BMJ Global Health: The unintended consequences of COVID-19 vaccine policy: why mandates, passports and restrictions may cause more harm than good

[Emily]

https://gh.bmj.com/content/7/5/e008684

Bardosh K, de Figueiredo A, Gur-Arie R, et al
The unintended consequences of COVID-19 vaccine policy: why mandates, passports and restrictions may cause more harm than good
BMJ Global Health 2022;7:e008684.

Abstract

Vaccination policies have shifted dramatically during COVID-19 with the rapid emergence of population-wide vaccine mandates, domestic vaccine passports and differential restrictions based on vaccination status. While these policies have prompted ethical, scientific, practical, legal and political debate, there has been limited evaluation of their potential unintended consequences. Here, we outline a comprehensive set of hypotheses for why these policies may ultimately be counterproductive and harmful. Our framework considers four domains: (1) behavioural psychology, (2) politics and law, (3) socioeconomics, and (4) the integrity of science and public health. While current vaccines appear to have had a significant impact on decreasing COVID-19-related morbidity and mortality burdens, we argue that current mandatory vaccine policies are scientifically questionable and are likely to cause more societal harm than good. Restricting people’s access to work, education, public transport and social life based on COVID-19 vaccination status impinges on human rights, promotes stigma and social polarisation, and adversely affects health and well-being. Current policies may lead to a widening of health and economic inequalities, detrimental long-term impacts on trust in government and scientific institutions, and reduce the uptake of future public health measures, including COVID-19 vaccines as well as routine immunisations. Mandating vaccination is one of the most powerful interventions in public health and should be used sparingly and carefully to uphold ethical norms and trust in institutions. We argue that current COVID-19 vaccine policies should be re-evaluated in light of the negative consequences that we outline. Leveraging empowering strategies based on trust and public consultation, and improving healthcare services and infrastructure, represent a more sustainable approach to optimising COVID-19 vaccination programmes and, more broadly, the health and well-being of the public.

 

[sharon sanders]

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[Emily]

https://www.researchgate.net/public...n_among_a_global_COVID-19_unvaccinated_cohort
Verkerk, Robert & Plothe, Christof & Kathrada, Naseeba & Lindley D.O. Facofp, Katarina. (2022). Self-reported outcomes, choices and discrimination among a global COVID-19 unvaccinated cohort. 10.13140/RG.2.2.28855.19369.

Results from a preliminary analysis of self-reported, self-selected survey results from a sub-cohort of >300,000 participants of the Control Group Cooperative project to understand more about their health outcomes, choices and any discrimination faced.

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DISCUSSION

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CGC respondents in the survey gave various reasons for declining COVID-19 injection,

including distrust of health authorities, governments or the pharmaceutical industry,

insufficient evidence of safety or effectiveness, or concerns over injuries or potential

adverse reactions, for which the manufacturers typically have indemnity in the event of

compensation for injuries resulting from vaccination.



Since the mass roll-out of experimental products was initiated in late 2020, the products

have been found to deliver very little protection against transmission of the current,

dominant, circulating, omicron variant (Amanatidou et al, 2022). This means the products

do not fulfil the widely accepted purpose of a vaccine, which is to induce herd immunity by

triggering an immune response that fully neutralises or sterilises the pathogen so preventing

transmission. The World Health Organization (WHO) updated its description of ‘herd

immunity’ on 31 December 2020, stating: “WHO supports achieving 'herd immunity' through

vaccination, not by allowing a disease to spread through any segment of the population, as

this would result in unnecessary cases and deaths” (WHO, 2020). Additionally, immunologic

effectiveness even against disease was found to wane rapidly, within a few months (Israel et

al, 2021; Ferdinands et al, 2022) implying that those relying on COVID-19 injections would


The findings from the present survey have five main limitations; 1) the respondents are self-

selected and therefore not randomly selected; 2) the data are self-reported and therefore

have not been verified independently; 3) the ~18,500 participant cohort may have been

biased towards the most diligent, health-conscious participants given they all completed

monthly surveys (although a number of cross-checks with the main ~300,000 cohort

suggests this bias is likely low); 4) there is no available comparative ‘control’ population that

includes individuals who have consented to one or more COVID-19 vaccines of different

types; and; 5) the questionnaire design is limited and does not account for multiple

variables that affect health status, such as socioeconomic status, urban, peri-urban or rural

residence, diet, or lifestyle.


That being said, the survey data do offer indicative or suggestive evidence that the CGC

COVID-19 unvaccinated cohort prioritises self-care and has placed very little burden on

healthcare systems in respective countries. It follows, then, that the marginalisation,

stigmatisation, coercion of and discrimination against this population group, one that has

not consented to COVID-19 injections, is neither valid nor ethical. Such discrimination and

restriction of liberties based on vaccination status may fall foul of relevant national anti-

discrimination laws and international treaties, such as the UN’s International Covenant on

Economic, Social and Cultural Rights (ICESCR, 1966), which includes fundamental rights to

liberty and security of person, freedom of movement, privacy, religion and belief, freedom

of expression, and peaceful assembly.


The findings also amplify the great need to ensure that well conducted observational studies

are carried out in order to compare outcomes, choices and potential discrimination in

COVID-19 vaccinated and unvaccinated populations.