Passports will entrench more divisions

Covid vaccine mandates are a heated topic in countries in which most of the adult population is vaccinated. French President Emmanuel Macron faced protests when he introduced a vaccine passport scheme, which limited access to public venues, including restaurants, bars and museums, and imposed vaccine obligations on public-facing employees.

This week the Italian government decided to go further, making the EU’s Covid19 “green pass” mandatory for all non-exempted public and private sector workers. Securing a pass, already required across much of the EU to access hospitality and leisure facilities, requires vaccination, recent recovery from Covid, or a negative test result.

A federal vaccine mandate in the US likewise obliges up to 80-million workers, including employees of private businesses with more than 100 employees, to get vaccinated or undergo weekly testing. This has prompted strong pushback in many states, fuelled by individualist doctrines, religious beliefs or vaccine scepticism.

Mandates and passports are inevitable in SA. Health minister Joe Phaahla has indicated that digital certificates will soon be available. Big companies, including Discovery and Sanlam, have charged ahead with vaccination requirements; educational institutions, churches and hospitality sector businesses are sure to follow.

Phaahla recently told the National Council of Provinces that the government prefers voluntary vaccination. But he cautioned that “if you want to enjoy your right not to be vaccinated, you can’t also say you have the right to put other people at risk”.

Occupational health legislation, together with directives issued in terms of the Disaster Management Act, make it possible for most large workplaces to introduce mandates legally. There will be battles, especially where alternative measures to protect coworkers and clients from Covid are available.

Vaccine mandates designed for specific companies will doubtless result in a field day for lawyers and conflict management specialists.

Whatever mandates emerge, SA is not France or the US. Despite great efforts, just 19% of the adult population is fully vaccinated. The health department’s laudable “whole of society” approach has taken vaccination beyond the wealthy, the urban and those with private health insurance. The elderly, who are most likely to fall seriously ill, remain a focus; single-dose vaccines are being reserved for rural areas and pop-up sites at social grant payment points.

It is nevertheless striking that Gauteng’s private sites have accounted for 1.8-million vaccinations, the Western Cape’s for 800,000, and KwaZulu-Natal’s for 480,000, overwhelmingly in urban areas. In other words, we have relatively high levels of vaccination among the middle classes and the wealthy.

Vaccine mandates, by increasing pro-vaccination pressure on those with formal sector jobs, health and care workers, the higher education sector and consumers of hospitality services and air travel, will push up vaccination rates among those who are already most likely to be vaccinated.

Mandates and passports will do nothing to improve coverage for the poor, the vulnerable, the less well educated and those living in rural areas, who account for the vast bulk of the unvaccinated population.

Vaccine boosters, designed to address waning immunity, may cement these long-term disparities between the rich and the poor. The same fifth of the population that enjoys access to formal sector jobs and private education, medical care and security, will also become embraced, over the longer term, by a system of vaccine updates, mandates and passports.

The danger is that Covid vaccination will become just one more part of the privatisation of apartness that has emerged in postapartheid SA. Many of these mandates may be essential. But they are also a sideshow to the more serious business of vaccinating those who lack information and knowledge — and access — across the wider society.