WHO wades into vaccine mandates dispute, saying they should be an 'absolute last resort'

• Vaccine mandates continue to be a divisive topic of debate.
• Many parts of the world are grappling not only with the delta variant but concerns over the spread of omicron, a mutation of the virus whose risk profile remains largely unknown.
• The WHO's Europe Director Dr Hans Kluge said Tuesday that compulsory vaccinations should be an "absolute last resort."

LONDON — Covid-19 vaccine mandates continue to be a divisive topic of debate, and the subject remains as salient as ever while the world grapples not only with the delta variant but concerns over the spread of omicron, a mutation of the virus whose risk profile remains largely unknown.

As some countries struggle to encourage a voluntary take-up of vaccines — which are proven to greatly reduce the risk of severe infection, hospitalization and death from the virus — some governments are considering, or have already stated, that they will introduce compulsory vaccinations.

Experts say there are a number of ethical questions to consider regarding vaccine mandates, but some countries have sidelined concerns in favor of the overall benefit that vaccination confers.

The WHO's Europe Director Dr. Hans Kluge weighed in on the thorny debate on Tuesday, cautioning that compulsory vaccinations should be a last resort.

"Mandates around vaccination are an absolute last resort, and only applicable when all other feasible options to improve vaccination uptake have been exhausted," Kluge said. They should not be done "if one has not reached out first to the communities" involved, he said at a press briefing.

Mandates "have proven effective in some environments to increase vaccine uptake," Kluge said, but added, "the effectiveness of vaccine mandates is very context-specific. The effect mandating vaccines could have on public confidence and public trust, as well as vaccination uptake, must be considered."

He cautioned that what is acceptable in one society or community may not be in another.

"Ultimately, mandates should never contribute to increasing social inequalities in access to health and social services. Any measure that might restrict a right or a movement of a person, such as lockdowns or mandates, needs to be sure that mental health and wellbeing is cared for," he said.

Only way to stop the virus?

The idea of compulsory vaccinations has been contentious in Europe for a long time, and levels of vaccine skepticism differ wildly from country to country. But the current Covid landscape has made the debate an increasingly prevalent one, and some officials believe mandating vaccines is the only way to stop the virus.

Covid vaccines greatly reduce the risk of severe infection, hospitalization and death from the virus, but we also know vaccine immunity wanes after around six months and that they are not 100% effective at reducing transmission.

European Commission chief Ursula von der Leyen said last week that it was time to "think about mandatory vaccination" in the EU, in which individual states can impose vaccine mandates. The comments were made as vaccination rates among some member states remain sluggish, and many countries are dealing with a winter surge of Covid cases.

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Some EU member states have already decided to enforce vaccines. Austria has said it will introduce compulsory shots next year, while Greece has said it will fine anyone aged 60 or over 100 euros ($114) a month if they do not get vaccinated. The over-60s must have had a first dose of a coronavirus shot by Jan. 16 to avoid the fine.

Germany's outgoing government had also proposed the possibility of mandatory vaccines — although the incoming new coalition said Tuesday that mandatory vaccination would be discussed, but nothing had been decided upon.

Indonesia made Covid vaccinations compulsory for its citizens earlier this year with Turkmenistan, Saudi Arabia (introducing compulsory shots for anyone wishing to enter a workplace) and the small island state of Micronesia all introducing similar measures.  

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Other countries or states, meanwhile, have made (or are making) Covid vaccines compulsory for some sectors of the workforce, such as public sector workers and, especially, health care staff. In the U.S., a slew of companies have said that their workers must be vaccinated against Covid too, often prompting protests from staff.

Many people who do not want to get a Covid vaccine, and vehemently oppose compulsory vaccinations, say that their freedom to travel, socialize and work is being increasingly restricted as the number of public spaces, leisure venues and jobs that can only be accessed by the vaccinated grows.

So-called "Covid passes," or passports, restrict access to public venues to the vaccinated, recently recovered, or those with a negative Covid test. They are increasingly being relied upon to keep leisure activities and businesses open, although critics say they are segregating societies down vaccination lines.

Europe was rocked by protests in November when thousands of people demonstrated against fresh restrictions and the implementation of Covid passes in Brussels, Vienna, Rome and Amsterdam following to a surge in Covid infections.

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