MARTIN KINGSTON: Mandatory vaccination: it’s not about coercion, it’s about responsibility

Given the emergence of the new variant, coupled with the rising levels of infection in Gauteng in particular, we believe our fourth wave will soon be upon us. With that in mind, we welcome the president’s commitment in Sunday’s address to considering the issue of mandatory vaccination and restricted access.

If we are to have reasonable discussions about the need for mandatory vaccination policies perhaps we need to begin by finding another way to name this concept. “Mandatory vaccination” has a draconian air about it, where people are vaccinated against their will and in contravention of their right to bodily autonomy.

However, the issue of mandatory vaccinations is not about issuing a society-wide decree that vaccinations will be compulsory for everyone in every situation. Instead, it’s about reserving access to certain public spaces for those who are vaccinated, given the risk the unvaccinated bring with them to those spaces. It’s about “right of admission reserved” — for those who have had their Covid-19 vaccination.

In congregate settings where large numbers of people work — or where they gather to worship or be entertained — there is incontrovertible evidence that vaccination provides protection against both transmission of, and infection with, Covid-19. Every unvaccinated person who enters that space pokes a hole in that protection.

In the workplace specifically, employers have a legal and ethical obligation to create a safe working environment. We wouldn’t send miners underground without their helmets and safety boots, or into mine shafts that aren’t properly reinforced and ventilated. We don’t ask surgeons to operate in theatres that aren’t properly sterilised. We expect that our workplaces will have lifts that operate properly and stairs with banisters; that the buildings will be sound and well maintained.

Safety is built into how we manage our public spaces and workplaces in myriad ways, large and small, for the benefit of all who enter, including customers, service providers and other visitors. Employees are entitled to expect that they will work in a safe environment — that they will be supplied with personal protective equipment where applicable, that the cleaners will warn them when the floor is wet, that there are protocols in place in case of a fire or a bomb, that the security guards will prevent people wielding loaded guns from entering the premises.

Of course, there are businesses where people can easily work from home, in isolation, and still carry out their duties. But there are a great many industries where this is not possible, such as mining, or manufacturing. Here people are required to work in close contact with each other, on site. Likewise, many services and shopping spaces are designed to have many people in close proximity to each other. 

Putting those employees in a situation where there is the potential to be infected with a deadly disease is, simply, irresponsible, especially when there are easily applied risk mitigation measures such as masking, hand hygiene, social distancing, adequate ventilation and, now, vaccination.

Vaccination is minimally invasive, free to all South Africans and readily available. And the evidence is overwhelming that it works.

There’s also nothing new about vaccine mandates. There are examples stretching back to the American Revolutionary War when Gen George Washington required all troops to be inoculated against smallpox. The US has had childhood vaccination mandates in place since the late 1970s. Italy requires children to be vaccinated against a range of pathogens, ranging from hepatitis B and diphtheria, through to measles, mumps and rubella.

Closer to home, the department of basic education requires that parents submit their child’s immunisation card when they apply to enrol in grade 1 to prove that the child has been vaccinated against childhood diseases such as measles, polio and whooping cough. Anyone who wants to travel to an area with a high risk of yellow fever must produce proof that they have been vaccinated against it. They can choose to forgo the vaccine, but then they are prohibited from entering those countries.

Of course, no-one wants to be forced to do anything — we all want our freedom. But some freedoms come with trade-offs. And that trade-off may have to be a “no jab, no access” policy in many places, for the sake of the greater good.

In many countries these policies are taking hold, and we believe will become the norm. Italy, France and Greece have all introduced mandatory vaccinations for healthcare workers and certain government employees. In France, entry into cinemas, sports stadiums, restaurants, bars, shopping centres and nightclubs requires proof of vaccination or a negative test. In New York you can’t enter a restaurant without proof of vaccination. 

The more than 270,000 excess death figures in SA since March 2020 paint a grim picture: we know for certain now that this is not “just the flu”. Covid-19 poses a considerable public health risk in much the same way that notifiable diseases such as cholera, listeriosis and tuberculosis do.

We know vaccination is not a silver bullet and medical experts around the world are still refining dosages and regimens as they grapple with trying to stay on top of rampant infections and the potential for new variants. But together with a suite of measures — such as ventilation, masking, social distancing and hand hygiene — widespread vaccination offers us the best chance of normalising our society.

Of course, employers will need to consider their individual set-ups and consult widely with employees, providing alternatives where they are reasonably practicable in much the same way that an employer would do everything possible to make accommodations for someone with a disability, for instance. But where those alternatives are not available or practical it may have to boil down to a policy of “no jab, no job”.

It’s not about coercion or compulsion. It’s about the responsibility employers or anyone responsible for a public space carries to provide a safe working environment for their employees or anyone entering an area they control. And in the face of a pathogen that has the potential to cause severe and long-term illness, and even death, vaccination may be required to ensure employees don’t pose a risk to others they encounter.

If we don’t dramatically improve the vaccination rate and infections continue to rise, we again risk overburdening the health system and forcing SA to consider the harsh lockdown restrictions that harm the economy, jobs and livelihoods. Vaccination can prevent this.

• Kingston chairs Business for SA.