Mandatory COVID-19 Vaccination: Lessons from Tuberculosis and HIV

There is little doubt that vaccines represent one of the most significant medical advancements in human history, eradicating smallpox and averting millions of deaths from infectious diseases annually.1 Neverthe-less, they are currently undermined by the convergence of three pandemics: COVID-19, vaccine hesitancy, and internet-facilitated misinformation. This convergence has had a catastrophic cost across multiple di-mensions: human lives, society and the economy, civil rights, individual rights, livelihoods, and access to essential health care services. At the same time, science has made tremendous progress. Within 12 months, pharmaceutical companies managed to develop, manufacture, and scale up access to COVID-19 vaccines, leading to the global distribution of several vaccines with proven safety and efficacy. However, as each new wave of infection approaches, vaccine uptake appears to be plateauing in many countries. In most settings, there is evidence that a significant proportion of people have so far chosen to remain unvaccinated despite the accessible and free delivery of vaccines. While many countries rapidly declared a state of disaster early in the pandemic, we are now seeing burgeoning national debates around mandatory COVID-19 vaccination and other COVID-19 precautions in democratic societies, where an argument is being made that autonomy, civil liberties, and individual rights are in conflict with the protection of public health and efforts to achieve population immunity.