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 Table of Contents  
Year : 2023  |  Volume : 2  |  Issue : 1  |  Page : 16-21

Mandatory COVID-19 vaccination: A controversial but necessary tool for public health

School of Public Health, AIPH University, Bhubaneswar, Odisha, India

Date of Submission16-Apr-2023
Date of Decision14-May-2023
Date of Acceptance22-May-2023
Date of Web Publication21-Aug-2023

Correspondence Address:
Dr. Paramjot Panda
School of Public Health, AIPH University. Bhubaneswar, Odisha
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/JIMPH.JIMPH_5_23

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BACKGROUND: The COVID-19 pandemic has caused a global health crisis, with over 6 million deaths and over 500 million cases reported as of February 2023. Vaccination is a critical tool for preventing the spread of COVID-19 and protecting people from severe illness, hospitalization, and death. MATERIALS AND METHODS: This paper reviews the evidence on the safety, appropriateness, and effectiveness of mandatory COVID-19 vaccination. The paper also discusses the ethical and legal considerations of mandatory vaccination. RESULTS: The available evidence suggests that COVID-19 vaccines are safe and effective. The vaccines have been rigorously tested and have been shown to be safe for most people. The vaccines are also highly effective at preventing severe illness, hospitalization, and death from COVID-19. Mandatory vaccination is a controversial issue, but it may be an appropriate tool for protecting public health during a pandemic. Mandatory vaccination can help to ensure that everyone is vaccinated, which can help to stop the spread of disease and protect the most vulnerable members of society. CONCLUSION: The evidence suggests that mandatory COVID-19 vaccination is safe, appropriate, and effective. Mandatory vaccination may be an important tool for protecting public health during the COVID-19 pandemic.

Keywords: Appropriateness, COVID-19, effectiveness, ethics, law, mandatory vaccination, safety, vaccination

How to cite this article:
Panda P. Mandatory COVID-19 vaccination: A controversial but necessary tool for public health. J Integr Med Public Health 2023;2:16-21

How to cite this URL:
Panda P. Mandatory COVID-19 vaccination: A controversial but necessary tool for public health. J Integr Med Public Health [serial online] 2023 [cited 2023 Sep 21];2:16-21. Available from: http://www.jimph.org/text.asp?2023/2/1/16/384123

  Background Top

The World Health Organization (WHO) received notice of a case of pneumonia with an unknown origin in Wuhan, China, on December 31, 2019, and the WHO formally reported the first COVID-19 case that day.[1] Chinese authorities discovered a brand-new coronavirus, tentatively known as 2019-nCoV, as the source of these infections on January 7 2020.[2] The rapidly spreading COVID-19 epidemic was deemed a global medical crisis of international concern by WHO a few weeks later, on January 30, 2020.[3] On February 11 of the next month, the novel coronavirus’ COVID-19 designation was officially adopted. By this point, Wuhan’s position had improved because to the implementation of novel virus containment techniques.[4] China reported thousands of new cases every day at the beginning of the pandemic, but by March that number had declined.[5] Meanwhile, the number of sick people in Europe is rising quickly every day, and from March 12 to 13, the recorded an exceptional 250 fatalities in Italy.[6] As a result, the WHO declared on March 13 that Europe had become the pandemic’s epicentre.[7] The same day, a state of emergency was announced in the United States.[8] To combat the pandemic, strict precautions are being implemented all across the world.[9] In March, travel restrictions and recommendations for proper hand-washing procedures come into place.[10] Researchers realized that in order to combat it, an mRNA vaccine would need to be created.[11] It was obvious that the COVID-19 outbreak could not be stopped by lockdown limitations. Most restrictions tightened quickly, and on March 26 it took effect in the UK. Many European nations started implementing their own state-wide lockdowns around this time.[12] By April 2, there were one million COVID-19 instances in the world as a whole. In several nations, the number of infections, hospitalizations, and fatalities have decreased as a result of restrictions placed on residents to stop the virus’s summertime spread.[13] However, a subspecies of Lambda was only recently identified—in August 2020—in Peru. This variety has currently spread to at least 29 countries, according to WHO.[14]

