Even though we are doing fairly well, the title Covid-19 Vaccination’s R&R is obviously not to brag about our vaccination Rolls Royce here in Canada… It refers to the fundamental tension between our rights and our responsibilities. Let me explain. Vaccination rates are increasing at an encouraging pace in Canada. As at July 10th, latest statistics show that most provinces are tracking well and that close to 70% of the population has received at least one dose with 40 to 46% who have received the second dose. If all goes well, the country should hit the target of 75% with two doses by mid to late fall. This is good. But is it enough?
When we look at the demographics of the Covid-19 vaccination rates, it is easy to see a trend: the younger the population segment is, the lower the vaccination rate. Of course, the way the vaccination process unfolded plays a role in such statistics as the doses were offered in a staggered way, starting with the oldest population and working its way towards the younger age groups. But still, can we reflect on the possibility that personal preferences, trends, beliefs, religion and other important identity-related influences could make it difficult to reach a higher rate of vaccination? I believe so.
In the province of Quebec, a lottery has been instituted for those having received two doses by September 2021 in order to create an incentive for the younger age groups having been identified as being less keen on getting the vaccine. In France, the threat of having two doses as a requirement to access certain services or enjoy certain freedoms was invoked and generated a wave of registration by younger generations to get the Covid-19 vaccine. But is it acceptable to create incentives or put pressure on those who refuse to get the vaccine?
In addition to the above, the delta variant has increased pressure on governments to respond to the threat and scientists have started to voice the need to increase the Covid-19 vaccination target for herd immunity from 75% to 90% . This exacerbates the debate regarding the population segments who are not keen or simply against vaccination. Historically, vaccination rates are always fairly low when it comes to seasonal influenza. Different approaches, beliefs and the lack of urgency regarding the potential seriousness of getting the influenza virus have kept the vaccination rates very low (too low in the opinion of most public health experts). The question has always been: but what can we do if people don’t want to get the vaccine? Under normal circumstances, not much. It is up to each and everyone concerned to make a decision and get the vaccine or not. The consequences are increased seasonal pressure on the system, health system cost and a week under the weather before getting better for most people contracting the influenza virus. However, the covid-19 virus is different: it kills and has significant consequences on the health of people. It also is at the heart of the most important economical shutdown of the past century, which affects the lives of billions of people. So, what can we do?
I am a strong believer in human rights and the Canadian Charter of Rights and Freedoms protects the right to decide for ourselves, regardless of the reason. We all have a right to say no. But does that mean that all should enjoy the same privileges and advantages if by doing so it puts others at risk? That is the question underpinning the current discussions regarding a vaccination passport and the requirement to have been fully vaccinated to access certain privileges such as entering or leaving the country without quarantine or other measures to protect the public. The rationale is sound and it can be used to a great extent in almost all sphere of activities. As with any measures, it can be used wisely, rightly, and it can also be abused. Not an easy task to walk on the fine line between the two but it seems warranted. If someone does not wish to get the vaccine, the wish should be respected. But it is a collective duty to protect each other. With full Covid-19 vaccination, odds are low that a person may be a threat to someone who is not vaccinated. Without it, odds are very high, especially with the delta variant. So, what should we do?
The economy must reopen otherwise millions, if not billions, will suffer. This is already at play after a year and a half of economic disruption. Future generations will be affected and will have to cover for the historical cost of all necessary measures whether related to health or the economy. But reaching a 90% vaccination rate in Canada is a tall order. So, mitigating measures could be seen as justified in order to achieve both, the respect of rights and freedoms of all citizens all while ensuring that measures are put in place to ensure that the responsibilities that come with them are upheld by all, including the responsibility to do no harm to others. But quite frankly, even if Canada pulls a miracle and achieves a 90% vaccination rate or implements measures that enable Canadians to go back to somewhat of a normal life, the real challenge would remain. It is global. The 90% vaccination rate would need to be achieved globally to eradicate the pandemic, which is far from on track for so many countries and especially the ones with less means than the developed countries. This represents about two thirds of the world population. Inequalities have never been so obvious. But this is a different story and a good one for another article…
In the meantime, may you be well, may you be happy.
B.
Read this article if you wonder ‘ why a blog on health care ’.