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It has been reported that Austria is to enter a full national lockdown from Monday amid a surge of COVID-19 cases, and is to become the first country in Europe to make COVID-19 vaccines mandatory by law.
Prof Lawrence Young, Virologist and Professor of Molecular Oncology, University of Warwick, said:
“It’s clear from our experience in England and from what’s happening across Europe that while vaccines do a lot of the heavy lifting when it comes to keeping COVID-19 under control, other interventions are required to prevent case numbers rising. Less mask wearing, more mixing indoors due to colder weather and waning immunity are also contributing to the high case levels across Europe.
“We need to learn from other countries. Israel experienced a sharp drop in the number of infections after a significant spike in June. This reduction was not only due to the widespread rollout of booster jabs and vaccinations for 12 to 15 year olds but also the use of vaccine passports and facemask mandates.
“The varying levels of case numbers across Europe reflect two things – human behaviour and the amount of immunity in the population. Waning immunity in those vaccinated more than 6 months ago, differing vaccine coverage of 12 to 15 year olds, and varying approaches to controlling virus transmission by restricting population mixing and by the wearing of face coverings are all factors impacting current case numbers in Europe.
“If the current levels of infection and hospitalisations in England continue or rise even further we will have no option but to limit virus transmission by introducing some form of vaccine passport alongside re-introducing compulsory facemasks in crowded, poorly-ventilated indoors spaces. These are minor inconveniences that could really help us through the winter months alongside the continued rollout of booster vaccinations.”
Dr Peter English, Retired Consultant in Communicable Disease Control, Former Editor of Vaccines in Practice, Immediate past Chair of the BMA Public Health Medicine Committee, said:
“I have commented on compulsory vaccination previously.[1,2]
“It is hard to compare across countries, however, as the traditions and norms – and even the understanding of “compulsory” or “mandatory” differ. I think that in USA “mandatory” sometimes means that states are obliged to provide free, universal vaccination (rather than it being paid for through private insurance schemes).
“In some countries, mandation is connected to social security payments or access to eg schooling.
“And in some countries, there is a tradition of mandating important vaccination programmes. In Italy for example, most childhood vaccines are “mandatory”. When other vaccines were introduced a few years ago and not made “mandatory”, many people assumed that they didn’t really matter, because if they did, they’d have been made mandatory, leading to poor uptake.
“So we must be cautious and ask what “mandatory” means in practice, and how it fits with other vaccination programmes in the country in question.
“You will note that, in my 2008 publication,[1] I suggest that, in the UK at least, we should not generally mandate vaccination I made some exceptions: occupational exceptions (on the basis that people who object are not obliged to follow that occupation); pre-school childcare (again on the grounds that such childcare is not mandatory, unlike school which sort-of is if you leave out the relatively small proportion of children who are home-schooled); and pandemics, because in a pandemic the threat to the population can mean it is proportionate to over-rule individual freedoms.
“The “problem” with mandatory vaccination is that it doesn’t necessarily fix the low uptake issues, particularly when uptake is already quite high. It is hard to enforce. How do you, in practice, vaccinate somebody who refuses consent? Does it actually increase the proportion of the population who take up the vaccine? And does it increase distrust in vaccination, increase dissent and protest, and thus actually drive down vaccination uptake?
“What exemptions are you going to permit, and will these lead to gaming of the systems as people seek loopholes? (We have seen a number of novel “religions” pop up in the USA, for example, so that people can take advantage of religious belief exemptions – in many cases they are clearly a deliberate attempt to find a loophole in the mandatory vaccination laws, rather than anything that can really be recognised as a genuine religion. Similarly, many of the mask exemptions claimed in the UK, where masks are or were mandatory are or were unlikely to be justified.)
“The issues with mandatory vaccination may apply even if vaccination is not legally required per see, but, rather, as a condition of other freedoms or benefits – although probably to a lesser extent compared to a legal requirement to be vaccinated.
“The Austrian lockdown for the unvaccinated (already in place, since Monday 15 Nov 2021) is in the latter category: you don’t absolutely have to get vaccinated; but if you don’t, your ability (legally) to mix with others is severely restricted. You can make a strong argument that this is proportionate.
“The proposed legal obligation to be vaccinated may be harder to justify.”
Prof David Matthews, Professor of Virology, University of Bristol, said:
“The introduction of lockdowns in many countries reflects slow or low take up of vaccines in those countries. This re-emphasises the need for us to keep talking to adults who, for whatever reason, have decided to not have the vaccine here in the UK. We need to engage with this group of people and hopefully they will think again about their reasons for not getting vaccinated in the light of all the latest information we have from around the world that the vaccines are safe and they work. Vaccination is easily the most effective way out of the pandemic and absolutely the best way avoid any more lockdowns.”
Dr Julian Tang, Honorary Associate Professor/Clinical Virologist, University of Leicester, said:
“Different countries need to react as needed according to how the virus is behaving in their populations
“The virus/infection dynamics will differ between countries as they have different cultures, healthcare systems, levels of natural or vaccine immunity – as well as different levels of concern and practices related to social distancing, PPE (masking) – and also their diagnostic testing and test/track/isolation/quarantine capacities/facilities.
“Nevertheless, we know that Eastern European countries controlled the spread of the virus well during the early pandemic first wave but then experienced more severe second waves as they opened up early post-first wave – in 2020.
“With the emergence of the delta variant in 2021, we now know that this virus can readily bypass natural and vaccine immunity, and cause more symptomatic and severe infections in the unvaccinated.
“We also now know that the degree of spread/breakthrough infection and severe disease with the delta variant is less common with doubly (rather than singly) vaccinated people. So this may account for some of the higher COVID-19 cases and hospitalisations in some countries that have fewer people who have been doubly vaccinated.
“Finally, waning vaccine immunity will more readily allow breakthrough delta virus infections – and such vaccine immunity will wane more quickly in singly compared to doubly vaccinated individuals.
“All of these factors will contribute to the different viral dynamics that we are seeing across Europe – and it is reasonable for those countries to take the measures they feel most appropriate to control the virus in their populations.”
All our previous output on this subject can be seen at this weblink:
www.sciencemediacentre.org/tag/covid-19
Declared interests
Dr Peter English: “Dr English is on the editorial board of Vaccines Today: an unpaid, voluntary, position. While he is also a member of the BMA’s Public Health Medicine Committee, this comment is made in a personal capacity. Dr English sometimes receives honoraria for acting as a consultant to various vaccine manufacturers, most recently to Seqirus.”
None others received