Most parts of India have faced two significant waves of Covid-19. Some places, such as Mumbai have been praised for its management of hospital resources, and rightly so. The current focus is on Covid-19 vaccination. While data from different parts of the world shows that the vaccines reduce risk of disease severity, an unsavoury aspect of the vaccine administration policy concerns coercion of citizens for vaccination.
For instance, Mumbai local train, the “lifeline of Mumbai”, has been made conditional on vaccination, and so has entry to various places such as malls. Aurangabad has made fuel purchase conditional on vaccination.
Various work places have also issued coercive notices. Such extreme coercion may “work” in the short term, but will erode public trust in the long run. We argue here that such coercion is not only wrong, but lacks any scientific basis.
The obvious question we can begin with is: if there is an effective vaccine for a deadly disease, then why coerce? After all, Covid-19 has been at the centre of people’s attention not only in India but around the world. And most people have been eagerly awaiting a vaccine.
The ostensible argument for vaccine coercion is: “no one is safe until everyone is safe”, and universal vaccination will “eradicate” the virus. But this stance is unscientific for three main reasons.
First, all the current Covid-19 vaccines are non-sterilizing. While there is individual benefit, especially among old and susceptible, in terms disease severity reduction, even those vaccinated can get infected and can transmit the virus.
Data from around the world shows this. For example, Singapore’s Covid surge started after about 75% of its population was fully vaccinated. As another stark example, Waterford city in Ireland had over 99.7% of its adults fully vaccinated as of the last week September 2021, yet had the highest incidence of Covid in Ireland by the second week of October.
The UK’s weekly reports show that vaccine efficacy against infection has been declining steadily; currently the rate of infection among fully vaccinated is much more than that among unvaccinated in all age groups above 30. The vaccine efficacy against infection touched as low as minus 109% for the 40-49 age group! Israel is currently facing its highest Covid peaks yet, despite approving as many as four jabs for each citizen!
If the vaccinated can also get infected and transmit the virus, then individual benefit of vaccination does not translate to societal benefit; so what is the rationale for coercion?
Second, the vast majority of people have already been exposed to the virus in India’s first two waves. Sero-surveys have shown that as high as 80% of Mumbai’s citizens, and over 90% of Delhi’s citizens have been naturally exposed.
Furthermore, pre-pandemic science as well as recent research show consistently that immunity from natural exposure is strong and long lasting. For instance, a large cohort study involving over 17,000 health-care workers in the UK showed not a single instance of symptomatic reinfection.
Even within Mumbai, it is well known that the 2nd wave was largely absent from the slums, which had widespread natural exposure in 2020. Therefore, those who have had natural exposure are extremely safe people to be around!
If the vast majority of people are already at much less chance to get infected or transmit compared to the vaccinated, then what the rationale for vaccine coercion?
Third, the goal of “zero-Covid” is a pipe-dream. Even if we can magically vaccinate every adult and child within a day, the virus will continue to thrive since the vaccines are non-sterilizing.
The SARS-Cov-2 virus also has other species as host, and thus eradicating the virus is a scientific impossibility. The disease will enter endemic phase and the virus will keep circulating, although with negligible severity compared to the pandemic phase.
If even universal vaccination cannot achieve zero-Covid, then what is the rationale for vaccine coercion?
The obvious question we can begin with is: if there is an effective vaccine for a deadly disease, then why coerce? After all, Covid-19 has been at the centre of people’s attention not only in India but around the world. And most people have been eagerly awaiting a vaccine.
The ostensible argument for vaccine coercion is: “no one is safe until everyone is safe”, and universal vaccination will “eradicate” the virus. But this stance is unscientific for three main reasons.
First, all the current Covid-19 vaccines are non-sterilizing. While there is individual benefit, especially among old and susceptible, in terms disease severity reduction, even those vaccinated can get infected and can transmit the virus.
Data from around the world shows this. For example, Singapore’s Covid surge started after about 75% of its population was fully vaccinated. As another stark example, Waterford city in Ireland had over 99.7% of its adults fully vaccinated as of the last week September 2021, yet had the highest incidence of Covid in Ireland by the second week of October.
The UK’s weekly reports show that vaccine efficacy against infection has been declining steadily; currently the rate of infection among fully vaccinated is much more than that among unvaccinated in all age groups above 30. The vaccine efficacy against infection touched as low as minus 109% for the 40-49 age group! Israel is currently facing its highest Covid peaks yet, despite approving as many as four jabs for each citizen!
