Covid-19 Vaccines: From herd immunity to herd mentality

“I AM surrounded by idiots.’’ – Scar in Lion King

Discovery has become the first JSElisted company to announce mandatory Covid-19 vaccinations for all staff in early 2022. Other Top-40 JSE-listed employers are expected to follow suit.

We all know about stock exchanges and herd mentality. At least one news editor cheered the company on in an editorial, saying: “Leaders would be wise to follow Discovery's example and hold firm on vaccines.”

To anti-vaxxers – sorry to disappoint, this township doctor is 100% supportive of science, medical engineering, human progress and vaccines or immune modulators.

But, Discovery may have jumped the gun here. It is rather premature in the evolution of the response to the pandemic to threaten to limit employees’ personal rights and freedoms. It is also an inappropriate strategy in South Africa at the moment.

The strategy would be aimed at the employed population in a country that has a high unemployment rate, more pronounced in the age category of 15 -24 years – a rate of more than 60%. The announcement came at the time when 10% of the population was fully vaccinated. The Western Cape is in the grips of a prolonged peak of the third wave.

There are multiple variant viruses of interest circulating elsewhere. The pattern of variants in South Africa and Africa is only now being mapped and there is no evidence that a fourth wave will be averted by vaccination.

Transmission of the virus occurs in asymptomatic and vaccinated individuals. Control of a pandemic requires control of transmission locally, regionally, across borders and continents. The virus circulates in more than one variant and with different dominant variants across continents and regions. Transborder or transcontinental restrictive measures offer a temporal slowing down of the rate of transmission. They are not sustainable. Employment-related control measures in an uncontrolled external environment are an exercise in futility.

The decision to make vaccines mandatory should be based on complete information. The current Covid19 vaccines or so-called vaccines and related vaccine strategy do not prevent infections and transmission of dominant variants.

There is a suggestion and a wish that they do. The biology of the virus is still unravelling. The interaction of public health measures, human behaviour, immunity and viral biology seem to be complex. The delta variant of Sars-Covid-19 virus is responsible for a reported surge of infections, hospitalisations and deaths in fully vaccinated communities in the US.

This raises more questions. For one this pandemic is a biological challenge that requires a biological solution.

Public health law and ethics are essential elements to disease and injury prevention or control. Law remains an important public health tool. Healthcare, media, employees, business and society at large are important partners to the state in ensuring that conditions are met for health maintenance and for defining limitations of powers of the state and legally protected interests.

The law works better where the biology of the virus is better understood.

Discovery has claimed to derive the mandate to introduce mandatory vaccination for their employees from Occupational Health & Safety Act. Public health law can be coercive and may infringe significantly on individual rights.

Public health ethics can be useful in deciding among legal options and whether to exercise legal authority.

Health workers have – over previous infectious disease outbreaks, such as multi-drug resistant tuberculosis and extreme drug resistant tuberculosis – been very reluctant to utilise the law against the individuals who failed to isolate, quarantine and take toxic drugs.

In the case of HIV, the creation of a special offence would have probably further stigmatised persons with HIV and, possibly, also have led to the epidemic being driven underground with an eventual negative effect on the preventive programmes of the health authorities.

In the case of Covid-19, there are too many anti-vaxxers and vaccine-hesitant persons to exclude them from the formal economy. With the speed at which science is moving and progress is made, it may not be necessary to institute mandatory vaccines through employers.

Good science and good communication will win the day, not threats. Biological problems require biological solutions. Covid-19 is not bound by statutes and court rulings.