THE Sindh government’s decision to make Covid-19 vaccinations mandatory and to block the salaries of government employees who are not inoculated is indeed a drastic measure, as admitted by the province’s chief minister himself. The announcement has come as the country battles the third wave of the coronavirus with a vaccination rollout which this far has covered 3.7m individuals with one dose.

While the Sindh government has good reasons to fear a scenario in which vaccine hesitancy leads to a continuing threat from Covid-19 and lethal variants, the order to make it compulsory and to tie it to incomes needs to be re-examined.

In many countries, though SOPs such as mask-wearing and distancing are compulsory, vaccination itself is largely still voluntary. In the United States, for instance, officials are going all out to incentivise citizens to get a jab but are staying away from making vaccines compulsory so as not to overstep when it comes to individual liberty. In Ohio, the governor has announced a weekly $1m prize draw that only vaccinated citizens can enter. In Maryland, state employees are paid $100 if they get both doses. In New York, those who get vaccinated will receive a seven-day Metro card and even tickets to a baseball game. The idea behind these incentives is to encourage people to get vaccinated voluntarily — an exercise that builds trust between citizens and the state.

In Pakistan, where citizen trust in public institutions is generally low, a coercive policy threatens to further undermine public trust confidence. This could have consequences for adherence to important public health measures. For vaccine sceptics, a mandatory vaccine order will fuel resentment and may be viewed as a form of state oppression.

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Though the government could justify such measures in the interest of public health and safety due to the unprecedented nature of the threat, there are several other steps it can take to encourage people to get vaccinated voluntarily. This exercise will be contingent on building trust, educating citizens and giving incentives to persuade vaccine sceptics.

Though the Sindh government’s early signalling when it came to Covid-19 prevention and SOPs was exemplary, the PPP’s participation in mass PDM rallies was totally at odds with scientific advice and gave the wrong message to the population. The party needs to do better and act as a role model for citizens so that trust can be gained. A door-to-door awareness campaign is also critical, as is messaging from public figures and government officials. Conspiracy theories must be battled in all public spaces through ads, mainstream media and even mosque sermons.

Fear and mistrust can be overcome to some extent through awareness, incentives and trust-building measures. Penalties and punishments for vaccine refusals should really be a last resort. More importantly, the government must ensure there are enough free vaccines for those who want them.

Published in Dawn, June 6th, 2021