid-19 relief grant, other social security available to young people is for reasons of disability — and childcare.  It would be unconstitutional to deny them those rights.

Perhaps old age pensions could be made conditional on vaccination, but it would be cruel to take away the only means of survival of an anxious and wary senior citizen. You’d first have to be absolutely sure that every bedridden individual is able to get vaccinated. In any event, first vaccination coverage in people over 60 has now reached 65% and in Limpopo and the Eastern Cape it is close to 80%. There is little reason to be aggressive there.

These realities alone render the option of compulsory proof of vaccination moot.

Even if it is not viable, one could argue that leaving the option dangling in the wind may still encourage people to come forward for vaccination. In France, for example, much of the impact of mandates was more in their anticipation than actual implementation. However, this is a very risky strategy in a country when public sentiment is already flashing amber.

Much like the stock market, vaccination demand seems easily swayed by public sentiment. After a relatively bullish October, the sense of national deflation following local government elections knocked 40% off the average daily rate of first dose vaccinations — a pattern that persisted right up until the public announcement of Omicron and the president’s family meeting a week ago. A spike in anxiety fuelled an uptick in vaccinations, but already that is wearing off. Trying to bluff an already cynical population into vaccination seems like a very long shot.

So what could work?  

There are seven million people aged 35-49 who are not yet vaccinated and 70% of them are employed. An increasing number of companies have implemented workplace mandates, compelling their employees to get vaccinated. Early adopters like Discovery have already demonstrated substantial effect, with more than 92% of its workforce now vaccinated. Given the large number of public sector employees in South Africa — about 1.3 million — mandating all public sector employees to get vaccinated could be a singularly powerful instrument in the hands of the government.

In the light of the “vaccine escape” demonstrated by Omicron and even earlier variants, the rationale for workplace mandates is not so much the transmission risk from an unvaccinated colleague as the benefit of a work environment where fewer colleagues get seriously ill. Milder infections will mean a healthier work environment for everyone and greater productivity, even if SARS-CoV-2 occasionally rampages through the office.

Similarly, the government can facilitate the reopening of social and sporting events, conference centres and tourism and hospitality through the use of vaccine passports. Again, their primary value is as a strong signal that vaccination is a new way of life — the path to stronger collective immunity — rather than a means of preventing community transmission. You may still contract the virus from the last person whose face pressed against the fish tank in the aquarium, even if both of you were vaccinated.

Even in the formal economy, however, these constraints will be difficult to implement when businesses are starved of customers. In taverns and taxis, viable vaccine passports are unthinkable.

Yet, the success of South Africa’s vaccination programme now largely rests on those who use minibus taxis, frequent taverns and operate in the informal economy — not by those going to hotels and conference centres, most of whom are already vaccinated. If the Covid-19 grants of R350 are continued beyond this financial year, then making vaccination a pre-condition would be very effective, as would topping up the childcare grant and old age pensions for a few months.

These government-led incentives should be augmented by private support in the form of small guaranteed rewards like mobile airtime and free data, as well as funding for lucky draws and other incentives. This combination of mandatable mandates and tangible incentives could set South Africa’s vaccination programme on an accelerated trajectory. DM/MC

David Harrison is CEO of the DG Murray Trust. In support of the national vaccination effort, he leads a cross-sectoral demand acceleration strategy mandated by the National Department of Health.

[hearken id=”daily-maverick/8881″]

News Related

OTHER NEWS

Goldman CEO David Solomon gets 27% pay bump to $35 million

Goldman Sachs‘ CEO David Solomon took home $35 million in total compensation in 2021, the bank reported late Friday. REUTERS/Mike Blake/File Goldman Sachs Chief Executive Officer David Solomon will get ... Read more »

De Vries: Formula 1 comparisons do not do FE justice

© PA Images Nyck de Vries waves to the camera. Abu Dhabi December 2021. Mercedes Formula E driver Nyck de Vries says the sport has established itself as a racing ... Read more »

Immigrant thriller 'Nanny' wins top prize at Sundance

© Ben Gabbe Anna Diop, the star of “Nanny,” was born in Senegal and moved to the United States as a child “Nanny,” a supernatural thriller about an undocumented immigrant ... Read more »

How to evolve Eevee into Umbreon in Pokémon Legends: Arceus

© Provided by GamePur Eevee has several evolutions that you can have it become in Pokémon Legends: Arceus. You have eight choices to pick from, each with a unique evolution ... Read more »

How to evolve Eevee into Glaceon in Pokémon Legends: Arceus

© Provided by GamePur There are eight Eevee evolutions for you to unlock in Pokémon Legends: Arceus. The Ice-type version is Glaceon, and there are a handful of ways you ... Read more »

