When vaccination plateaus and the numbers are not achieved, the debate always turns to sticks and carrots. After carrots, only sticks are left. Singapore is reaching the plateau level as about 50% of the population has been vaccinated against Covid19. At this point, we are fortunately not as politicised as the Americans or the Brits over vaccination. I trust the little people in this tiny island have bigger, saner minds and we can work our way through this sensibly.
Vaccination is a way to achieve herd immunity which is a state where a large number of the population has been immunised and a contagious disease can be managed as infection level decreases. What is the target vaccination % is very easy by the books. It simply depends on the Ro, or rate of infection, which roughly translates to the average number of persons an infected person can transmit to. In reality it is not really determinable. It depends on the efficacy of the vaccine, the virus, and a Ro that differs wildly for cities, suburbs, villages, countryside, etc. I believe WHO initially targetted 70% to achieve herd immunity. There is no magic number.
A policy on vaccination is always predicated on beneficence, which basically means core consideration must be the well being of everyone. It all boils down to risk-benefits analysis. The Covid19 situation is still evolving as the virus mutates, and data is lacking on the transmission rate, efficacy of the vaccines, and their long term effects. At this point, even a 1 sigma risk-benefits analysis is highly impossible.
Covid19 vaccination is being promulgated in a manner never seen before. The speed of the vaccine development and deployment as an emmergency measure is clouded in political FUD. This is the tactic of Fear, Uncertainty and Doubt to overwhelm opposition. It's a tactic salesmen use to suppress the ability of prospects to think clearly. Today, the vaccine salesmen not only use FUD, but control the information to the public, thus monopolising the narrative.
No matter how much it is FUDed, vaccination is a very serious matter. It is natural to recoil from injecting unknown foreign substance into one's body. There will always be those who object. Mandatory vaccinations have accommodated religious and philosophical exemptions. Given the mRNA is a new form of untested vaccine, with publicised deaths and serious side effects, a higher level of resistance is not surprising. The recent decision not to publicise negative vaccination events is a big policy mistake as it fuels public anxiety. Suppressing information promotes the Streisand Effect as the public relies on anecdotes.
Certain segments of the population cannot vaccinate, such as those with some underlying health issues and the very young. It falls on those who can vaccinate to do so in order to reach heard immunity so as to protect the weak. Indeed it then becomes a duty to vaccinate. Those who do not wish to vaccinate will have to grapple with an ethical decision. All sensible person does their own risk-benefits analysis to make a decision. Unfortunately, behavioural economics dictate that people skew to internality. They view from selfish perspective of the risk and benefits to themselves. The externality, or the greater good of the community, is a non-factor.
A debate on vaccination invariably brings up the spectre of the 'tragedy of the commons'. It is an economic term where an individual reaps the benefits of the system and his action or ommission creates negative consequences for the greater community. Who has the benefits and who bears the costs or takes the risks? A person may avoid vaccination knowing well he benefits from the herd immunity created by those who bear the burden of getting the jab. A vaccination dodger is a free rider.
The government has a tough job balancing and managing the fine line between respecting the individual's right of refusal to vaccinate and maximising the greater good through herd immunity. It also has the ethical responsibility to ensure to its best ability, the safety of the vaccines. For Covid19, the burden is heavy given the vaccine is only for emergency use, its efficacy debatable, negative reactions threatening, and long term effects unknown.
What then can be done to get vac dodgers to get the jab when all carrots and persuasion have failed? Is it time to bring out the sticks, as the contributor to the Straits Time Forum suggested. The writer conveniently made no recommendations. Armchair talk is easy. The US, UK and some EU countries appear to be heading toward exclusionist policies. No vaccine -- no passport, no access to various services. Corporations that support goverrnment policies implement their own exclusionist rules.
Exclusionist policies are divisive. Imposition of fines are scorned. Either way, vaccination enforcement has a political cost to the government. As regards enforcement, surely the doctrine of benificence is abandoned in making an unapproved vaccine mandatory. What then is the liability of the government for vaccine deaths and injuries? The government cannot be sued. That said, it is a non-issue in the context of Singapore where draconian regulations get by with little consequences for the ruling party.
Tort remedies appear the most equitable. Tort is a civil action where one's rights have been infringed. A person who has vaccinated gets infected with Covid19 from someone can sue for tort. To succeed, the plaintiff must show duty, infringement of the duty, and damage. He has to show the defendant has a duty not to infect others, he has infected plaintiff who has suffered in health and healthcare costs. Duty can be pinned on the defendant's refusal to get vaccinated. But in the case of a group, how can the plaintiff show proof the virus came from defendant. Since a vaccinated person ought not get infected, the defendant rightly should be the pharmaceutical companies. Cosy non-liability arrangement with governents cover them from legal suits arising from deaths or injuries from the un-tested vaccines. Big pharma have their rears covered way ahead of anybody.
The most equitable remedy of tort is apparently not available. Going forward, how are we as a nation, going to do deal with it. Calling those who refuse to vaccinate as Trumpean, conspiracy theorists, ignorant believers of pseudo-science, dogmatic, etc is'nt helpful. Public fear of the mRNA vaccination has to be respected given the returning data of deaths and serious injuries, unknown long term effects, and the low efficacy. As far as Singapore is concerned, the low death rates of Covid19, thanks to a super efficient healthcare infrastructure and dedicated, professional healthcare workers, the risk-benefits do not seem to favour vaccination.
