While many European countries are still debating whether to introduce vaccination mandates, Ecuador became the first Latin American country to make vaccinations against Covid-19 compulsory. The legislation is probably the world’s toughest: since 23 December 2021, it has been mandatory for all Ecuadorian citizens over the age of 12 to be vaccinated, with inoculation also recommended for children over 5 years of age. As of 21 February, just under 84 per cent of the country’s population of 17.8 million has received their first dose, with 77 per cent on their second and 22 per cent having had a booster too.
In contrast to what might be expected in view of the often-controversial debates in Europe or the US about compulsory vaccination, its introduction in Ecuador has been met with little political or societal resistance. There wasn’t much criticism of the legislation, and even in what is otherwise a deeply polarised party-political system, there was broad consensus regarding the mandate. Calls to public protest from the small number of anti-vaccination activists were not widely heeded, which was disappointing for a movement that, although historically by no means as well-established as in Europe or North America, is present on social media and certainly does reach people in Ecuador.
It would seem that their messages are simply falling on deaf ears. If anything, most Ecuadorians see debates about the merits of vaccination against Covid-19 as a first-world problem which, in view of the economic and social crisis in which their country finds itself, they simply cannot afford. Moreover, the traumatic events of March and April 2020 are too deeply burned into the country’s collective memory: Ecuador was the first in the region to be hit by the pandemic, with the virus entering a country ill-prepared and poorly governed; the results were corpses piling up on the streets as hospitals in Guayaquil, the epicentre of the first wave, overflowed. The images went round the world and, in the country itself, made it clear to Ecuadorians that they best stay cautious – unable as they were to rely on either a functioning health system or indeed a functioning state. For weeks on end, health provision, run into the ground over years previously, collapsed entirely; undertakers were overrun.
In this context, the government under conservative-liberal Guillermo Lasso was quick to focus on vaccination. It was clear to the new administration that, for it to retain any credibility, there could be no repeat of April 2021 and, as the Omicron wave hit and sent case numbers and death rates rising again, the compulsory vaccination act looked very much like the safe option.
Then again, in terms of implementation, compulsory vaccination in Ecuador is nowhere near as drastic as the law itself would make it seem. While all non-essential activities such as restaurant dining or going to bars or shopping centres require citizens to provide proof of vaccination (generally in stamped paper document form), and while this obligation can be extended at higher alert levels, it is the venue operators who are responsible for checking – and only they who can be punished for non-compliance. Private individuals do not face any sanctions for failing to obey the vaccination mandate. As such, while Ecuador’s compulsory vaccination policy has certainly garnered attention internationally, in practice, it has not actually proved to be particularly relevant, primarily since vaccine take up was already high prior to its introduction and remains so regardless of it.
Constantin Groll, FES Ecuador
In declaring the country free of Covid-19 in January 2021, the Tajik government acted somewhat prematurely, as five months later it had to admit that the pandemic was not yet past. Indeed, in July 2021, several of President Emomali Rakhmon’s relatives fell ill with the virus, and as his older sister Kurbonbi Rakhmonova died on 20 July, there is speculation afoot that Covid-19 was the cause of her death.
Shortly before, in an attempt to halt the spread of the virus in Tajikistan, the government had legislated for compulsory vaccinations for all aged 18 or above. It is unclear, however, why the government opted straight for such a roundly unpopular measure; presumably, a blend of political, personal, and economic concerns played a role.
What is certain is that the Tajik government, like many others, was taken by surprise by the wave of coronavirus infections in summer 2021 and was concerned that public trust in the administration would suffer, especially after it had already declared the country to be free of the virus. By introducing mandatory vaccination, the government hopes to prevent this kind of loss of trust in the future. Furthermore, due to the illness in his own family, the virus became, besides a potential threat to his hold on power, a personal issue for the authoritarian president Rakhmon.