If the vaccinated can also get infected and transmit the virus, then individual benefit of vaccination does not translate to societal benefit; so what is the rationale for coercion?
Second, the vast majority of people have already been exposed to the virus in India’s first two waves. Sero-surveys have shown that as high as 80% of Mumbai’s citizens, and over 90% of Delhi’s citizens have been naturally exposed.
Furthermore, pre-pandemic science as well as recent research show consistently that immunity from natural exposure is strong and long lasting. For instance, a large cohort study involving over 17,000 health-care workers in the UK showed not a single instance of symptomatic reinfection.
Even within Mumbai, it is well known that the 2nd wave was largely absent from the slums, which had widespread natural exposure in 2020. Therefore, those who have had natural exposure are extremely safe people to be around!
If the vast majority of people are already at much less chance to get infected or transmit compared to the vaccinated, then what the rationale for vaccine coercion?
Third, the goal of “zero-Covid” is a pipe-dream. Even if we can magically vaccinate every adult and child within a day, the virus will continue to thrive since the vaccines are non-sterilizing.
The SARS-Cov-2 virus also has other species as host, and thus eradicating the virus is a scientific impossibility. The disease will enter endemic phase and the virus will keep circulating, although with negligible severity compared to the pandemic phase.
If even universal vaccination cannot achieve zero-Covid, then what is the rationale for vaccine coercion?
Vaccination should focus on hitherto unexposed susceptible people; coercive methods should stop
To summarize, each of the assumptions behind vaccine coercion: (1) vaccines prevent or stop spread of Covid-19, (2) natural immunity is weak, and (3) zero-Covid is possible, are scientifically flawed.
The current Covid-19 vaccines have a positive role for old, susceptible, and hitherto unexposed individuals, to reduce disease severity. At the same time, while vaccine adverse effects may be rare, they are not nil.
The UK’s yellow card system has reported adverse events at the rate of about 1 in 106 doses for the AstraZeneca vaccine (Covishield). Changes to women’s menstrual cycle have been reported too. Blood clotting from the AstraZeneca (Covishield) vaccine is rare but can be devastating, causing even death in rare cases.
Therefore, there must be a risk-reward analysis: each individual must be free to decide his/her health risks and medical decisions, without any pressure or coercion.
Much trust has been lost due to lack of scientific rationale for vaccine coercion. Recently, in the Mumbai high court, the state of Maharashtra had to cut a sorry figure, forced to state that they do not even have the minutes of the meeting, where the vaccine requirement for travel by Mumbai local train was decided. Honest admissions are overdue to rebuild lost trust.
The assumptions of societal benefit behind vaccine coercion do not hold any water on close examination. Coercion erodes trust which will take years to rebuild. Discrimination based on vaccine status also divides society.
Do we really want a society where we view each other as unclean, especially when there is no scientific basis for this? Certain not. Therefore coercion and mandates must stop with immediate effect; they have no role in public health.
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*Faculty in the Department of Computer Science and Engineering at IIT Bombay. Views expressed are personal
The current Covid-19 vaccines have a positive role for old, susceptible, and hitherto unexposed individuals, to reduce disease severity. At the same time, while vaccine adverse effects may be rare, they are not nil.
The UK’s yellow card system has reported adverse events at the rate of about 1 in 106 doses for the AstraZeneca vaccine (Covishield). Changes to women’s menstrual cycle have been reported too. Blood clotting from the AstraZeneca (Covishield) vaccine is rare but can be devastating, causing even death in rare cases.
Therefore, there must be a risk-reward analysis: each individual must be free to decide his/her health risks and medical decisions, without any pressure or coercion.
Much trust has been lost due to lack of scientific rationale for vaccine coercion. Recently, in the Mumbai high court, the state of Maharashtra had to cut a sorry figure, forced to state that they do not even have the minutes of the meeting, where the vaccine requirement for travel by Mumbai local train was decided. Honest admissions are overdue to rebuild lost trust.
The assumptions of societal benefit behind vaccine coercion do not hold any water on close examination. Coercion erodes trust which will take years to rebuild. Discrimination based on vaccine status also divides society.
Do we really want a society where we view each other as unclean, especially when there is no scientific basis for this? Certain not. Therefore coercion and mandates must stop with immediate effect; they have no role in public health.
---
*Faculty in the Department of Computer Science and Engineering at IIT Bombay. Views expressed are personal
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