By Isaac Jarratt-Barnham.

We live in an increasingly polarised, siloed and fractured world. The week in UK politics as I write shows this all too starkly – five days ago, 300,000 protesters marched through London for peace in Palestine, the far-right attempted to storm the cenotaph, and 145 were arrested for crimes including racially aggravated assault and inciting hatred. Three days ago, Suella Braverman resigned as Home Secretary following her role in encouraging this unrest. Today, the government is threatening withdrawal from international human rights treaties in order to bypass the Supreme Court’s blocking of refugee deportations to Rwanda. The depth of division within our society has never been clearer.

In hindsight, the COVID-19 pandemic can be seen to have played a role in catalysing these divisions. By driving reliance on the online world and closing real-world public spaces, the pandemic lockdowns encouraged reliance on social media as a news source, facilitating each of our retreat into our own echo chambers and providing a breeding ground for conspiracy theories.

It is unsurprising that, in this context, rapidly developed COVID vaccines were a source of global controversy. Around the world, a significant minority refused to accept vaccination for a host of reasons. This prompted others to call for various forms of discrimination against the unvaccinated.

One of the most prominent arguments raised for this discrimination was based on a very understandable intuition – that those who refused vaccination when it was offered were in some sense ‘letting the side down’.

Whilst, to a degree, this sentiment might be applied to refusal of vaccination against any infectious disease, in the setting of COVID the unvaccinated could be accused of undermining the collective in an entirely different way. In countries reliant on lockdown to control virus spread, the freedoms enjoyed by society as a whole were contingent on COVID case numbers. By refusing vaccination, therefore, the unvaccinated were contributing to the restriction of others’ freedoms.

In my essay, I wanted to explore and interrogate whether this intuition could be reasonably used to justify prejudicial treatment of the voluntarily unvaccinated in a healthcare context. I conclude that it is inappropriate to do so. Such discrimination would worsen the polarisation that is itself the reason such a significant minority of the public is susceptible to accepting anti-vaccination conspiracy theories, particularly were the medical profession seen to become a partisan actor.

Further, we must remember that we do not choose the echo-chamber into which we fall. Cultural, social and economic background play a key role in determining risk of refusing vaccination. We should avoid allowing these characteristics to determine healthcare access.  

Whilst COVID has abated, this topic remains relevant. There will be another pandemic, and it will prompt the same discriminatory calls. When it comes, it is crucial that we remember our compassion and understanding for one another and resist temptation to penalise others for behaviours that we may not fully understand.

Paper title: Should vaccination status be a consideration during secondary triage?

Author: Isaac Jarratt-Barnham

Affiliations: University of Oxford

Competing interests: None

Social media accounts of post author:  @icjb2