The dangers of COVID-19 immunity-based licenses - opinion
To incentivize vaccination, the government initiated a certificate granting access to entertainment, sporting and dining venues to anyone who has been fully vaccinated or has recovered from COVID-19.
By SHIRLY BAR-LEV
Throughout March, Israel’s coronavirus vaccination rate remains one of the highest in the world. Nearly 60% of the state’s roughly nine million residents have gotten at least one shot of a COVID-19 vaccine.To incentivize vaccination, the government initiated the “Green Pass” – a certificate granting access to entertainment, sporting and dining venues to anyone who has been fully vaccinated or has recovered from COVID-19. Since in Israel vaccination is not compulsory, the “Green Pass” was initially limited to leisure activities. But as businesses grappled with the thorny issues of managing vaccinated and unvaccinated employees in the workplace, businesses initiated restrictive policies of their own. At first, these policies offered perks and bonuses to employees who were willing to vaccinate.But quickly, the tone changed. By February, the Manufacturers Association had asked the government for permission to put workers who refuse vaccinations on unpaid leave, or at the very least demand non-vaccinated workers to present a negative coronavirus test every 72 hours. In the same month, Health Minister Yuli Edelstein revealed that he was considering legislation that would enable employers to prevent workers who weren’t vaccinated against the coronavirus from coming in to work. Moreover, health officials admitted to seeking ways to make getting tested more difficult – thereby encouraging more people to vaccinate. Charging for tests, limiting their numbers and cutting back on testing locations are but a few steps that were considered (incentive programs).Supporters of “immunity-based licenses” argue that it can maximize benefits to individuals and society by allowing immune people to engage in economic activity, while protecting vulnerable populations, and allowing safer care for all. Reluctant voices argue that such restrictions can antagonize those already concerned about infringement on citizens’ rights. While others debate its epidemiological merits by noting the World Health Organization’s epidemiologically based objection to immune certificates. While important, these discussions lead to an ethical deadlock. By framing the issue as a battle between individual freedoms and social responsibility or solidarity, the dangers of bio-economism are downplayed if not ignored. Bio-economism refers to the translation of health and well-being into an economic resource through the conflation of “health and fitness” with “health and fitness for purpose.” Authorizing workplaces to vaccinate employees against their better judgment violates employees’ autonomy over their minds and bodies, as well as infringes on their right to informed consent, and medical confidentiality. Moreover, it dangerously aligns health and wellness with the economic interests of the firm. Is it ethically sound to allow businesses to force medical procedures upon their employees, in the name of the benefit of the business or even in the name of protecting other workers?The “Green Pass” policy should be considered in light of the recent upsurge of a “wellness movement” within organizations. Spotify, Adobe, Lyft, Facebook and Pinterest award their employees’ comprehensive fertility benefit packages. Natural Intelligence offers to subsidize surrogacy procedures for its employees. WeWork hosted Yoga and meditation workshops with the New Age guru Deepak Chopra. Google and Apple offer on-site gyms, mindfulness classes and on-site health checks. On its website, Microsoft states its purpose “Sick employees don’t just cost money in the form of sick days and lost productivity. They also bring down morale and can lead to unhappy customers.” Workplace wellness programs, states Microsoft, help employees get healthier and happier (Microsoft wellness program). While I do not deny or dismiss these corporations’ genuine concern for well-being, I am bothered by the alignment of employees’ health and well-being with organizational goal attainment. Vaccination differs from offering subsidized fertility treatments or hosting wellness workshops. First, it is not offered, but coerced. Second, vaccination is an intrusive and irreversible act with possible short and long-term effects. And so, allowing corporations to mandate vaccination, can most certainly pave the way for more aggressive intrusions on individuals’ health related decision making and behaviors.Within this wellness discourse, health and illness are an ongoing project riddled with individual choices and actions that make up a “good” person, citizen, or employee. The wide array of repertoires and techniques offered to employees are principally designed to create a fitter, more resilient, and reliable workforce, whose morals align with the organizational goals and objectives. In this light, vaccine hesitancy can be construed as interfering with the organizations’ normalization efforts. Vaccine resisters can be stigmatized for their choice, publicly shamed, and even ostracized.Coercing employees to act against their better judgment can backfire in terms of employee’s well-being, motivation, trust and identification with the organizations’ goals. It can also hamper working relationships and collaborations between colleagues. Finally, mandating vaccination in the workplace absolves the corporation from thinking of ways to create a safe and non-coercive environment for all employees. Corporations should acknowledge employees’ reservations about this particular vaccination. They can educate them on the merits of the vaccine, invite them to lectures, or encourage personal consultations with medical experts. They can also offer to pay for the time spent in the clinic, and even station a vaccination-stand on the premises. Employees, on their part, should act responsibly – comply with the health instructions, test themselves if suspected to be sick, and accept responsibility for absences due to sickness. In this way we can ensure that employees/citizens voluntarily consent to medical procedures after carefully considering the risks, benefits and alternatives of a given procedure or intervention. The writer is the head of the Dror (Imri) Aloni Center for Health Informatics, Ruppin Academic Center.