Ladies and gentlemen,
Thank you for inviting me to speak on the highly topical and sensitive issue of “Vaccination by Law”;
Since the outbreak of the pandemic, the Parliamentary Assembly which I have the honour to preside, has done significant work on what has become a new pressing political issue and a high political priority: upholding Council of Europe values in the context of a serious public health emergency and supporting national parliaments in addressing the consequences of the pandemic by making full use of the Council of Europe legal standards, practical tools and expertise.
The Assembly has adopted very important reports that focus on the impact and consequences of the pandemic for our health systems, democratic institutions, human rights and the rule of law, equality and non-discrimination, violence against women and domestic violence, the situation of migrants, refugees and asylum seekers and recommendations for action by governments and parliaments to address them.
Our Resolutions and Recommendations provide clear and useful guidance to national and international authorities – including parliaments - on the action and measures needed to tackle the pandemic and uphold human rights. And in January, the Assembly debated another crucial issue related to Covid –vaccination policies.
In June, the Assembly will debate an additional three reports related to the Covid pandemic:
1. Overcoming the socio-economic crisis sparked by the Covid-19 pandemic
2. The impact of the Covid-19 pandemic on children’s rights
3. And - Covid passes: protection of fundamental rights and legal implications
Thus providing a robust response from the parliamentary perspective to the challenges we face and action to overcome them.
Let me first stress, what is and should be very obvious but is challenged by misinformation and fake news: vaccination is crucial for public health protection. Practiced and tested the world over, vaccination provides the safest and most effective method of protection against many infectious diseases. It prevents 2 to 3 million deaths every year worldwide.
And when enough people have been vaccinated, this creates what is called “herd immunity”, meaning that each individual vaccination is beneficial for the society as a whole.
Yet, the number of people getting vaccinated in general is currently in decline, negatively impacting public health and safety. Society becomes vulnerable, both with respect to new diseases, like Covid-19, and to diseases that have previously been under control but may resurge as a result of reduced immunization, such as measles and other so-called “childhood diseases”.
This decline results mainly from vaccine hesitancy - an issue that is currently being addressed by one of the forthcoming reports being prepared by our colleague Mr Vladimir Kruglyi, a doctor and member of the Russian Federation delegation to the PACE.
The average percentage of negative opinions on vaccine importance, safety, and effectiveness is high in the European region. 7 of 10 countries with the worst opinion on vaccine safety belong to Europe and a recent study indicates that vaccine acceptance in Europe varies between 44 to 66 percent.
Hesitancy primarily results from public debates around the medical, ethical, and legal issues related to vaccines. But many of those who are sceptical of Covid-19 vaccines are not the usual vaccine-hesitant. Vaccine hesitancy generally represents a problem where people are hesitant towards vaccines that have already proven to be safe and effective. Another group of people that are hesitant towards Covid-19 vaccines has concerns about the safety of these particular vaccines due to the speed at which they have been developed, and the fear of side effects.
Some people may hesitate to take vaccines because of the lack of access to reliable and easy-to-apprehend information, particularly due to misleading and false information on the internet. Others distrust public authorities, the healthcare system, and/or vaccine providers, “Big Pharma”. Vaccines are globally highly regulated by the government, recommended by the government, and sometimes required or mandated by the government. So, if you do not trust your government, you are less likely to trust vaccines.
In view of this hesitancy, and in the context of the Covid-19 pandemic, the question has been raised if vaccination should be mandatory, for example as a condition to work with or care for older people and people who are at high risk of severe illness or death from Covid-19.
But would it be acceptable for countries to make vaccination compulsory for everyone, or for specific groups only?
Compulsory vaccination is a difficult policy issue, with important human rights dimensions, requiring authorities to balance public health with individual liberty. Vaccination, like any other medical intervention, must be based on the recipient’s free and informed consent, as made clear by the Oviedo Convention of the Council of Europe.
However, this rule is not absolute. Indeed, States have a positive obligation to protect the health and life of their residents, including those particularly vulnerable. According to the International Covenant on Economic, Social, and Cultural Rights, States have a responsibility to ensure good public health provision and high immunization coverage.