How to win with Phoenix in Valorant – tips and strategies

© Provided by GamePur Coming from the U.K, Phoenix brings an egotistical and flashy fighting style to the battleground of Valorant. With some of the best solo dueling abilities in ... Read more »

Zeri is already getting nerfed in patch 12.3

Read more »

Intermittent fasting can help stop type 2 diabetes, reduce blood sugar

A diet low on carbohydrates can help type 2 diabetes control their cholesterol and glucose levels. Getty Images/iStockphoto Having a healthy and balanced diet is key for everyone – but ... Read more »

Bodies of family that froze to death trying to cross border may not return to India

A relative of a family that froze to death in southern Manitoba while trying to cross the United States border says it’s expected the bodies will not be flown home ... Read more »

I've spent £18,000 on 450 bottles of gin – I won't stop buying my fave drink

A GIN lover has found just the tonic — an £18,000 collection of more than 450 bottles of the booze. Allison Strydom has spent the past five years filling cupboards ... Read more »

Biden sending some troops to Eastern Europe to deter Russia from invading Ukraine

President Joe Biden intends on deploying “not too many,” soldiers into Eastern Europe during Ukraine’s standoff against Russia. EyePress News/Shutterstock President Biden said Friday that he’s sending US troops — ... Read more »

Reliance Industries Rating ‘Hold'; Core businesses aided growth in quarter

Q3FY22 earnings were largely in line with consensus estimates adjusting for a one-time gain on the sale of shale assets. Ebitda rose c14% q-o-q, 38% y-o-y, to Rs 297 bn ... Read more »

Budget 2022: Decoding Corporate India's expectations from Nirmala Sitharaman

© Provided by Firstpost Budget 2022: Decoding Corporate India’s expectations from Nirmala Sitharaman With direct taxes contributing nearly half of the government’s revenue streams, expectations from the taxpayers are aplenty. ... Read more »

Google to invest $1 bn in Airtel to boost India play

Google will invest as much as $1 billion in Bharti Airtel Ltd, India’s second-biggest telecom services provider, as the Internet giant redoubles efforts to increase smartphone access and accelerate digital ... Read more »

The best gaming headset deals you can get right now

© Photo by Amelia Holowaty Krales / The Verge Logitech’s budget-friendly G435 boasts color and comfort, as well as a host of solid features. A good gaming headset is practically ... Read more »

Knackigste Aussage, souveränster Auftritt, skurrilste Ausrede: Das war die erste Woche im Vincenz-Prozess

1750 Stunden brauchte Vincenz’ Anwalt Lorenz Erni für die Prozessvorbereitung. Der Punkt für die knackigste Aussage geht allerdings an die Staatsanwaltschaft. Diese und weitere Highlights der ersten Prozesswoche. © STEFAN ... Read more »

Ab 299 Franken im Monat: Ist das der günstigste Kleinwagen der Schweiz?

Abhängig von Marke, Modell und Technologie belastet ein Auto das Budget enorm. Dass es auch sparsam geht, zeigt dieses Beispiel mit einem Stromer im Auto-Abo. ​​Vor allem, wenn man die ... Read more »

‘Nanny,' ‘Exiles,' ‘Navalny' among top Sundance winners

The Associated PressThis image shows a scene from “Nanny” by Nikyatu Jusu, an official selection of the U.S. Dramatic Competition at the 2022 Sundance Film Festival. (Sundance Institute via AP) ... Read more »

Harga siling vaksin, GP mungkin henti tawar suntikan atau caj lebih, kata doktor

© Provided by Free Malaysia Today Pengamal perubatan am swasta mungkin berhenti menawarkan suntikan vaksin atau mengenakan caj lebih, kata seorang doktor. PETALING JAYA: Keputusan kerajaan untuk menetapkan harga siling ... Read more »

6 workout motivation tips to stay on track with your fitness goals this year

© Halfpoint Images / Getty Images 6 workout motivation tips to stay on track with your fitness goals this year To boost workout motivation, switch up your routine — if ... Read more »

Here's How Much It Costs to Study at the University of Asia and the Pacific

© Provided by Candy Located within the central business district of Ortigas Center, the University of Asia and the Pacific has been fostering young minds and equipping them with a ... Read more »

With secrets, lies and cries of ‘racism,' Biden covers up huge influx of illegal migrants

President Biden is endangering his country by sending undocumented immigrants with criminal records into communities. AP Photo/Andrew Harnik Last summer I was notified of secret overnight flights coming into Westchester ... Read more »

Fan says Julius Randle had him kicked out of FTX arena

A Knicks fan claimed that Julius Randle had him kicked out of FTX Arena in Miami earlier this week for heckling the slumping forward. Earlier this month, Randle was fined ... Read more »

