The argument for or against making COVID-19 vaccination compulsory before individuals can access public places, states, or even countries is raising concerns across the world, writes MOSES EMORINKEN
The World Health Organization (WHO) says nearly 6 billion doses of COVID-19 vaccines have been administered globally. Africa has, however, only administered 120 million doses, which represents about two per cent of that number.
The European Union and the United Kingdom have vaccinated over 60 per cent of their people and high-income countries have administered 48 times more doses per person than low-income nations.
Hence, vaccine inequity continues to be a major challenge for low-income countries, including Nigeria. Therefore, the WHO has called on richer countries to share vaccine doses with countries that cannot afford the vaccines or have access to them because of global politicisation of the vaccines.
In Nigeria, as of September 19, 1,771,140 persons have been fully vaccinated with their first and second doses of COVID-19 vaccine, while 4,415,507 have received their first dose only. This means that less than 10 per cent of the population have been vaccinated.
This year alone, Nigeria plans to receive about 41 million doses of vaccines – AstraZeneca, Moderna, Johnson & Johnson etc. However, as of September 19, 2021, the country has received roughly 10 million doses of COVID-19 vaccine.
Given the above vaccination/vaccines statistics, coupled with the Delta variant of the virus fuelling the third wave of the pandemic, there is an urgent need to ramp up vaccination efforts across states to ensure that more Nigerians are protected.
Should COVID-19 vaccination be made compulsory?
As part of measures to encourage the populace to embrace COVID-19 vaccines, certain states are beginning to give hints about their intention to make vaccination a requisite to visit public places like markets, worship centres, offices, malls, relaxation centres etc.
Few states such as Edo and Osun have started to take steps towards compulsory vaccination for their people, starting with civil servants and public officeholders. The Federal Government has mulled the idea of compulsory vaccination, stating that it is finalising plans to make vaccination compulsory, starting with employees in public service.
The WHO has, however, urged countries not to make vaccination a requisite for entry into their countries considering the fact that many African countries are yet to vaccinate up to 10 per cent of their population.
Read Also: Buhari to push global COVID-19 vaccine equity at UNGA76
During the conference of the Forum of Commissioners for Health in Nigeria, the Secretary to the Government of the Federation (SGF), Boss Mustapha, said: “The vaccine mandate obviously will come. Before now, without the simple yellow fever vaccine, you could not travel the world without the card until Nigeria was exited from the list of endemic countries. Therefore, the world is gravitating towards that direction. I can tell you that by the time the western world vaccinates its people, you can’t get into any of the western countries without the vaccine certificate; it has started happening in the European Union dispensation now. They have created some waivers for people that have been vaccinated. It is better we begin to prepare people at home.
“One of the reasons we want to do that with federal civil servants is because they will be traveling to perform roles on behalf of the Federal Government.
“It is a sequential thing and we are taking one step at a time. We realised we do not have sufficient vaccines, so we will not be able to impose those kinds of mandates on an automatic basis; it has to take some time and we will make sure that the vaccines are available and are deployed to the appropriate places and people will have the opportunity of getting the vaccines before we now impose the mandatory nature of whether you have vaccines or not before you can access government facilities.”
The Executive Director of the National Primary Health Care Development Agency (NPHCDA), Dr Faisal Shuaib, explained that the debate on compulsory vaccination is a healthy one, and will become inevitable in the long run.
“At this juncture, I would like to remind all Nigerians that evidence of vaccination against COVID-19 is now mandatory for all pilgrims to the holy cities of Saudi Arabia and Jerusalem. I, therefore, urge adherents of both religions who are planning to perform pilgrimage next year or in the future, to get vaccinated now to avoid any delays. This is also to bring to our attention that as the COVID-19 vaccines become available worldwide, some countries have made vaccination a requirement to gain access to their country.
“I do not know the specific instances in States around compulsory vaccination. What I believe most of the governors are doing is providing an incentive for people to get vaccinated.
“People have a choice not to get vaccinated. Yes, you do have a right to say that you do not want to get vaccinated but you also do not have the right to infect others. Those are healthy conversations that are going on in the state, and I do not think there should be censorship of those kinds of conversations. It is part of democracy,” he said.
Experts differ on the subject
Speaking with The Nation, Nigeria’s foremost Virologist, Prof Oyewale Tomori, opined that although getting everyone vaccinated will be a very good idea, especially towards achieving herd immunity, however, with fewer available vaccines to cater for over 200 million Nigerians, the compulsory clause on vaccination should not be activated now.
He said: “Not now. Before you begin to make something compulsory it must be available to everybody. It is only when it is available and the person does not take it that you can talk of compulsory vaccination. The idea is good for the sake of all of us, but then you can’t take what you don’t have. We are looking at about 120 million to 140 million to be vaccinated, and you have only less than 10 million doses, and you are saying it is compulsory that people take the vaccines; my question is – take what?