Several other factors may have tipped the scales in favour of compulsory vaccination. In logistical terms, for instance, Tajikistan has, alongside many other developing countries, received vaccine donations; mandatory inoculation will help to make sure that as much vaccine as possible is distributed despite uncertain delivery dates. Another explanation for making vaccination compulsory are remittances: last year, 2.4 million Tajiks went to Russia for work – almost 25 per cent of the population. And so, in order to stabilise the country’s economy, the government has to make sure its workers can travel internationally thus high vaccination rates are desirable.
In the Tajik population, however, compulsory vaccination is controversial, with scepticism about the jabs widespread. As the country is ruled by an authoritarian regime, there are no publicly-available statistics, and the government’s ability to stifle debate is made clear by its reaction to protests in Gorno-Badakhshan. The demonstrations had nothing to do with the vaccine mandate, but rather with the government’s efforts to tighten control over the region; it responded by shutting down the internet for several weeks.
Polarisation and radicalisation have long been tendencies in Tajik politics, and the Gorno-Badakhshan protests have only reinforced them – as has the Taliban’s seizure of power in neighbouring Afghanistan. It remains to be seen whether compulsory vaccination will further contribute to this spiral. It will be decisive how the country’s migrant workers view the issue: as the source of income for many families, their attitudes count for a lot in forming public opinion overall. They have also been exposed to the debates around compulsory vaccination in Europe, especially in Russia and Kazakhstan, and are introducing arguments from these controversies into Tajik discourse – evidently one of the reasons for the country’s high levels of vaccine scepticism.
Philipp Jahn, FES Kyrgyzstan
When, in January 2022, fines came into force for unvaccinated Greek citizens aged 60 or over, conservative premier Kyriakos Mitsotakis gave himself a pat on the back. In the first 45 days after the introduction of compulsory vaccination was announced, 220,000 people in this age group opted for the jab, and the government announced that it considered its initiative successful. This changes nothing, however, about the catastrophic death rates Greece has experienced at the hands of the virus: in January, around 100 people were dying every day, in February the figure averaged at around 85; hospital stays are at record levels. If the January death rates were multiplied up to a population the size of Germany’s, then there would have been 700 fatalities every day.
Speaking on the BBC World Service, secretary of state Akis Skertsos stated that nine out of ten Greeks over 60 had now been vaccinated, adding that the country has the second highest average age in the EU, with 28 per cent of the population in the highest risk group. The figures are indeed impressive: 88.6 per cent of the over-60s have had their first jab and 85.4 per cent are fully vaccinated (defined as having received a second dose within the last seven months or a third booster dose).
In September 2021, Greece was early in introducing compulsory vaccination for staff in care homes and the health sector; in November, the decision was taken to impose mandatory vaccination on the over-60s, with the legislation coming into force in mid-January 2022.
In concrete terms, the vaccine mandate for healthcare staff has been enforced by suspending the roughly 4,700 workers in the sector who have not yet provided proof of vaccination until 31 March, after which point a decision will be taken on whether to extend it until the end of the pandemic or indefinitely. Non-vaccinated citizens over 60 years of age will now face a fine of €100 per month, with the proceeds ring-fenced to finance hospitals. There are, however, various exceptions, including those with potential health risks from vaccination or if the jabs were administered abroad and problems occur recognising them in Greece.
In parliament, the governing conservative party Nea Demokratia was joined in voting for compulsory vaccination by the centre-left KINAL party; the radical left Syriza, led by Alexis Tsipras, and Mera25, Yanis Varoufakis’ party, voted against it, as did the right-wing populists Greek Solution.
The opposition parties have not pulled their punches in criticising the policy, calling it the result of a failed national vaccination campaign in which the government failed to provide enough information and to convince sceptics. Syriza was particularly caustic: ‘Those who must bear the guilt for this health crisis and warn that our national provision is about to collapse refuse to accept any responsibility – and so are, once again, delegating it to ordinary citizens’. Other points of criticism are the many other professional groups such as the police or the clergy, have not been included in compulsory vaccination policy. The fines for non-vaccinated over-60s are also under fire: critics doubt whether there can be any justification for them from a public-health perspective or whether they are simply there to exert pressure on those who have declined to be vaccinated against Covid-19.
Arne Schildberg, FES Greece