nature | Vaccine mandates do risk overly politicizing health policy, says
MacDonald. But it is hard to accurately quantify the consequences such
as social exclusion, loss of public trust or inequitable outcomes.
Numerous other factors are at play, such as the way a government handled
the pandemic overall, wider political campaigns against vaccination or
mandates, or frustrations with the way that a mandate was implemented.
Another crucial aspect of whether mandates are successful is the
political skill and messaging used to introduce them.
Opposition
to vaccines — and mandates — can also be a way of expressing displeasure
with other aspects of civil society, says Heidi Larson, an
anthropologist and founding director of the Vaccine Confidence Project
at the London School of Hygiene & Tropical Medicine. “All of a
sudden everyone who had an issue with government has an issue with
vaccines,” she says. Oliu-Barton says that some mandates seem like a
referendum: “Do you like the government? You can say, ’no’, by not
getting a shot.”
Ward has tried to gauge how the French public
reacted to vaccination policies by using questionnaires. When asked if
they felt relief, anger or regret when they got vaccinated, respondents
who were vaccinated in early 2021 said they mostly felt relief. But most
of those vaccinated later, especially after the government imposed
health-pass requirements, reported anger or regret6.
In a later poll conducted in March this year, more than 60% of
respondents said they had felt at least somewhat ‘constrained’ to get
vaccinated. Ward’s future work will further dissect why and how.
In Germany, Katrin Schmelz, a psychologist at the University of
Konstanz, has led a unique series of surveys that tracked the evolving
views of nearly 2,000 German residents over the course of the pandemic7.
The
questionnaire showed that only around 3% of the population consistently
opposed vaccination if it was voluntary. By contrast, each survey
revealed that around 16% of people opposed mandatory vaccination —
crucially, however, it was not always the same 16% of respondents who
felt this way. Roughly half of respondents changed their minds over time
— and the shifting variables most closely tied to support for mandates
were trust in government and belief in vaccine effectiveness.
“Mandates
are an essential part of public health policies,” says Schmelz, but her
work also suggests that it was a good decision to make vaccination a
personal choice initially. Polling before vaccines were available showed
that 73% of German adults were OK with getting vaccinated voluntarily8
— which corresponded almost exactly to the fraction who were vaccinated
before mandates were introduced. Schmelz says she believes that a sense
of moral autonomy motivated these people to help battle the virus, and
that mandating vaccination earlier would probably have reduced this
motivation. “People respond to feeling distrusted by lowering their
effort,” she says.
A major concern is that if a substantial
proportion of society has lost trust in public institutions, this will
make public-health policies harder to implement — in particular, other
ongoing vaccine programmes. “Sentiments around vaccines are hugely tied
to trust in government,” says Larson. “What’s the knock-on effect of
this COVID experience on routine vaccination?”
Deciphering those
longer trends might take time. Larson is awaiting the results of the
Vaccine Confidence Project’s latest survey of overall attitudes to
vaccines, which she thinks will be an indicator of how views have
shifted.
Like so many aspects of the pandemic, decisions about
mandates and their implementation have occurred at speed — amid a
constantly shifting crisis. The legal requirements now being studied
were introduced in the summer of 2021, when anxieties about the pandemic
still ran deep, and such measures were more palatable. Available
vaccines also offered protection against infection, not just against
serious illness. With people becoming less afraid of COVID-19 and
vaccines offering less protection against infection by Omicron variants,
plans this spring to introduce new nationwide mandates in Austria and
Germany, for example, were rejected or never enforced.
As concerns
about the pandemic wane in many countries, researchers fear that
research fatigue is setting in, too, not least when it comes to
analysing the complex behavioural responses of people to the virus and
mitigation strategies. Yet behavioural science is an essential part of
the response to this pandemic and future ones. “People are tired,”
MacDonald says, “I think everybody wants this done.” But what she’s more
tired of is seeing governments not learning the lessons of previous
public-health emergencies. “We need this analysis done.”
That is unheard of! Are you talking about living patients actually??? Do the unjabed patients with Covid have identical symptoms of that severe clamping or it is 'just' the jabbed? Thank you very much for sharing all this... Actually I wrote many posts with the genetic analysis of the Spike code, which has pieces of everything, including every single clotting factor out there, as if the Spike sequence was made for hemophiliacs, to keep their blood running properly...