Vaccination has been making the headlines for weeks, resulting in a heated debate between those who feel it’s necessary to get back to some normalcy and those who are either worried of its possible side-effects or the autocratic way in which it is being imposed. Nalini Burn, socioeconomist, has been at the forefront of this debate. We approached her for her views on the matter. 

“I ask the opponents of mandatory vaccination: If it was not mandatory, would you get vaccinated? If you would, then, why give priority to individual freedom over the right to health?” 

There has been a lot of debate and exchanges about mandatory vaccination. You are one of the proponents of the vaccine and have been forceful about it. Give us the reasons why we should all be vaccinated?
Hey, there is a pandemic out there-Covid 19! The official deaths -underestimated- are about 3.96 million with millions ill, some seriously, and over a long period, globally. And this mostly in rich countries, such as the USA and the UK, despite their life-saving public health capabilities. 

Be that as it may, why are you advocating vaccination as the only solution?
First, because of commitment to the right to health. It is about the best available universal health care that is possible to achieve in any country and which means to stop preventable deaths and morbidity.

How about the approach of allowing the disease to run its course “naturally”?
That will lead to millions of deaths, debilitating disease and complications and devastate livelihoods. It is not a moral and ethical option and is a gross violation of human rights. Also, in the case of a transmissible disease, like COVID 19, the one effective human rights-compliant way to prevent it is through vaccination. 

But up until now, there is no certainty about the efficacy of the vaccines available, is there?
Yes there is. Vaccines greatly reduce how severely you get the disease and how much you can transmit it. Since their roll-out in January 2021, we can already see how the link between infection, hospitalisation and death can be broken. We are more vulnerable because of the burden of non- transmissible diseases like diabetes, heart disease, cancers do increase risk of being seriously ill and not surviving COVID, particularly as we age. 

Can’t we stop the spread of Covid through any other means without violating human rights?
The so-called Zero Covid, through physical barriers like quarantine, lockdowns, but with low vaccination rates, is not working, as “fortress” Australia is now discovering. That way of dealing with Covid is also a life threatening violation of human rights because of the social, economic, cultural, health, psychological damage inflicted on humans as social beings, on their livelihoods.  It has revealed and amplified the inequalities and injustices burdening our societies, increasing gender-based violence, placing intolerable strains on the care we provide to each other, paid and unpaid. Vaccines are a way of preventing that transmission to enable us to manage to live with Covid, eventually tame it, as we now do with the flu. 

Going to the extent of forcing people to get the jab? 
I am NOT a proponent of mandatory vaccination. It is deeply concerning that the debate has been framed, conflated, and is now polarised in this way. 

“The virus is targeting younger age groups as the vaccinated develop the immune response to fight infection.”

Are you saying people should have a choice if they don’t want to be vaccinated?
Some have even called trying to convince them and challenging their viewpoint over vaccination as ‘terrorism’!  But I will persist in helping, with empathy, nurture a human rights-based ecosystem of INFORMED CONSENT to nudge vaccine-hesitant people towards vaccination.  

So you are for free choice, aren’t you?
Yes, free choice for you as long as you respect my right to health within this ecosystem, not to be infected as far as possible and with access to health care for other illnesses. The State Party has an obligation to protect. I, as a rights-holder also have a responsibility to protect myself and respect others. The right to individual freedoms and liberties (and the corresponding obligation to respect) are other fundamental human rights. It is a sort of contract between the state and citizens. But all bound within public space, guaranteed by the rule of law as a fundamental human rights principle. The infectious nature of the disease makes health a public good, indivisibly delivered to one and all. It cannot be individually exclusively packaged and privatised. The virus does NOT respect individual bodily integrity. It cunningly violates all its defences. It does not choose. It will just keep finding someone out there it can infect and it mutate. The limits of an individualised right-wing libertarian ethos and anti-human rights agenda are exposed. Letting the disease run its course does mean the ‘freedom’ to die of hunger, disease, pestilence. It is up to individual choice and circumstances. Laisser-faire again. The issue is ideological, ethical! Focusing on the mandatory nature galvanises the anti-state – any state – stance, while commandeering its obligation to respect.

There are many reasons why the opponents of vaccination do not want to take the jab. Some resent its mandatory nature, others because of health concerns and some worry about whether it is effective and safe or not. All this is very confusing, isn’t it?  
I ask the opponents of mandatory vaccination: If it was not mandatory, would you get vaccinated? If you would, then, why give priority to individual freedom over the right to health? I signed the disclaimer form to get vaccinated. Given the State’s obligation, I will challenge it in court, if necessary. Yes there are people for whom vaccination is risky on health grounds. And that is the reason why healthy people should protect them by getting vaccinated. As for efficacy, the virus is targeting younger age groups as the vaccinated develop the immune response to fight infection. Yes, it is confusing: What information is pertinent?  How to process it? But is it information or deliberate disinformation? Last year, when Covid first stopped the world, remember the conspiracy theories and Covid denial: About China, WHO, Bill Gates, Big Pharma, a programmed sequenced New World Order.  Now the vaccines have given these another shot in the arm. An infodemic grafting onto the pandemic, inflaming vaccine hesitancy.  I spend much time, like others, researching, checking and calling out obscurantist disinformation churned out by the cyberfactories - very good at going viral. 