“I think the first step the government should take is to make sure that the vaccines are available, and then if after that people refuse to take it, then you can bring in this new mandate. It doesn’t make sense to me when a thing is not available and then you say people should take it; how do they take what is not available? We need to get as many doses as we require. If people now refuse to take vaccines, thereby endangering other people’s lives, then you put a mandate on it. You do not put a mandate when you do not have enough vaccines available. This is putting the cart before the horse.”
Another Pathologist, and a Research Professor at the National Open University, Mba Okonkwo, believes vaccination should be made compulsory immediately because the country is in a public health emergency.
He said: “My advice is that with other COVID-19 variants like the Delta variant and others coming up, there are expected exigencies in vaccination. These organisms can mutate and change their forms, thereby making the vaccination ineffective. It is therefore important that we have herd immunity by vaccinating as many people as possible.
“As the vaccines are made available, people should actually go for the vaccination. I know that the World Health Organization and other health institutions are working to provide vaccines for the new variants as well.
“Yes, the government should make vaccination compulsory because this is a public health emergency, and it should be taken with all seriousness. Making it compulsory will bring the information close to people who were not interested before and who did not understand why vaccination was necessary.
“Many people up till now still do not believe that COVID-19 is real. For that reason, they have a lackadaisical attitude towards the preventive measures that the government is proposing. I strongly believe that the government should make it compulsory and try to enforce and implement it.”
How safe and effective are the vaccines?
The WHO, United Nations Children’s Fund (UNICEF), and other global health bodies have continued to urge people to take the vaccines because they are safe and effective against COVID-19 and its sundry variants. Also, it remains the most potent tool against the pandemic, alongside other non-pharmaceutical interventions like regular handwashing with soap in flowing water, hand sanitising, proper wearing of the facemask, practising social distancing, and avoiding large gatherings.
Even the National Agency for Food and Drug Administration and Control (NAFDAC) certified as safe and efficacious the vaccines being administered in-country.
Speaking during a media dialogue on COVID-19 vaccination with reporters in Kano, organised by UNICEF, Dr Murtala Jubril, an Immunologist and a Vaccine Development Expert, explained that the vaccines are safe and effective against the virus, adding that the vaccines available in the country cannot lead to a reinfection with COVID-19.
He noted that unlike other vaccines that are produced using inactivated while viruses, the vaccines available in the country only make use of a part of the virus, not the whole organism, hence, there can never be a reinfection with COVID-19 by taking the vaccines.
“Current vaccines were designed for earlier versions of coronavirus, but they still work, albeit less well. Lab research suggests antibodies that can fight the infection – triggered by vaccination or past infection – may be somewhat less effective against Delta. Pfizer or AstraZeneca vaccines still protect people from getting very ill. Data from the Oxford-AstraZeneca vaccine team suggests it protects just as well against the Alpha variant. It offers less protection against the Beta variant – but still protects against severe illness. Gamma variants may resist antibodies in people who’ve recovered from COVID-19. The Moderna vaccine is effective against the Beta variant, although the immune response triggered may be weaker and shorter-lived.
“There is growing information on the safety of COVID-19 vaccination during pregnancy. Data from the US – where over 130,000 pregnant women have been vaccinated mainly with mRNA vaccines (Pfizer-BioNTech and Moderna) have not raised any safety concerns. Also, Public Health Scotland have reported that 4,000 pregnant women have received a vaccine until May with no serious adverse effects recorded. Different side effects have not been reported in pregnancy for mRNA vaccines. Recent reports have shown that COVID-19 mRNA vaccination during pregnancy (mostly during their third trimester) have passed antibodies to their foetuses,” he added.
Dispelling myths, misconceptions with facts
Misinformation, disinformation and conspiracy theories are the new pandemic. They tend to fuel vaccine hesitancy. Hence, depriving people of taking lifesaving vaccines because they think it may hurt them.
The Vice-Chancellor of the Federal University, Kashere in Gombe State, Prof Umar Pate, has therefore urged Nigerians to dismiss all rumours and conspiracy theories associated with COVID-19 vaccines, adding that the vaccines are safe and effective in protecting Nigerians against the deadly pandemic.
“Our communities are highly vulnerable to believing fake information and even more on the sources and prevalence of the virus and its treatment. Therefore, debunking loads of fake information about the vaccination should be multifaceted; it should not be medicalised or highly politicised.
“Efforts should focus on active leadership involvement at all levels, community engagement, informed media engagement, intensive awareness campaigns debunking rumours and negative theories, promotional of media and digital literacy among young people (to learn to be critical in consuming social media messages), and avoidance of mixed messages particularly by opinion leaders,” he said.