As the Novak Djokovic saga has shown, politicians across the world are losing patience with the unvaccinated.
Governments are wielding increasingly bigger sticks in an effort to push vaccination rates skyward - from the threat of prison time to withholding free Covid healthcare and the rise of ‘no jab, no job’ policies.
“Governments are frustrated,” said Prof Devi Sridhar, chair of global public health at the University of Edinburgh. “If all adults were vaccinated who were offered it, [the] pandemic would be over.
“ICUs are full of people who chose not to get vaccinated, then regret it later,” she told the Telegraph. “Is that fair to doctors and nurses? And to those who need care for heart attacks and other life-threatening conditions?”
Whether such strategies work is hotly contested. Some argue they amplify mistrust of science and governments, exacerbate inequities and create martyrs of those - like Djokovic - who refuse shots. Others point to real world data showing dual rules have an impact, and are especially effective at convincing the ambivalent.
Here, we take a look at some of the strictest strategies adopted across the globe.
The Philippines: unvaxxed face jail time
In the Philippines - where cases have jumped by almost 2,000 per cent since the beginning of January amid a “massive, uncontrolled surge” of omicron in Manila - President Rodrigo Duterte has ordered the arrest of unvaccinated people who violate stay-at-home orders.
He declared last week he was “appalled” at the large number of people yet to get jabbed; only around 51 per cent of the total population have had at least one jab, including 34 per cent who are fully vaccinated.
It’s too soon to say whether these measures will have the desired impact in the hard hit country, but some vaccine refuseniks insist they will not get shots, even in the face of imprisonment in the country’s notoriously overcrowded jails.
Roger Luna, 51, a professional driver suffering from a needle phobia since childhood, says that although the thought of prison leaves him “nervous and stressed”, it hasn’t prompted a change of heart.
“Even when I learned that a lot of my colleagues died from this pandemic, I still didn't want to be vaccinated,” he told the Telegraph. “I believe I can survive through my own actions… I will hibernate somewhere and not come out until the pandemic ends.”
Rodel Sabile, 54, who works as a caretaker, believes vaccines induce a “zombie-like” status - and this is a greater risk than ending up in jail, he says. His belief has already cost him access to government financial aid and food packages linked to vaccine drives.
“I heard some unvaccinated folks in the [district] were apprehended, their names were listed and officials convinced them to get their vaccine. But I know my rights and will not allow the authorities to dictate to me,” he said.
Singapore: no jab, no healthcare
In Singapore, the government has escalated restrictions on a stubborn minority of residents refusing vaccines, in an effort to protect its “living with Covid” strategy and continue reopening society without risking the healthcare system.
Late last year unvaccinated individuals were banned from dining in restaurants or entering shopping malls, and warned that they would have to pay their own medical bills if they contracted Covid after refusing the jab without a valid reason.
And from January 15, only fully vaccinated employees or those who have recovered from Covid-19 within the past 180 days will be allowed to enter the workplace.
“The intent of these measures has been to disincentivise remaining unvaccinated, and it has worked: over 90 per cent of those aged five or more have been vaccinated in Singapore, and about half have received their booster jab,” said Dr Alex Cook, from Singapore’s Saw Swee Hock School of Public Health.
But progress on persuading the final few holdouts has slowed. “The number of unvaccinated people is now so low that ‘flipping’ them into the vaccinated group is very difficult,” he told The Telegraph.
Quebec: health tax for refuseniks
Quebec, Canada has taken a slightly different approach, announcing on Wednesday that it will impose a “health contribution” - in effect a healthcare tax - on unvaccinated residents.
The province has not yet unveiled details of how this would work, or how much the tax would be, but Quebec’s health minister said the announcement alone may have had an impact, with appointments for first-doses surging. The policy has already provoked a fierce backlash.
There have also been reports in local papers of draconian restrictions on individuals - an unvaccinated father lost the right to visit his 12-year-old child as a judge ruled it would not be in the child’s “best interest” in the “current epidemiological context”.
Austria: lockdown for the unvaccinated
In Europe, Austria has led the way on stringent measures for the unvaccinated. The government is planning to fine those over the age of 14 to pay €3,600 (around £3,000) for every three months that they remain unvaccinated.
In November, the country announced that some two million people yet to have two Covid jabs would be the targets of a new lockdown - at the time just over 68 per cent of the population had received at least one shot, a figure that now stands at 74 per cent.
But the Government now looks set to introduce the first population-wide vaccine mandate for adults on the continent, which would last until 2024. While initially envisioned to come into effect in February, the controversial initiative may be delayed until April due to technical difficulties, according to local media.
Until then, strict measures remain in place, as new daily infections hit record-breaking levels on Wednesday. Surgical standard FFP2 masks are mandatory - outdoors as well as indoors - and the ‘2G’ rule (proof of two shots or recovery from Covid) is required to enter most public places.
Germany, Micronesia and Ecuador: the push for compulsory jabs
Germany is also considering the introduction of mandatory vaccinations in an attempt to boost uptake. In December jabs were made compulsory for certain professions, and parliament is expected to debate whether to go further and impose a population-wide vaccine mandate later this month.
Internationally vaccinations are already compulsory in countries including Indonesia, Turkmenistan, Tajikistan, Micronesia and Ecuador - which became the first nation in Latin America to introduce mandates in December. Here, the sweeping rules require everyone over the age of five to have a Covid shot.
‘No jab, no job’ and coronavirus passes widespread
Policies requiring people to have a vaccine to do their job are now also widespread - including the UK’s care worker mandate, restrictions on America’s 3.5 million federal employees, and “no jab, no job” rules for healthcare workers and teachers in New Zealand.
Companies, too, have taken matters into their own hands - Ikea, for instance, cut sick pay for unvaccinated staff forced to self-isolate.
Meanwhile in France, where President Macron told refuseniks to “piss off”, protests have erupted at proposals to tighten the country’s coronavirus pass. While in place since last summer, new proposals would remove the option of showing a negative Covid test to enter a host of venues - effectively banning unvaccinated people from public life.
At the other end of the spectrum, countries including Costa Rica and Puerto Rico require children to be vaccinated to go to school, said Dr Thomas Hale, an associate professor of Global Public Policy at Oxford University.
“My reading of the evidence is that requirements to get vaccinated clearly increase the number of people who get vaccinated,” he added. “Such strategies may be particularly effective in places where there is a large degree of apathy toward or mild scepticism of vaccines.”
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