Israel Hopes for a Coronavirus Vaccine Soon, but Can It Make People Get It?

Despite much talk about the possibility of a mandatory vaccine, recent history shows legislation would be unlikely and that other incentives will drive most people to get vaccinated

Ronny Linder
Ronny Linder
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A woman holds a small bottle labeled with a "Vaccine COVID-19" sticker and a medical syringe in this illustration taken April 10, 2020.
A woman holds a small bottle labeled with a "Vaccine COVID-19" sticker and a medical syringe in this illustration taken April 10, 2020.Credit: Dado Ruvic / Reuters
Ronny Linder
Ronny Linder

The internet is ablaze about the prospect of Israel making it mandatory to get vaccinated against the coronavirus as soon as a ready immunization option reaches its shores.

In other words, the vaccine would be forced upon even those who object. This possibility didn't emerge from thin air, but rather comments by the professionals in charge of managing the country’s pandemic response.

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These officials summarized after their most recent meeting that consideration should be given to introducing legislation that would require everyone to vaccinate against the coronavirus. Chezy Levy, the Health Ministry director general, said in a recent interview that “a way has to be found to force people to immunize … we are in talks with the attorney general about this and clarifying whether there’s a way to make it mandatory to get vaccinated against the coronavirus. I would definitely want to advance a law that would require people to get vaccinated if it does not pose any medical risk to them.”

We can venture a prediction that the likelihood of Israel passing a mandatory vaccination law is close to zero. It’s difficult-to-impossible to imagine the Knesset passing such a law, given precedent and the objections of a majority of public health professionals.

Theoretically, however, the legal infrastructure for mandating vaccinations does exist. Section 19 of the Public Health Ordinance enacted during the British Mandatory era, in 1940, allows for fines to be imposed on anyone refusing to immunize during an epidemic. That clause has been enforced twice: once during a smallpox outbreak in 1949 and later during a measles outbreak in the early 1990s. Section 20 of the ordinance goes even further, authorizing forcible immunization during an epidemic, but only of certain people, namely, public figures, pilgrims, immigrants, passengers or people suspected of having been at recent risk of contagion.

Yet remembrances of what happened two years ago when there was a failed attempt to legislate an even more limited law indicates that no such legislation plans currently exist. Then, amid a measles outbreak in Israel, lawmakers Yoel Hasson and Shuli Moalem tried to pass a law encouraging immunization, which they had worked on together with the public health awareness non-profit organization Midaat, and in cooperation with the Health Ministry.

The bill did not seek to make vaccinations mandatory or to fine anyone who refused to be vaccinated, but rather required parents who chose not to vaccinate their children to attend a meeting explaining vaccines in full. If they continued to refuse, they would have to sign a refusal form. Only someone who refused to attend such a session would be fined.

Even this very balanced bill, worded so as to pass all kinds of legal scrutiny, ran up against an infinite number of obstacles and crises and barely passed the ministerial committee stage. The measure died when the previous Knesset was dissolved, but was reintroduced in August; it has still not moved past that stage. Any past attempts to link vaccines with child stipends or school enrollment have met political and legal failure.

Could a situation emerge in which the country makes an unprecedented economical, logistical, national effort to import the vaccine against the coronavirus, only for people to opt not to use it? It’s hard to believe that would happen. First, if there are no great surprises to shake public confidence in a vaccine, most people will probably want to get it, creating the opposite problem: demand outstripping supply.

Second, even in a scenario in which people are not interested in being vaccinated, a change could come from the bottom – not via laws, but via positive and negative incentives.

Certain countries might allow only those who can prove they’ve been vaccinated into their midst, private places of employment could condition job acceptance on being immunized, and perhaps even private schools would require it. All these factors could push people to get the vaccine. Why is it reasonable to suppose that these things could happen? Because the coronavirus is a very tangible illness that causes great economic turmoil. A commercial enterprise seeking to survive will want to do all it can to prevent coronavirus infections.

How effective might these incentives be? You can look at the example of a coronavirus test, which is a slightly unpleasant process, but one that is risk-free and much less sensitive or invasive than a vaccine. The moment countries demanded negative coronavirus results as a condition for entry, those traveling abroad agreed to take the test. However, the government’s important call for teachers in the lowest grades to be tested to prevent infection in the classroom – which was voluntary – received a very limited response, with fewer than half participating.

At the end of the day, Israel is not a totalitarian country and will not forcibly immunize its citizens, whether or not they are hesitant about being vaccinated. The pressure to get vaccinated will become a natural part of life. It will begin with incentives such as the ability to travel abroad and may move swiftly into other realms. This may all be influenced by what happens elsewhere – for instance, if large companies begin requiring their employees to get vaccinated, similar to the pressure for doping tests among professional athletes.

In a once-in-a-century pandemic, there are an infinite number of new issues and the march continues into uncharted territory. The vaccine has opened an endless number of new dilemmas that the world will certainly have to deal with in the coming months and which will enter the annals of the history of public health.

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