Is the Covid-19 Vaccine Safe and Will it be Mandated?

On Monday, AstraZeneca said its Covid-19 vaccine was "highly effective." This comes after similarly positive vaccine news from drug companies Pfizer, which last week applied for emergency use, and Moderna. The long-awaited coronavirus vaccine, like many immunisations, is proving controversial with growing concerns about its safety and whether the vaccine will be mandatory.
 
WILL THE COVID VACCINE BE SAFE?
 
For many people injecting a brand-new scientific discovery into their body doesn’t sit well. Many are asking questions such as: Has the speed of developing and testing the vaccines compromised their scientific integrity? How do regulators decide what an acceptable side effect is? And what would happen if someone did have a serious reaction to the COVID vaccine after it was released? 
 
Safety trials begin in the lab, with tests and research on cells and animals, before moving on to human studies.  The principle is to start small and only ever move on to the next stage of testing if there are no outstanding safety concerns. As long as the safety data from the labs is good, scientists can check that the vaccine or treatment is effective too.  That involves tests on large numbers of volunteers.  All of the work and findings are checked and verified independently.  
 
While the Covid vaccine trials have happened at breakneck speed, they haven't skipped any of these steps.  The Oxford/AstraZeneca Covid vaccine trial was voluntarily put on hold at one stage to investigate why one participant - out of many thousands - had died. It restarted once it was clear it was not related to the vaccine.
 
In a White House Task Force briefing, Dr. Anthony Fauci tried to settle concerns about the safety of the first two vaccines for which early Phase 3 clinical trial results have been reported.
 
“The process of the speed did not compromise at all safety nor did it compromise scientific integrity,” Fauci, director of the National Institute of Allergy and Infectious Diseases, said. “It was a reflection of the extraordinary scientific advances in these types of vaccines which allow us to do things in months that took us years before.”
 
Vaccines are licensed on the basis of data from clinical trials, which aim to assess their short-term safety, ability to generate an immune response, and their ability to prevent disease in hundreds, and then thousands of volunteers. It is also important to note that most adverse events occur shortly after receiving a vaccine, rather than after many months or years. Approval will only be given for a vaccine if the government regulator is happy that it's both safe and effective.  
 
After approval, checks continue to make sure there are no further side effects or long-term risks. Crucially, health workers are trained to report any adverse event that they are concerned about, regardless of whether they think the vaccine triggered it. And they are told to be particularly vigilant in the case of newly introduced vaccines. If an adverse event is reported, the healthcare regulatory agency will carefully investigate whether it is likely to be a coincidence or a result of the vaccine, and intervene where necessary, e.g. by issuing warnings not to give the vaccine to certain groups, or even withdrawing the vaccine in rare circumstances.
 
WILL VACCINES BE MANDATORY?
 
Acceptance of a vaccine, mandatory or not, is similarly challenged.  A Gallup poll in November found that 58 percent of Americans say they would get a Covid-19 vaccine, up from a low of 50 percent in September. 
 
But lots of people opting out would delay herd immunity, so some officials support compulsory immunisations. In August, Australia’s prime minister suggested the vaccine would be mandatory in his country, but later backtracked on those comments. 
 
Dr. Anthony Fauci said he would “definitely not” support a nationwide mandate of the COVID-19 vaccine. “You don't want to mandate and try and force anyone to take the vaccine. We've never done that. You can mandate for certain groups of people like health workers, but for the general population you cannot,” Fauci said in August. “We don't want to be mandating from the federal government to the general population. It would be unenforceable and not appropriate.”
 
While the government may not mandate the vaccine, it does have some ways to get people to vaccinate, imposing it as a condition of getting a passport, for example, or using freedom passes, immunity passports or vaccination certificates, as a nudge towards the process.
 
A paper published in The Lancet last month acknowledges that some consider immunity passports “unethical and impractical”, but argues that “a strong presumption should be in favour of preserving people’s free movement if at all feasible”. A return to normality would bring both “individual and social benefits”, the authors add.
 
Some members of the UK Scientific Advisory Group for Emergencies (Sage) are backing the idea too. “I think a vaccine passport does make sense, at least initially,” Janet Lord, a professor of immune cell biology at the University of Birmingham, told The Times.
 
Airlines are also mulling over mandatory COVID-19 vaccines for international passengers. In Australia, the boss of Qantas, the country’s largest airline, said once a virus vaccine becomes widely available, his carrier will likely require passengers to use it before they can travel abroad or land in Australia. South Korea's largest airline has a similar message. Jill Chung, a spokesperson for Korean Air, said on Tuesday there is a real possibility that airlines will require that passengers be vaccinated. She said that is because governments are likely to require vaccinations as a condition for lifting quarantine requirements for new arrivals.
 
Other industries are also weighing whether they should simply encourage people to get vaccinated or make it mandatory.  Health workers are the classic example. Hospitals often require some staff to get a flu or hepatitis B vaccine. Universities may mandate student, faculty and staff to be immunized for certain diseases before coming on campus. Schools may have the same requirements for children.  Employers are also weighing up the idea, but while it may be legal for employers to compel their workers to get the COVID-19 vaccine, doing so would be a huge, difficult undertaking.