In this regard, States enjoy a wide margin of appreciation in determining vaccination policies, as long as vaccination is not forcibly imposed. Measures must not violate the right and liberty of an individual to bodily autonomy and informed consent. It is thus clear that vaccination cannot be forced upon an individual under normal circumstances.
At this point, it is necessary to mention a recent judgment of the European Court of Human Rights. On 8 April 2021, the Court weighed in on the issue of compulsory vaccinations in the context of childhood vaccines. Although the ruling did not deal directly with Covid-19 vaccines, it is of particular significance given the current health situation and debates on mandatory vaccination. According to the Court, mandatory vaccination does interfere with personal integrity, protected by Article 8 of the European Convention on Human Rights. But this right is not absolute, and interference can in some cases be justified to safeguard public health. States must consider all relevant factors in this context.
Vaccination strategies are only lawful if proportionate. According to the judgment, governments may use economic sanctions and incentives to encourage vaccination.
Although the ruling by the European Court may have set the precedent that mandatory vaccinations do not violate the European Convention on Human Rights if such vaccination mandates are a necessary and proportionate tool to protect the life and health of others, this does not mean that European countries should mandate for people to get vaccinated by law, even in the current situation of the Covid-19 pandemic. Indeed, in its Resolution 2361 (2021) on “Covid-19 vaccines: ethical, legal and practical considerations”, adopted in January 2021, our Assembly urged Council of Europe member States and the European Union to ensure a high vaccine uptake by informing citizens that the vaccination is not mandatory and that no one is under political, social or other pressure to be vaccinated if they do not wish to do so.
The Assembly called on States to ensure that no one is discriminated against for not having been vaccinated against Covid-19, whether due to possible health risks or not wanting to be vaccinated.
Repressive tools may, in fact, prove counterproductive, increasing mistrust and opposition to vaccination. A better and faster way to overcome resistance from those who do not want to get vaccinated remains to inform them to do so rather than trying to convince them to do so against their will.
Combating vaccine hesitancy should be done first and foremost through awareness-raising and education. The Covid-19 pandemic has proved once again the importance of engagement and communication. States need to build trust and provide clear, transparent and reliable information.
They can do so by using fact-based communication and public health campaigns that explain the benefits of vaccination. They can build on experience gained with, for example, childhood vaccines where there is more acceptance as a result of the time that healthcare workers take to explain to parents, both before and after the birth of the child, any concerns that they may have regarding vaccination and the benefits of vaccination.
When developing and implementing tailored strategies to support vaccine uptake, governments can benefit from cooperation with non-governmental organisations and/or other local initiatives to reach out to marginalised groups, and to engage with local communities.
Identifying, monitoring and countering false information or fake news on the Internet, for instance with the help of search engines and targeted information on relevant digital platforms, is also very important to reach out to the population and increase the acceptance of vaccination.
In all cases, relevant measures must be human rights-compliant, and freedom of speech should be respected.
The Covid-19 vaccines were not developed overnight – scientists relied on years and years of research to come up with very quick solutions. Therefore it is important that more resources are made available for the research, development, and testing of new vaccines. This will allow vaccines to be improved and side effects and other risks that come with vaccination to be reduced.
As the experience with Covid-19 so far has shown, a global pandemic requires cooperation and coordination at global level. No State can on its own win the battle against Covid. Massive vaccination and development of herd immunity is the best safety guard that we have. We should all work together to develop suitable, fact-based and timely strategies to engage with the public and increase vaccination acceptance.
This cannot be done, nor is it appropriate, in the view of the Assembly, through imposing vaccination by law.
The Council of Europe Parliamentary Assembly will continue to follow all developments, consequences, impact and challenges resulting from the Covid-19 pandemic and will continue to provide practical, doable and human-rights based solutions to the member States to ensure both the protection of public health, and the protection of the human rights and fundamental freedoms of our 830 million European citizens.
Thank you for your attention.