In light of the parliamentary debates about possibly introducing a mandatory vaccination, the Superior Health Council (HGR) stated that it does not support the extended use of the Covid Safe Ticket (CST) if it becomes a "hidden" obligation to get vaccinated.
While several countries report that their vaccination coverage increased after the introduction of CST and/or compulsory vaccination, the HGR warned against "interpreting and generalising these data to the Belgian situation."
"How strictly the CST is applied, what the vaccination coverage and vaccination hesitations were before its introduction, and what the epidemiological status of a specific region is, are all important factors that can influence the effect of the CST and compulsory vaccination on vaccination coverage."
The HGR said that using tools to encourage vaccination (like the CST) is "acceptable," but it does not support their use when they actually become a "hidden" vaccination requirement.
In this sense, the Council believes that the use of the CST and the obligation to vaccinate are separate health measures that are "not necessarily mutually exclusive," but both should be used with a clearly defined purpose and based on the latest scientific evidence.
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"In particular during epidemiological peaks, compulsory vaccination does not exclude the usefulness of CST. Conversely, the use of CST does not exclude the added value that compulsory vaccination can bring."
In Belgium, a CST - based on a vaccination, test or recovery certificate (3G) - is needed to enter certain public areas such as restaurants, gyms, events and to travel. "This tool makes it possible to limit virus circulation within the population and reduce the risk of large-scale transmission during peaks of infection."
However, certain population groups could perceive the CST negatively, which could also have an impact on other vaccination programmes, especially among those who already have little confidence in existing programmes and government agencies.
"Additionally, CST may also lead to a false sense of security, leading to the unwise abandonment or relaxation of other basic rules, such as physical distance, hand hygiene and the wearing of face masks."
Keeping the right target in mind
In November last year, the HGR and the Belgian Advisory Committee on Bioethics already recommended compulsory vaccination of healthcare personnel. Depending on what goal policymakers currently want to set with the introduction of the vaccination requirement, it is relevant to think about certain age limits, the Council stressed.
"If the authorities' aim is to reduce mortality, then it could only apply to all people over 65. If the main goal is to relieve the hospital system and minimise the delay of care, an age limit of 40 years and above would be relevant." More generally, a requirement for the entire adult population could have the objective of tackling the overburdening of GPs and primary care.
Based on current knowledge of this virus, its variants and the current vaccines, the HGR stated that a temporary vaccination obligation is a possibility. "It should be regularly reviewed - for example every year - based on evolving insights about future variants, new vaccines and the epidemiological situation at that time."
In any case, a thorough political debate on all these elements is needed, and if this option is chosen, it should be "communicated to the public in a clear and transparent way."
The parliament hearings can be followed (in Dutch and/or French) via this link.
