For or against compulsory vaccination? Old and deep divisions

Should people be forced to get vaccinated? The idea, as old as the vaccines themselves, is currently resurfacing in the face of Covid and is still driving deep divisions between guardians of public freedoms and defenders of health security.

Austria will require all adults to be vaccinated against Covid in early February, becoming the first European country to do so, after other nations such as Indonesia.

The subject “is the subject of a very intense debate”, admitted the Austrian Chancellor, Karl Nehammer, at the end of January.

As in other countries, compulsory vaccination crystallizes the controversy between its opponents, who see it as a profound attack on individual freedom, and its supporters, including many exhausted caregivers who question the responsibility of the unvaccinated.

This debate did not wait for the Covid crisis. It has reappeared regularly for two centuries, almost since the invention of the first vaccine, against smallpox, at the end of the 18th century.

As early as the 1800s and 1810s, some Scandinavian countries imposed compulsory smallpox vaccination. A few decades later, in 1853, the United Kingdom adopted an emblematic law to this effect.

Paradoxically, these countries are today those where there is freedom in terms of vaccination. Others, like France, impose on the contrary many vaccines, whereas they were initially slow to decide on it.

“When France decided on the obligation”, at the beginning of the 20th century, “England abandoned it and never took it back”, sums up the doctor and philosopher Anne-Marie Moulin to AFP, who participated in multiple consultations on compulsory vaccination under the aegis of the State.

– Violent demonstrations –

This double movement illustrates the zigzagging history of compulsory vaccination. This has imposed itself or lost its luster depending on the era and the country, sometimes in circumstances that are more political than health.

This is the case of the Franco-Prussian war of 1870, heavily lost by France. Less well vaccinated than their opponents, many French soldiers were struck down by smallpox, which may have contributed to their defeat.

In the following years, several European countries drew the conclusions and legally imposed the smallpox vaccine. France is part of it even if, here again, nothing is simple: it took thirty years of agitated parliamentary debates.

Conversely, in the United Kingdom, violent demonstrations, notably in the city of Leicester, caused the authorities to reverse compulsory vaccination in the 1900s.

The obligation is therefore rarely imposed or removed for purely health reasons, especially since public health is itself subject to fluctuating trends.

In the 2000s, “public health specialists thought that politically, we could no longer oblige: (it) seemed useless, unpleasant and anti-democratic”, underlines Ms. Moulin. In 2007, France abolished in particular the obligation to vaccinate BCG (against tuberculosis) for children, this disease having almost disappeared in France.

– Not a strict obligation –

These “impure” considerations, in the words of Ms. Moulin, are favored by the difficulty of evaluating the effectiveness of the obligation.

Many countries, especially Scandinavian ones, record excellent vaccination rates while they leave freedom to their citizens. But is this free choice a cause or a consequence of the willingness to be vaccinated?

Another difficulty: to define precisely what constitutes an obligation. As such, the Covid crisis has seen the emergence of a new concept, as in France, that of the health or vaccination pass.

It is not a strict obligation. Citizens theoretically keep the choice to get vaccinated, but if they don’t, they are deprived of many places like restaurants.

Should we see a simple variation in the long history of compulsory vaccination, or a real novelty?

“There is a real fundamental difference”, slices the French historian Laurent-Henri Vignaud. “In one case, we say: + it is the protective state that takes its responsibilities and tells you what to do +”.

“In the other case it’s: + Do what you want, but depending on the choice you make, you will be called upon to participate completely in social life or not +”, he concludes, seeing there the reason why the Socialist Party, historical representative of the French left, defends compulsory vaccination.

All rights of reproduction and representation reserved. © (2022) Agence France-Presse