Mandatory vaccination: Science vs law?

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I am on the fence about House Bill No. 9252, which intends to practically make compulsory the vaccination of the public as protection against COVID-19 through a process of what I deem to be selective exclusion. Authored by Cavite Rep. Elpidio Barzaga, Jr., the bill is to be tackled by the House Committee on Health in August or September, according to the lawmaker.

Under the proposed measure, to be known as the Mandatory COVID-19 Immunization Act of 2021, the COVID-19 Vaccination Program will be “mandatory for persons as may be determined by the DoH (Department of Health) and shall be given for free at any government hospital or health center, and as provided in Republic Act No. 11525, provided, that inoculation must, at all times, be science and evidence based.”

Where it gets unclear is in its provision that “no persons who are covered by this Act, as determined by the DoH, shall be allowed to enter, convene or occupy public places, whether or not government or privately owned.” This appears to imply that public places will be only for vaccinated individuals, selectively excluding the unvaccinated majority — including children — from public places.

The bill also provides for the issuance of vaccine cards, making such “as an additional mandatory requirement for educational, employment and other similar government transaction purposes.” Does this mean the proposed law will have the effect of temporarily suspending the civil rights of those unvaccinated against COVID-19? Just like those in detention or in prison?

Moreover, the Barzaga bill provides that “any person who violates any provision of this Act, or any of its rules and regulations or without permission of the quarantine officer in charge, shall be punished by a fine of not more than P50,000, or by imprisonment for not more than one year, or both.”

Mr. Barzaga perceives the need for a “drastic” measure to counter vaccine hesitancy, with urgency prompted by the 2022 polls. “In order to safely achieve herd immunity, a substantial proportion of a population would need to be vaccinated,” he was quoted in a news report. “We hope that we will be able to finish this before the end of the 18th Congress because our problem is elections is just around the corner, and we might run out of time.”

In persuading more people to get vaccinated as protection against disease, would we rather have them persuaded by science or by law? Science, or course, can make compelling arguments for or against, but the choice to act remains personal and free. Law, on the other hand, compels one to act under duress, or through some form of pressure, regardless of science.

In March, I called on legal and medical experts to chime in on whether COVID-19 vaccination should be mandatory or compulsory — an interesting case for Bioethics. This was after I noted that while pandemics were not unprecedented, COVID-19 is, and the same goes for the extraordinary havoc it continues to wreak on lives and the global economy.

With the Barzaga bill filed in late April and now seemingly under way, now is the time for the legal and medical community to be heard. The public will surely benefit from expert opinion on the matter, and I am sure lawmakers cannot claim a monopoly on ideas. Making experts’ opinions, backed by data, publicly available will benefit the public and policy makers alike.

The Barzaga bill has an unintended political dimension, and that is the possible selective exclusion of the unvaccinated majority from public places like polling precincts. If the bill passes before the end of the year, imagine the implication on the 2022 presidential, senatorial, and local elections? When in fact COVID-19 should not be an issue. The United States successfully held presidential elections in 2020 without making vaccination mandatory.

One compelling argument in favor of mandatory vaccination is that vaccine hesitancy may prevent herd immunity, and that unless a critical mass or people will get the vaccine, the infection and death toll from COVID-19 will continue to rise. If only 10 out of 100 will favor vaccination, then the overall inoculation process may be for naught.

On the other hand, experience also shows that mandatory vaccination is not a cure all. In a Feb. 16 report in The Straits Times by Indonesian Correspondent Wahyudi Soeriaatmadja, he wrote that “Indonesia has made coronavirus vaccination for citizens compulsory,” and that “people who are eligible for vaccination but refuse a jab can be penalized” with fines, delays or suspension of social aids, or delays or suspension of access to public services. That was in February. Since then, six months after, Indonesia is still struggling with the Delta variant.

In the US, which is also struggling against the Delta variant now, the 1905 US Supreme Court case of Jacobson v. Massachusetts already affirmed the authority of the state to compel vaccination, noting that “the rights of the individual may at times, under the pressure of great dangers, be subjected to such restraint to be enforced by reasonable regulations as the safety of the general public may demand.”

Even the US Equal Employment Opportunity Commission, last December, reportedly issued guidance stating that employers were legally allowed to require employees to be vaccinated before they return to offices. In a way, vaccination can also indirectly address the concern that further easing of quarantine restrictions or allowing greater capacity for businesses and transportation can lead to more deaths.

But this brings me to the point that if the state’s regulation of healthcare is intended to ensure the protection of lives and the promotion of the greatest public good, but at the same time acknowledging that COVID-19 vaccines are generally “experimental,” can we morally make inoculation compulsory for all? Can we deny people the right to vote in a public polling place? Can we suspend the civil rights of those who chose to skip vaccination? Can the Barzaga bill settle the constitutional and moral issues?

 

Marvin Tort is a former managing editor of BusinessWorld, and a former chairman of the Philippine Press Council

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