Princess Diana portrait sells for $201k, 10 times the expected price

A rare portrait of Princess Diana sold for a whopping $201,600 – more than 10 times the expected price, Sotheby’s auction house announced Friday. The oil painting by the late American ... Read more »

CBCP releases updated prayer vs. COVID-19

© Danny Pata Catholic devotees say their prayers outside the Minor Basilica of the Black Nazarene, more commonly known as the Quiapo Church, on Monday, January 3, 2021, as it ... Read more »

Cynthia Nixon defends And Just Like That's Miranda and Steve storyline after backlash

And Just Like That star Cynthia Nixon has defended her beloved character, Miranda Hobbs. The 55-year-old actress, who has played the Sex And The City favourite since 1998, has backed ... Read more »

Charity shop sold £564 Balenciaga handbag after owner forgot it in changing room

Zharkyn Ermekovna had tried on a coat and forgot to pick up the luxury Balenciaga bag she had bought at Harrods. A CHARITY shop flogged a £564 handbag after its ... Read more »

How ‘Encanto' saved parents from the tyranny of ‘Frozen' and ‘Let It Go'

Encanto’s “We Don’t Talk About Bruno” has surpassed Frozen’s “Let It Go” — much to parents’ relief. ©Walt Disney Co./Courtesy Evere “Hamilton” netted creator Lin-Manuel Miranda three Tony awards, an ... Read more »

Hunarbaaz: Judges get teary as contestant pays tribute to trans mom; Karan Johar says 'I saw true humanity'

© Provided by Pinkvilla Hunarbaaz Desh Ki Shaan has featured many remarkable stories of contestants that would leave you speechless The show, which just kicked off last week is off ... Read more »

Appeals court upholds California's net neutrality law

© Illustration by Alex Castro / The Verge California can enforce its net neutrality law A federal appeals court on Friday ruled that California’s net neutrality law can remain in ... Read more »

Girl Scouts' first Asian American CEO credits her diverse girlhood

Unlike many of her predominantly white peers, Sofia Chang, the new CEO of the Girl Scouts, had an unique upbringing, spending much of her childhood working at her parents’ Chinese ... Read more »

U.S. House to take up bill next week on China competition, chips industry

WASHINGTON (Reuters) – The U.S. House of Representatives will take up next week a massive bill aimed at increasing competitiveness with China and supporting the U.S. chip industry, including $52 ... Read more »

Ontario Progressive Conservatives pick their 2022 candidate for Hamilton-Centre riding

Ontario’s Progressive Conservatives have picked their candidate to run in the riding of Hamilton-Centre for the provincial election in June. © Press Release Sarah Bokhari is running for the Ontario ... Read more »

IS conspiracy case: NIA files charges against ex-Cong MLA's kin, others

© Provided by The Indian Express THE NIA has filed a chargesheet against a family member of former Congress MLA from Karnataka, late B M Idinabba, among others, in connection ... Read more »

I started a fake Rent-a-Hitman website as a joke & helped bust dozens trying to order horrific assassinations

AN IT whizz who created a spoof assassin-hiring website as part of a school project has helped to thwart dozens of would-be murder-for-hire plots, potentially saving the lives of more ... Read more »

Everybody will be streaming the heartwarming hit ‘Cha Cha Real Smooth'

Cooper Raiff and Dakota Johnson star in “Cha Cha Real Smooth.” Courtesy of the Sundance Institute Cooper Raiff is the fresh comedic talent we’ve been waiting for. A new one ... Read more »

Nearly 411,000 Kias recalled for airbag issue

The National Highway Traffic Safety Administration on Tuesday announced Kia is recalling nearly 411,000 vehicles for a potentially gnarly defect. A damaged airbag circuit board could prevent the safety restraints from ... Read more »

The ACLU's hypocrisy over school transparency is a danger to free speech

Over the years, the ACLU has demanded curriculum transparency for religious studies and sex education, while demanding the opposite for critical race theory. Getty Images In at least a dozen ... Read more »

Judge sides with Treasury in tribes' coronavirus relief case

FLAGSTAFF, Ariz. — A federal judge has sided with the Treasury Department in a case that challenged the distribution of coronavirus relief aid to Native American governments. Tribal governments had ... Read more »

Where to find a Shiny Stone in Pokémon Legends: Arceus

© Provided by GamePur Like the Dawn and Sun Stones, the Shiny Stone is in Pokémon Legends: Arceus will only evolve a couple of Pokémon, but it is practically a ... Read more »
On free-english-test.com you will find lots of free English exam practice materials to help you improve your English skills: grammar, listening, reading, writing, ielts, toeic