Israel debates how to handle those who refuse vaccines
Inoculation push has restored much of its pre-pandemic routine, but holdouts remain.
JERUSALEM — After spending much of the last year in lockdown, Tel Aviv makeup artist Artyom Kavnatsky was ready to get back to work. But when he showed up for a recent photo shoot, his employer turned him away. The reason? He had not been vaccinated against COVID-19.
“He didn’t take me because I didn’t get vaccinated,” Kavnatsky said. “It’s discrimination, and it’s not all right.”
The breakneck pace of Israel’s vaccination drive has made it one of the few countries able to return to much of its pre-pandemic routine. Bars and businesses, hotels and health clubs have all sprung back to life in Israel, where some 80% of the adult population is fully vaccinated and new infections and COVID-19 deaths have plummeted.
Although Israel provides a glimpse of what may be possible with high immunization rates, it also offers insight into the problems that lie ahead: Workplaces and schools are now grappling with what to do with those who refuse to be vaccinated as the next phase in the pandemic again pits public health concerns against individual rights and possibly new questions of equity. One case has already ended up in court, and others are expected to.
Airlines are already considering whether vaccination, or a recent negative test, might be required for travel, as is the European Union. Some officials in Britain and the United States are exploring whether proof of immunization could help large-scale gatherings to return, though there remains significant resistance to such measures in the U.S. Whether a shot is necessary to go back to work or class is an even thornier question.
In many countries, the decisions may raise the prospect of further dividing populations along the lines of wealth and vaccine access. Although the vast majority of the 100,000 Palestinians who live in the West Bank and have Israeli work permits have been vaccinated, immunization drives in the West Bank and Gaza have lagged far behind. Many parts of the world have received few, if any, vaccines.
So far, Israel has relied primarily on a series of incentives meant to encourage people to get a vaccine. It has established a “green pass” for the fully vaccinated whose holders can attend concerts, dine out, go to the gym or travel to popular vacation spots in places such as Egypt, Cyprus and Greece. Those who do not have the pass are out of luck.
The system has worked well in areas of leisure and entertainment. But now it is moving into other realms. Health officials have recommended barring unvaccinated workers who have not recently tested negative for the coronavirus from schools, elder care facilities and other high-risk places.
Israel’s healthcare system has also mandated that all employees — doctors, nurses, administrators and support staff alike — receive the COVID-19 vaccine. If they refuse, they will be transferred to jobs that do not involve contact with high-risk patients.
Rights groups have expressed concern that such regulations could jeopardize workers’ income.
Similar concerns exist in education. Tel Aviv University, Israel’s largest, has found an uneasy balance for now.
As the university resumes in-person classes, Eyal Zisser, its deputy rector, said that only students who are vaccinated can be physically present. Those who are not can continue to learn remotely.
“In the initial stages, we are bringing back some of the students according to the green pass and making lessons accessible to the rest of the students,” Zisser said.
Even with Israel’s success, hundreds of thousands of people remain unvaccinated — some who are opposed to vaccines in general but also many who are hesitant to take a shot that was developed so quickly. U.N., U.S. and European health experts have said the vaccines authorized by Israel are safe and effective.
Kavnatsky, the makeup artist, objects to vaccines and modern medicine more broadly, saying he doesn’t want to put “any needles in my body.” He is not alone. He is one of over 15,000 members of a Hebrew-language antivaccine Facebook group who are critical of what they see as forced immunization by the state.
Rappeh, a political party headed by outspoken antivaccine advocate Aryeh Avni, received over 17,000 votes in last week’s parliamentary elections. That was not enough to get into parliament but illustrates the challenge for policymakers.
Israel’s Health Ministry acknowledges its powers are limited.
“We cannot force people to vaccinate,” said Einav Shimron, the ministry’s deputy director for international relations.
The Assn. for Civil Rights in Israel, an organization that deals with labor issues, said that the long-term application of the green pass raises a potential civil rights issue and has called on the government to pass legislation on the matter.
In the meantime, the debate is already playing out in the courts.
In the first major decision on the topic, a Tel Aviv labor court in March allowed a day-care center to bar a teaching assistant who who refused to be vaccinated or undergo coronavirus testing. The decision is expected to be appealed.
Dr. Nadav Davidovitch, the head of Israel’s association of public health physicians, said he believes people have an obligation to be vaccinated, particularly given the evidence that the vaccine not only prevents the worst outcomes from COVID-19 but also may reduce the spread of the virus. Israel, with 9.3 million people, has recorded at least 6,220 deaths since the pandemic began.
“We see vaccination as a solidarity act, not just an individual choice,” he said.
Still, he said he opposes forced vaccinations or firing people for refusing. Instead, he favors alternative approaches, including education and persuasion. Those who continue to refuse can perhaps be given different jobs, work remotely or undergo frequent testing.
Davidovitch, a former military epidemiologist, has experience with the issue. He said that well over 90% of Israeli recruits who did not want to be vaccinated when they enlisted ended up agreeing once they were educated by medical experts.
“I think it’s a bad idea to move quickly to compulsion,” he said. “Most people are hesitant. They are not against vaccination in general.”