In September 2020, a month after WHO identified, an alpha variant spotted in the UK.[15] Researcher believed that identification of the variants’ is crucial since it shows that the virus was changing. As a result, disease outcomes and symptoms have changed.[16] demonstrated that COVID-19 alpha mutations enhance the chance of a bad prognosis. As a result of the appearance of these new varieties, COVID-19 cases started to increase once more in several nations, and as of September 29, 2020, the number of COVID-19 deaths had reached one million.[17]

  Efficacy of Multiple Vaccines Top

In record time, vaccines were approved by WHO[18] and country approval for the administration of vaccine to the people. The Pfizer and BioNTech vaccines were shown in studies to be over 90% effective[19] on 2020 November 9; a week later, on November 16, the Moderna vaccine was also shown to be successful.[20] The University of Oxford and AstraZeneca COVID-19 was likewise proven to be successful one additional week later, on 2020 November 23. The Delta variety was later detected for the first time in India in December.[21] Concerns about the variant’s potential for higher mobility have compelled several governments to strengthen lockdown measures to some extent, which has been fuelled by a surge in cases in some nations including the India and European countries.[6]

The COVID-19 vaccine was finally given the first urgent validation by WHO on December 31, 2020, making the Pfizer/BioNTech vaccine the first to go on distribution. Urgent validation was viewed as a step in the right direction for a COVID-19 vaccine to be made widely accessible. This is an essential action to stop the pandemic.[18] Since that time, the Moderna and Oxford/AstraZeneca vaccines have also received approval for use, and a serious effort to deploy vaccines across the country has started. However, researcher was worried about the efficacy and if there would be negative impact then who would be responsible as most of the vaccine got fast approval so researchers were interested whether the medicines company follow all the procedure of the trials.[4] Also, in the other hand believed that the vaccine distribution must continue in all nations if the epidemic is to be contained and new outbreaks are to be avoided. The history of the COVID-19 epidemic teaches us a lot.[22] Several researchers believed that the lessons discovered will help nations get ready for upcoming outbreaks and stop potential pandemics.[23]

  Fear of Vaccination Top

The debate related to the vaccines is not new. The first smallpox vaccine, invented by Edward Jenner in 1796,[24] was at first thought of as a miraculous cure for the illness that was killing millions worldwide. As a result, the United Kingdom government made small pox vaccination as compulsory by vaccination act of 1853.[25] This legislation then increases the resistance and divide the population into two groups. One is for the vaccination and the other is against the vaccination. As a result of it many people who were against the vaccination were activated in most part of the Britain.[25] People formed anti vaccination leagues and most of them come to street and protest against the government. The major objection was like vaccination was against their religious practices, against human right, health condition (who can take the vaccine and who cannot take the vaccine was not clear).[26] Due to the intensity of the outrage, the law was amended in 1898 to permit “conscientious objection” to having a vaccination.[26] Similar pattern has been found in 2020 when the different vaccine arrived for the COVID-19. To achieve universal immunization, the principles of respect for human autonomy, charity, or the obligation to do good, and greater justice, or the duty to protect entire communities, must be the driving factors, that unvaccinated people can become a deadly reservoir of coronavirus, igniting further outbreaks of infection or causing a sustained spread of the disease. That unvaccinated people can become a reservoir for the virus, igniting further outbreaks of infection or causing a sustained spread of the disease.[27]

  Addressing Vaccine Hesitancy in India Top

To ensure COVID-19 proper conduct, health promotion (and COVID appropriate behaviour) awareness initiatives were regularly carried out by the government of India.[28] It was necessary to wear a mask outside starting in April 2020. To prevent crowding in public spaces, restrictions on social gatherings have been put in place.[28] On June 25, 2020, Niti Aayog began a campaign to modify behaviour. Communication service providers also employ caller melodies and short message services to promote appropriate conduct.[29] In mid-March, a separate hotline was established to notify locals of any COVID-19-related inquiries on a regular basis. The hotline received almost 3.5 million calls by July 2020. Jan Andolan started a public campaign on October 14th to nudge individuals toward good behaviour over the winter and holiday seasons. In order to contain the sickness, the second wave in May emphasized the value of mask use, social isolation, hygiene, and ventilation.[29]

