Mandatory vaccinations should be 'last resort' in worldwide fight against Covid-19

"I think you have to be in a position where you have tried everything else, and you're not making progress, Dr Ryan said.

"Where the potential public health and health impact in terms of deaths is so high, that you have no other choice but to introduce a mandatory regime."

Dr Ryan's comments come as the Austrian government has pledged to make vaccinations mandatory by February 1.

The country has one of the lowest vaccination rates in western Europe, at around 66% of the population of almost nine million people.

Dr Ryan said that if mandatory vaccinations are introduced by governments it should be for the "shortest possible period of time" and with "due regard" for human rights.

"This is the issue of the rights of the individual or the rights of many, and it's a very hard balanced strike.

"I would advise countries considering mandatory vaccination to be sure that they have tried everything else," he added.

A nationwide lockdown in Austria was announced on Friday, as the average daily deaths tripled in recent weeks and hospitals in hard-hit states warned that intensive care units were at capacity.

The renewed restrictions will be in place for around 20 days, after which the government has indicated plans to open up so Austrians can celebrate Christmas normally. However, restrictions will remain in place for unvaccinated people.

Meanwhile, the executive director of WHO in Europe, Dr Robb Butler said that while compulsory vaccination can increase the uptake, it does not always and there are lessons of history here that we have to take into account.

“Mandates often come at the cost of trust and social inclusion that can polarise communities so mandates have to be used with care. It's a healthy debate to have now. I would say it is our last resort," he told Morning Ireland.

Dr Butler said that he kept hearing the blame game, but that it was no one individual or policymakers versus community fault.

“We've got to get these sub-optimal rates down, but we need to target the populations that are unvaccinated to try and bring the curve down.” 

He said the WHO was constantly looking at every age group in real-time about vaccination, the bigger question was how to get the 45% that are eligible for vaccine vaccinated. In some countries there were very low levels – that was due to three Cs - complacency, convenience and confidence.

Some countries did not have confidence in the vaccine or in the authorities that deliver them, he said. There were also issues of access and service delivery in some countries.

The current wave of Covid in Europe was happening for a number of reasons, he said. The half-million deaths projected, could be down to three factors – “the first is we have this winter seasonality behaviour, of course, we're moving indoors particularly in the northern hemisphere, northern Europe, where mask use, ventilation is going to become all the more important.” 

Dr Butler pointed out that a British Medical Journal study last week showed a 53% reduction in transmission with mask use. 

“In the region we see only 48% of the one billion people in the 53 member states of the European region using masks, so we think there's a real opportunity to boost mask use to see a real dividend in terms of reducing that projected number of deaths.

“The second reason this is happening is there's just too many people still vulnerable to infection in Europe. We have 54% of the population vaccinated which means 45% or thereabouts remains unvaccinated in the region.

“The vast majority of those hospitalised today are the unvaccinated, the most vulnerable in our population and also we're seeing some waning immunity especially after 30 weeks of a full course, those are two reasons.

“The third reason would be the more transmissible Delta variant which is accounting for 99% of the cases in our region.

“It is a worrisome picture but it is avoidable and that's our message today.” 

The WHO's message was one of hope, he said, “in the sense that we know how we can reduce this burden and we would really promote mask use and absolutely promote reaching every last individual with vaccines, there are pockets of the population that the Delta variant is seeking out.” Dr Butler also said there was a need to promote booster vaccinations among the elderly, healthcare workers and the immunocompromised. He hoped that if offered a booster vaccine that they would be accepted.

“The other stabilisers which would make a real difference is ventilation and more work on treatment and therapeutics.

“This is a moving target, we have to wait and see if three doses will be sufficient for a longer period or lifelong immunity.”