Last week, Boris Johnson called for a “national conversation” about unvaccinated people. “I don’t think we can keep going with non-pharmaceutical interventions, I mean restrictions on people’s way of life,” he said, “because a substantial proportion of the population sadly has not got vaccinated.”
Unfortunately, the national conversation that ensued was almost entirely about Downing Street parties, flat redecorations and other self-inflicted agonies, greatly weakening the prime minister’s authority at a time when he needs it most. The conversation he had intended to happen was reduced to denials from the government that he had been hinting at Austrian-style mandatory vaccination. With the biggest revolt by Tory MPs in Tuesday’s vote likely to be over vaccine passports for large public venues, ministers are at pains to play down the PM’s remarks — and he made no further attempt at this particular conversation when announcing the accelerated booster campaign on Sunday night.
Yet this is a national conversation that is indeed necessary and will become more so as successive variants of Covid emerge on its path to becoming endemic. The four or five million adults in the UK who still have not had even their first vaccine are compromising the health and freedom of the vast majority. Most of the under-50s who died from Covid last month were unvaccinated. Three quarters of the patients in critical care beds had not been vaccinated, according to the latest data from July.
Crucially, studies have also shown that vaccines can make you less prone to pass Covid on: research in Israel showed the nasal swabs of vaccinated individuals had smaller viral loads even if they had the virus, and they were therefore less likely to infect others. Sir Andrew Pollard, the Oxford scientist who chairs the Joint Committee on Vaccination and Immunology, has said “Covid-19 is no longer a disease of the vaccinated”.
The inescapable conclusion of such evidence is that a refusal to be vaccinated, excepting those cases where people are immuno-compromised and have a medical reason not to be jabbed, is an important factor in keeping everyone else under threat of restrictions on their liberty. The main reason the government has to revert to its plan B and think of a plan C is the risk that health service capacity will be overwhelmed. The disproportionate number of NHS beds required for unvaccinated individuals means the point of using up all capacity, and having to cancel other much-needed operations, is reached more rapidly than it need be.
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This is presumably going to be a bigger problem as time goes on. Any new variant that takes over from Omicron — perhaps just in time for next Christmas — will have to be even more infectious. By then, most people in Britain will probably be on their fourth jab, with brilliant scientists having adapted their vaccines to defeat more variants. But to hold off something so extremely infectious and avoid a third winter of crisis, virtually everyone would have to be vaccinated. If that is the case one year from now, the antivaxers will move, in popular opinion, from being merely irritating to being downright infuriating. In a survey published at the weekend, 59 per cent of voters already believed that unvaccinated people should not be allowed into restaurants, pubs, cinemas and workplaces.
Such an issue should not, of course, just be a matter of looking at a poll. It raises difficult ethical and political issues about the nature of freedom. Does our idea of unfettered personal liberty, that we apply to the freedom to hold religious beliefs or political views, extend to vaccination? Or do vaccines fall into the same category as paying taxes, or not drink-driving or not smoking on an aeroplane, where we all have a responsibility to contribute to our collective welfare and safety? My view is that they are indeed in this latter category: against a highly infectious disease, vaccinations are a collective defence, not a matter of individual morality. But in that case, where does the boundary lie between compulsion and encouragement?
Sajid Javid has ruled out mandatory vaccination. That is the right judgment. Compulsion would raise formidably difficult problems of enforcement and is ethically wrong — even in the world wars, people were not compelled to fight. But doing a great deal more to persuade, nudge, incentivise and push people towards taking part in our collective defence is another matter. Ministers can still do more to persuade hesitant ethnic minority groups. Fewer than half of 12 to 15-year-olds have been jabbed and advice to parents could be more categoric. Many pregnant women have been concerned about vaccination and some still haven’t heard of the overwhelming evidence that it is effective and safe for them.
Yet there are a few million adults in Britain who have no medical reason not to be vaccinated and have not been persuaded by the arguments. For them, vaccine passports surely have a role. Proof of vaccination to enter a venue is no guarantee that you can’t catch the virus there, since efficacy of vaccines wanes over time and fully jabbed people can still carry it. But experience abroad suggests that more people will turn up for their injection when their access to aspects of normal life is at stake. Several million additional French people booked their vaccinations in the week after President Macron announced that a health pass would be needed for most public venues and long-distance transport.
For Conservatives, rightly watchful of yet more intrusions on freedom, these issues are particularly difficult. But the point Boris Johnson was hinting at was important; there is a growing tension between the perfect liberty of the antivaxer and the wider freedom of the majority of the population. Most of us would prefer to be free to go to a restaurant while showing a pass than find it has to shut down in new lockdowns. MPs intending to rebel against vaccine passports in Tuesday’s vote are aiming at the wrong target.
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To point out that vaccine passports are a real hassle for businesses, who at least need consistency, is fair enough. To be fed up with new constraints in a long struggle against Covid is understandable. To warn against compulsory jabbing should be a point well taken. But to push the government away from wider use of vaccine passports in future, when that policy might help liberate the great majority of citizens, is a mistake. A conservative view of freedom stresses responsibilities as well as rights: it is different from pure libertarianism.
In the fight against Covid, real freedom is when 50 million people who have taken the trouble to get vaccinated and joined in a vital common defence are able to go to work every day, enjoy their holidays and see their families without worrying what comes next. Let’s start that national conversation.