The spread of accurate information by neighbourhood health professionals was another endeavour by the government of India to minimise the effect of the COVID-19. After accomplishing goal of 100% immunization of the target population in three months, a community by the name of Janefal became a national model.[30] A task force comprised of physicians, healthcare professionals, police officers, and representatives of the neighbourhood community has been established by the village administration. Members of the task force routinely went door-to-door to convince homeowners to have their children immunized in front of her neighbours, record recordings of her lobbying, and identify the population that qualifies.[30] The administration started holding vaccination camps in the countryside to enhance vaccination coverage after determining that the main cause of vaccination resistance was a fear of hospitals. The task team also gathered and registered ID cards from all target populations to address the problem of online registration for vaccinations.[31] state that, the village’s full immunization status was attained by bottom-up cooperative efforts and root cause analysis by local leaders, with a cascading effect on neighbouring communities.

  Vaccine Drive in India from Development to Distribution Top

The start of vaccine development efforts coincided with the first wave of the pandemic in the country. In April 2020, Government of India has formed a research task force for a COVID-19 vaccine to advance vaccine development.[30] Bharat Biotech (BB), Zydus Cadila, Serum Institute of India (SII), Dr. Reddy have initiated vaccine clinical trials of Covaxin, ZyCoV-D, Covishield and Sputnik V. Covishield and Emergency Use Authorization for Covaxin was granted in January 2021, followed by approval of Sputnik V, mRNA-1273 (Moderna) in April. Single dose Johnson & Johnson vaccine in the last week of June and ZyCoV-D vaccine from Zydus Cadilla in August. To create a plan for the introduction of immunization, the National Expert Group on Vaccination Against COVID-19 (NEGVAC-2020) was established in August 2020. On December 28, 2020, operational standards for COVID-19 immunization were created, followed by a 10-day trial. The Indian government subsequently published his COVID-19 immunization advice, outlining risks, contraindications, and contrasting his two licensed vaccines.[30] On January 16, the immunization campaign was introduced across the country in three stages. Governments at the federal and state levels have been crucial to the COVID-19 immunization effort. The central government is in charge of developing rules and regulations, approving vaccines in an emergency, funding vaccine makers to increase their capacity for producing vaccines, generating money, purchasing and distributing vaccines, and managing vaccination programs.[23] The state’s responsibilities included locating vaccination sites, provide logistical support, educating staff, and maintaining daily vaccination records. To spread accurate information on vaccination, both governments have organized awareness programs.[21] state in India based on factors like as infection rate, vaccination rate, and degree of vaccine wastage, vaccine doses were allocated to states and UTs. Prioritizing states with a high viral load required first calculating infection rates based on the number of ongoing cases. Second, using his 7-day mean of vaccine consumption, criteria evaluating state performance in the immunization program were listed. This offers incentives for states to quicken vaccination campaigns and encourage effectiveness.[30] state that the amount of vaccine waste was selected as a different metric to reduce vaccine waste when it was discovered that 4.6 million doses had been thrown away in India by April 11. The usage, waste, and coverage of COVID-19 vaccinations were tracked using the CoWIN program.[32]

  Should COVID Vaccine be Mandatory Top

Most of the researchers[12],[28],[30] reported that the, governments and legislators encounter tremendous obstacles and raise the questions “How can we build a solid defence against the ever-evolving dangers that harm our citizens and jeopardize the social and economic fabric of our nations?” “Vaccines offer a simple answer.” Should it be made necessary? Every country has a different legal framework addressing required vaccinations for specific public and private activities. This problem was investigated in 193 nations for a study that was published by[33] title “Global Assessment of National Compulsory Vaccination Guidelines and Consequences of Non-Compliance.” More than 100 nations have some type of national mandatory vaccination policy in place, according to the report. 62 of these governments impose fines or other sanctions for non-compliance, mostly monetary or educational (such as restriction to open school).[33]