So let me put the question to you again: How does the ordinary citizen find her way through all of this?
Yes, I really feel for who you call the “ordinary citizen”. There is unfortunately in many a tendency to choose a trusted influencer/guru and believe and go by whatever he or she says. Anti-science as belief is now an acknowledged global risk. I do believe the only way is to vastly communicate interactively, inclusively tease out the moral, policy trilemmas to respond to this disaster risk, based on informed science-backed consent.

Shouldn’t the government be part of this communication plan?
The government has refused to initiate an inclusive interactive dialogue with citizens, who did suggest it. It has responded with haughty opacity, selective drip-dripping of bits of meaningless data, harsh, ill thought-out measures, top-down draconian legislation and measures. Then it has given conflicting messages about being Covid free and safe. It has not used the quarantine/confinement window to prepare for opening, for living as safely as possible with a virus that has far from run its course anywhere. Let’s not forget the context of COVID- related procurement scandals, the Wakashio episode and the unprecedented mobilisation against all of this. Now it has lurched into vaccines by heavy-handedly trying by the back door to make it mandatory. While disclaiming responsibility for any risk associated. This unjust breach of trust is yet another human rights violation. The anti-vax lobbies have seized the opportunity to weaponise the rights discourse. And some of the supposedly alternative opposition is also jumping on the anti-mandatory vaccination bandwagon as platform to oppose the government. 

While Government is making it more and more difficult for its citizens to move around without being vaccinated, the types of vaccines on offer have sometimes not been cleared by the World Health Organization. Isn’t that tyrannical?
 Was the word tyrannical framed when there were non-pharmaceutical interventions such as lockdowns and quarantine? No transport, income, food, workplace, schools, places of worship, fresh air/exercise, split families, incarcerated at home with your abuser, burnt out with multiple care responsibilities. Human rights violations, unequal, backed by repressive legislation. WAPs like the Pass Laws of colonialism and where biosurveillance now adds to the coercive apparatus of the surveillance state. But the fixation is on vaccines, which actually offer the easing of movement restrictions. When I travel to countries where yellow fever vaccination is mandatory, I consent to it for my safety.  

That’s a tried and tested vaccine. The Covid-19 vaccines are new and have only got the Emergency Use Licence. Some we are asked to take have not even reached that status.
Closer scrutiny of the procedures can make one anticipate likely approval. Sputnik V listing is being held up NOT essentially on safety and efficacy but on production issues. Are people aware of the colossal, unprecedented collaborative efforts and technological advances, building on previous SARS research, to accelerate vaccine development? Impelled by an emergency race between vaccine and the virus and its variants, given our globalised lifestyles and population levels? THE global health risk is the shortage of vaccines and the inequalities of where it is available, accessible and affordable. Waiting for further safety leaves free course to the virus to reach the vast majority of mostly unvaccinated populations and mutating, particularly in the poor discriminated countries of the Global South. Some protection is much better than none!

Some side-effects reported lately are worrying. Don’t they worry you?
Some reported side effects go viral without closer scrutiny and with spurious, scary conclusions. There are also mixed messages from some medical authorities and some medical professionals. The research into reported adverse events after vaccination have to sort out whether they are because of vaccination or some other related and unrelated factors. And communicate results, as gradually they are investigated, through surveillance. Up to now, the numbers and proportions involved in side effects are actually very small, the side effects are mild and not long lasting. I think there is a need for a sort of ongoing clearing house for this, the sort of interactive platform I was mentioning, with a consortium of concerned media, health professionals, lay persons.

“I am NOT a proponent of mandatory vaccination. It is deeply concerning that the debate has been framed, conflated, and is now polarised in this way.”

The statistics coming out of the Seychelles, the good student of the Indian Ocean when it comes to vaccination, do not tell a good story, do they?
Seychelles was a good student for many lobbies. Of vaccinate and open up quickly for compelling economic reasons. Did the authorities think vaccination was the only quick fix and so did its people, celebrating with super spreader events? And was it not caught out by variants, from elsewhere?

How about Israel, one of the first countries to have vaccinated a large chunk of its population?
Vaccines alone are not a miracle solution. They are not 100% effective. They should be used with complementary measures that also boost the immune system as hygiene, physical distancing.  In the case of Israel, not all have been vaccinated, least of all Palestinians. Even with the contagious Delta variant, the vaccination rate has reduced the transmission of the infection, hospitalisation and death among the vaccinated. 

British Prime Minister Boris Johnson has announced “freedom day” to be effective on Monday 19th – a very controversial decision that has pushed a large part of the scientific community to be up in arms. How do you feel about that?
Totally irresponsible from a populist ideologue who now again leaves it to the population to decide, having initially sought herd immunity, leading to tragic death tolls, all sorts of mental, physical and social pathologies, exhausted front line staff, overwhelmed NHS. Yet, he still keeps sending confused messages, with confinement fatigue rampant. Some “freedom” this, indulging in Wembley-like super-spreader events!