Mandatory vaccination is here

09 December 2021
I make no secret of my support for mandatory vaccination and my belief was that one way or another such a thing would eventually come, and now it has started to happen. Earlier in the month Singapore announced that people unvaccinated by choice will have to pay for any treatment, but this is a trend that had already started when Delta Airlines required unvaccinated employees to pay a $200 heath insurance surcharge. Before long anyone who wants to fly internationally will basically have to be vaccinated because even countries that shy away from domestic vaccine mandates have fewer queams about requiring it for people flying in and transiting. These de-facto requirements for vaccination is what I expected but now Austria has decided not to mess around and make it a legal requirement for everyone above 14. They will not be the last.

Before vaccines came out it was thought that vaccination rates as low as 30-40% would be enough to have a significant impact on transmission, with early estimates of 60% being enough for herd immunity from the original strain. With the Alpha variant this went up to circa 80% and with Delta it was propelled to somewhere around the ball-park of 95%. Even before Omicron came along some were already thinking that Covid-19 is here to stay and vaccination is now really about avoiding serious illness rather than stopping the spread of Covid-19, and in fact my own working assumption is that getting exposed to Covid-19 is a matter of when rather than if. There is simply no room for significant numbers of people to remain unvaccinated and I have already booked to have what will be my fourth BioNTech shot.

Today the unvaccinated and Covid-19 is classical Pareto principle since all countries I have looked at have circa 10-20% of their total population unvaccinated but when it comes to people needing hospital treatment the unvaccinated cohort is around 80% of cases. In Ireland where only 6.5% of adults are still unvaccinated over 50% of all occupied intensive care beds are taken up with unvaccinated Covid-19 patients. Even though the odds of an unvaccinated individual dying of Covid-19 is quite low these days they are still clogging up hospitals and as a result other people are dying due to undiagnosed or untreated conditions through lack of hospital places.

Earlier this year the fears about a vaccine with emergency approval were partly realised due to the Oxford/AstraZenica blood clotting that has killed 70 people in the UK, but things have moved on since then and the safety of the mRNA-based vaccines (i.e. BioNTech and Moderna) is about as certain as it is ever going to get. My unvaccinated friends talked about long-term side-effects but things are now at the stage where any such potential side-effects would have to be ones that remain latent for years, which as far as I am aware is unheard of for vaccines. The world just does not have the luxury of being able to wait-and-see. Not that long ago the German health minister stated that before long everyone would be “vaccinated, recovered, or dead” which aside from the time-scale is the expected end-game. In short everyone has to choose between two risks: the theoretical long-term effects of vaccines and the known long-term effects of getting Covid-19 itself.