Structure Polish Academy of Sciences

Vaccinations are an essential tool to effectively and safely limit the spread of COVID-19, its consequences, and its costs. For this reason, it is necessary to urgently consider introducing mandatory vaccinations for selected groups and in selected situations.

Over almost a year, SARS-CoV-2 vaccines have been one of the main topics of public debate. In administrative terms, they are completely voluntary, which means that getting (or refusing to get) a vaccine is a decision made by the patient. In Poland, the costs of voluntary vaccinations are essentially borne by patients. SARS-CoV-2 vaccines are an exception to this rule – the patient pays neither for the vaccine nor for the administration procedure. Such a solution has been adopted for reasons related to the important interests of the state and the high risk that COVID-19 poses to the health of each of us.

In the Polish legal system, there are also mandatory and much more frequent vaccinations: for children and adolescents (rubella, mumps, measles, tuberculosis, polio, tetanus, Streptococcus pneumoniae, whooping cough, and so on), individuals at a particularly high risk for infection (such as the hepatitis B vaccine for medical professionals), and post-exposure vaccines (for example, against rabies). As a rule, mandatory vaccinations are available for free. In the case of these vaccinations, the obligation to get vaccinated arises from a ministerial regulation. The doctor’s role in determining the eligibility of patients is limited to ruling out contraindications, including those listed in the product characteristics of a given vaccine. An administrative obligation, in turn, means that a patient who fails to comply with the legal provisions will be fined, just as a driver who does not stop at a red light. An obligation does not mean coercion. In the current epidemiological situation, physical coercion measures can only be lawfully used to enforce isolation or quarantine.

Until recently, introducing the obligation to get vaccinated against SARS-CoV-2 in the situation of vaccine shortages (and even rationing) were unjustified. However, this situation has changed in recent months, and access to vaccines is now practically unrestricted. The efficacy and safety of SARS-CoV-2 vaccines authorized for use by the European Medicines Agency (EMA) no longer raise any doubts in the scientific world. More than one billion people in the world have already received vaccines, including 17 million fully vaccinated Poles. We are now waiting for the EMA’s decision authorizing the use of vaccines in children aged 0-11 years, pregnant women, and immunocompromised individuals.

COVID-19 vaccines have gone through an extremely rigorous testing process. No other vaccine has ever been studied studied, monitored, and commented on so intensively and in such great detail. In the light of the ongoing fight against the pandemic, it would be unrealistic and irresponsible to further wait for a vaccine that is 100% effective against all variants of SARS-CoV-2 and free from any vaccine reactions. Let us not be deceived by various individuals who are spreading doubts and peddling pseudoscientific theories. There is, as yet, no possibility of treating COVID-19 at home, and ordering people to stay at home as a preventive measure is troublesome and very expensive.

Expecting a new wave of COVID-19 infections, we should consider introducing mandatory vaccinations against SARS-CoV-2, at least for those at a particularly high risk of infection. It stands to reason that this obligation should apply first of all to medical professionals, for the same reasons why members of this group were among the first to be offered vaccines (“group zero”). It is likewise worth noting and appreciating the maturity, responsibility, and professionalism of Polish doctors – approximately 90% of them have already received their COVID-19 vaccines.

In addition, we should consider mandatory vaccinations for other professional and social groups that are of key importance for the functioning of the state during the pandemic (the Armed Forces, police, fire brigades, and teachers) or at a particularly high risk for SARS-CoV-2 infection for reasons related to their direct contacts with customers (such physiotherapists, hairdressers, mail carriers, beauty salon employees, and so on). These topics require urgent debates and decisions. One clear epidemiological argument in favor of mandatory vaccinations is the ongoing pandemic along with its high costs and long-term consequences, associated with reduced access to health care and the prospect of closing for example workplaces, schools, universities, churches, cultural institutions, and recreational facilities.

Mandatory vaccinations imply limiting personal liberty. Nevertheless, we should remember that the unfettered liberty of an individual ends where the individual starts to pose a threat to others. To put it openly and bluntly, when it comes only to the financial aspect of keeping vaccines voluntary for all, if it is obvious that vaccine refusals cause additional expenses, resulting from the burden placed on health care and lockdown measures, should those who consciously refuse to receive free vaccines not bear the cost of these losses, which are after all deliberately caused by them? If a vaccinated patient has been waiting for many years for a scheduled surgery (ocular, oncological, orthopedic, cardiac, and so on), will he or she want to continue to wait, while hospitals treat those who deliberately expose themselves to the risk of infection and its sequelae? Imposing an obligation is a means used by the state to achieve important societal goals: universal education is possible thanks to the obligation to go to school, the efficient functioning of the state is possible thanks to the obligation to pay taxes, and so on. Mandatory COVID-19 vaccinations will protect the public and the state from the dangerous consequences of the COVID-19 epidemic: numerous deaths among COVID-19 patients, excess deaths among those suffering from other diseases, and the serious socioeconomic consequences that may be caused by the need to implement various lockdown measures. It is sad that we are now forced to recall the old slogan “there is no freedom without solidarity” and reiterate that brotherhood should go hand in hand with freedom.

At the beginning of 2020, the pandemic was an unexpected disaster of a global reach. Today, we have a readily available and well-tested tool to effectively extinguish the pandemic at the level of the country, provinces, and municipalities. Vaccinations remain an essential tool to effectively and safely limit the spread of COVID-19, its consequences, and its costs. For this reason, it is necessary to urgently consider introducing mandatory vaccinations for selected groups and in selected situations.

About the team

The Interdisciplinary COVID-19 Advisory Team to the President of the Polish Academy of Sciences was set up on 30 June 2020. The team is chaired by Prof. Jerzy Duszyński, President of the PAS, with Prof. Krzysztof Pyrć (Jagiellonian University) as deputy chair and Dr. Anna Plater-Zyberk (Polish Academy of Sciences) as its secretary. Other members of the team are:

• Aneta Afelt (University of Warsaw)
• Małgorzata Kossowska (Jagiellonian University)
• Radosław Owczuk, MD (Medical University of Gdańsk)
• Anna Ochab-Marcinek (PAS Institute of Physical Chemistry)
• Wojciech Paczos (PAS Institute of Economics, Cardiff University)
• Magdalena Rosińska, MD (National Institute for Public Health – National Hygiene Institute, Warsaw)
• Andrzej Rychard (Institute of Philosophy and Sociology PAN),
• Tomasz Smiatacz, MD (Medical University of Gdańsk)