Immunizations that may be deemed “vital” in some nations, meaning that if a kid is not immunized, they may not be able to attend school or their parents may be subject to fines or jail time.[34] However, one feel very uneasy when parents are “encouraged” to vaccinate their children under the fear of such actions because it violates the concept of informed consent to medical procedures (which is occasionally required in writing). Although the Australian government has officially stated that it will not require Covid-19 vaccination, Allison Choi Flanigan, publications and newsletter editor for the (IBA’s Health and Life Sciences Legal Committee 2020), asserts that access to some government services is contingent upon the manufacture of vaccines.[35] Australia has long maintained a strict “no jab, no pay” policy that forbids parents from receiving certain tax advantages if they choose not to vaccinate their children.[36]

Wang et al.[37] state that the Covid vaccination was also obligatory in Brazil, but local governments are not allowed to physically force people to obtain the injection, according to a Supreme Court decision. The ability to refuse vaccinations is subject to several restrictions, such as being barred from government programs and educational opportunities, as well as from dining establishments and public transportation.

There is currently no tolerance for coercion in the UK.[38] But as of this writing, a third of the nursing home staff had rejected his Covid injection. Therefore, the challenging question is whether the right to physical integrity can or should endure not-withstanding the hazards to others, in this example, clinically vulnerable elderly people. Can alternatives to vaccination—like regular testing and wearing protective gear—fill the void? Someone who contacted Covid-19 from an unvaccinated employee or official died as a result. If that’s the case, will legal action be taken soon?

From these few examples, it is obvious that national laws vary and that governments continue to face challenging problems. Punitive actions also accomplish little to “address critical problems,” as Connolly emphasizes.

  Availability of the Vaccines Top

Most of the empirical studies[28],[34] argue that if the vaccine become mandatory then whether the manufacturer will be providing the stocks or not. Most of the empirical studies and the evidence from the COVID -19 revealed that countries with ingredients start apply restriction on the use, restrict the export. There would be issue whether it would be possible to provide vaccine to all the human race for COVID-19 which differ in its structure and spreading the infection in term of with symptoms or with out symptoms, some come with mild symptoms and some come with severe symptoms and some time need the emergency service.[30]

The majority of the world’s vaccinations are made in a small number of nations. India supplies several poor nations with vaccinations.[39] The global availability of vaccinations would be hampered by universal immunization requirements. Especially for underdeveloped nations where the burden of disease is more.[40] There is just no way to produce enough vaccine to cover the entire planet.[41] Empirical studies stated that the necessity for COVID-19 vaccination is 50% even with herd immunity when taking into account COVID-19’s reproductive number (R0) scores of 2-3. Therefore, vaccination is not required, but it is important to promote vaccination, foster vaccination trust, and provide them with information so they can make an informed decision.

  Conclusion Top

The COVID-19 pandemic has shown us that even the most developed countries are vulnerable to global health crises. In the future, it is likely that we will face other pandemics, some of which may be caused by re-emerging diseases. Re-emerging diseases are diseases that have been brought under control but that can re-emerge if conditions are right. for example, the COVID-19 pandemic was caused by a coronavirus that had been circulating in animals for years before it jumped to humans.

To be better prepared for future pandemics, we need to invest in research and development of vaccines and other preventive measures. We also need to develop early warning systems and response plans so that we can quickly contain the spread of disease. In addition, we need to educate the public about the importance of vaccination and other preventive measures.

By taking these steps, we can be better prepared to protect our communities and save lives from future pandemics.

Here are some specific examples of how we can be better prepared for future pandemics:

We can invest in research and development of vaccines and other preventive measures. for example, we can fund research into new vaccines for diseases that are currently not vaccine-preventable. We can also develop new technologies for detecting and tracking the spread of disease.

We can develop early warning systems and response plans. for example, we can create a global network of laboratories that can quickly identify new diseases. We can also develop plans for how to quickly contain the spread of disease in the event of a pandemic.

We can educate the public about the importance of vaccination and other preventive measures. for example, we can make sure that everyone has access to accurate information about vaccines. We can also promote public awareness of the importance of social distancing and other measures for preventing the spread of disease.

By taking these steps, we can be better prepared to protect our communities and save lives from future pandemics.

Financial support and sponsorship


Conflicts of interest

There are no conflicts of interest.

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