I pray for wisdom on our leadership to guide us through these perilous times.
Vaccination is a way to achieve herd immunity which is a state where a large number of the population has been immunised and a contagious disease can be managed as infection level decreases. What is the target vaccination % is very easy by the books. It simply depends on the Ro, or rate of infection, which roughly translates to the average number of persons an infected person can transmit to. In reality it is not really determinable. It depends on the efficacy of the vaccine, the virus, and a Ro that differs wildly for cities, suburbs, villages, countryside, etc. I believe WHO initially targetted 70% to achieve herd immunity. There is no magic number.
A policy on vaccination is always predicated on beneficence, which basically means core consideration must be the well being of everyone. It all boils down to risk-benefits analysis. The Covid19 situation is still evolving as the virus mutates, and data is lacking on the transmission rate, efficacy of the vaccines, and their long term effects. At this point, even a 1 sigma risk-benefits analysis is highly impossible.
Covid19 vaccination is being promulgated in a manner never seen before. The speed of the vaccine development and deployment as an emmergency measure is clouded in political FUD. This is the tactic of Fear, Uncertainty and Doubt to overwhelm opposition. It's a tactic salesmen use to suppress the ability of prospects to think clearly. Today, the vaccine salesmen not only use FUD, but control the information to the public, thus monopolising the narrative.
No matter how much it is FUDed, vaccination is a very serious matter. It is natural to recoil from injecting unknown foreign substance into one's body. There will always be those who object. Mandatory vaccinations have accommodated religious and philosophical exemptions. Given the mRNA is a new form of untested vaccine, with publicised deaths and serious side effects, a higher level of resistance is not surprising. The recent decision not to publicise negative vaccination events is a big policy mistake as it fuels public anxiety. Suppressing information promotes the Streisand Effect as the public relies on anecdotes.
Certain segments of the population cannot vaccinate, such as those with some underlying health issues and the very young. It falls on those who can vaccinate to do so in order to reach heard immunity so as to protect the weak. Indeed it then becomes a duty to vaccinate. Those who do not wish to vaccinate will have to grapple with an ethical decision. All sensible person does their own risk-benefits analysis to make a decision. Unfortunately, behavioural economics dictate that people skew to internality. They view from selfish perspective of the risk and benefits to themselves. The externality, or the greater good of the community, is a non-factor.
A debate on vaccination invariably brings up the spectre of the 'tragedy of the commons'. It is an economic term where an individual reaps the benefits of the system and his action or ommission creates negative consequences for the greater community. Who has the benefits and who bears the costs or takes the risks? A person may avoid vaccination knowing well he benefits from the herd immunity created by those who bear the burden of getting the jab. A vaccination dodger is a free rider.
The government has a tough job balancing and managing the fine line between respecting the individual's right of refusal to vaccinate and maximising the greater good through herd immunity. It also has the ethical responsibility to ensure to its best ability, the safety of the vaccines. For Covid19, the burden is heavy given the vaccine is only for emergency use, its efficacy debatable, negative reactions threatening, and long term effects unknown.
What then can be done to get vac dodgers to get the jab when all carrots and persuasion have failed? Is it time to bring out the sticks, as the contributor to the Straits Time Forum suggested. The writer conveniently made no recommendations. Armchair talk is easy. The US, UK and some EU countries appear to be heading toward exclusionist policies. No vaccine -- no passport, no access to various services. Corporations that support goverrnment policies implement their own exclusionist rules.
Exclusionist policies are divisive. Imposition of fines are scorned. Either way, vaccination enforcement has a political cost to the government. As regards enforcement, surely the doctrine of benificence is abandoned in making an unapproved vaccine mandatory. What then is the liability of the government for vaccine deaths and injuries? The government cannot be sued. That said, it is a non-issue in the context of Singapore where draconian regulations get by with little consequences for the ruling party.
Tort remedies appear the most equitable. Tort is a civil action where one's rights have been infringed. A person who has vaccinated gets infected with Covid19 from someone can sue for tort. To succeed, the plaintiff must show duty, infringement of the duty, and damage. He has to show the defendant has a duty not to infect others, he has infected plaintiff who has suffered in health and healthcare costs. Duty can be pinned on the defendant's refusal to get vaccinated. But in the case of a group, how can the plaintiff show proof the virus came from defendant. Since a vaccinated person ought not get infected, the defendant rightly should be the pharmaceutical companies. Cosy non-liability arrangement with governents cover them from legal suits arising from deaths or injuries from the un-tested vaccines. Big pharma have their rears covered way ahead of anybody.
The most equitable remedy of tort is apparently not available. Going forward, how are we as a nation, going to do deal with it. Calling those who refuse to vaccinate as Trumpean, conspiracy theorists, ignorant believers of pseudo-science, dogmatic, etc is'nt helpful. Public fear of the mRNA vaccination has to be respected given the returning data of deaths and serious injuries, unknown long term effects, and the low efficacy. As far as Singapore is concerned, the low death rates of Covid19, thanks to a super efficient healthcare infrastructure and dedicated, professional healthcare workers, the risk-benefits do not seem to favour vaccination.
I pray for wisdom on our leadership to guide us through these perilous times.
No comments:
Post a Comment