As Victoria's COVID-19 pandemic declaration comes to an end, a behavioural scientist says the continuing use of vaccine mandates may be "ethically problematic" and should be carefully scrutinised.
While, from 11:59pm Wednesday, the state government's mandate will only apply in healthcare, in many other sectors vaccination requirements will remain in place.
Julie Leask — whose work focuses on vaccination — said although mandates did have an important role to play during the COVID-19 pandemic, continuing them was "ethically problematic".
"You should only have them in place when you've got very clear objectives that make them ethically and pragmatically justifiable," the University of Sydney social scientist said.
Professor Leask said there was a clearer imperative for mandates in health and aged care settings, where there was an "ethical weight towards ensuring that those patients feel safe".
The public health professor said vaccine mandates that incentivised more than 80 per cent of Australians to get two initial COVID-19 vaccine doses in 2021 did their job.
"We went above and beyond our wildest dreams with primary dose vaccination coverage last year and mandates made a big difference there," she said.
As of 11:59pm Wednesday, the state government's vaccination mandate will apply to health settings such as all hospitals, public sector aged care facilities, the ambulance service and facilities where day procedures take place.
In its announcement about the end of the pandemic declaration, the Victorian government said the mandate in health would be supported by the health departmental secretary's directions.
It said that, in other workplaces, occupational health and safety laws would back vaccination requirements, "allowing employers to decide which measures are most appropriate to keep their workplaces protected against COVID-19".
In some cases, existing mandates required Victorian workers to have three vaccine doses, including in aged care, health care, specialist schools, disability care, custodial settings and emergency services.
Most other vaccine requirements refer to two doses.
Companies such as Woolworths, Coles, ALDI, Virgin and Telstra are among those who told the ABC they would retain policies requiring staff to be vaccinated.
Mandates could hinder booster uptake
Professor Leask said the fact that COVID-19 vaccines were most effective at reducing severe disease, and less effective at reducing transmission was an important consideration.
"You've got to ask whether it's reasonable to exclude the completely unvaccinated from certain workplaces," she said.
"I think it's getting increasingly difficult to justify that, given the limited ability for the vaccine to stop you getting COVID, [which would therefore mean] you're a vastly reduced transmission risk."
Professor Leask said vaccine mandates could have adverse outcomes, becoming "hard to walk back" for subsequent vaccines or boosters.
"People take the absence of the mandate as a signal that it's not as important because the mandate requirement became the anchor," she said.
Last year, Professor Leask co-authored an article in the Medical Journal of Australia that laid out considerations that should be satisfied for a "justifiable mandate", including whether vaccines reduce transmission and whether less-restrictive measures have been tried first.
Meanwhile, Doherty Institute director Sharon Lewin said she did not think mandates were "appropriate at this point in time in the pandemic".
"I do, however, think mandates are suitable in hospital settings and aged care where you've got very vulnerable people," Professor Lewin said.
She said mandatory flu vaccinations had already set a precedent for there to be similar rules in place in health and aged care.
"Really, what matters now is the third and fourth doses to protect an individual from worse disease," she said.
"I don't think mandates are needed at this stage."
While first and second COVID-19 vaccine dose figures for people aged 16 and older sit at 97.1 per cent and 95.8 per cent, respectively, third and fourth doses continue to lag.
Of that age group, 72.7 per cent of people have received a third dose or a booster.
The rate for fourth doses, or additional boosters, which have been available to vulnerable people and those aged over 30, sits at 41.2 per cent.
Shift to vaccination policies creates 'grey area'
Melissiah spends her days as a hypnotherapist on the Mornington Peninsula providing one-on-one support to people managing the effects of anxiety, depression and trauma.
The 53-year-old is part-way through her studies to qualify as a psychologist, but she is concerned that, once she begins trying to practise, her vaccination status will hold her back because she will be categorised as a healthcare worker.
Melissiah — who asked for her surname to be withheld — said she had experienced a constant ache in her arm since getting her second COVID-19 dose more than a year ago, and is afraid a booster shot would have the same effect.
"It's very annoying having a constant ache in my arm," she said. "Any sort of chronic pain negatively affects a person's wellbeing."
The psychology student said she was not able to qualify for an exemption, and is concerned the "black and white" approach of vaccine mandates will affect her career.
"As a hypnotherapist, I can see clients having just had the two vaccinations but, as a psychologist, I don't believe I'd be allowed to do that," she said.
"I think [vaccines] are very important because they save lives in hospital settings.
"But I think, where there have been adverse effects, I don't think it should be expectant upon people to keep getting vaccinated."
Health experts have continued to highlight the protection against severe COVID-19 illness provided by vaccinations, including fourth booster doses for more vulnerable Australians.
Currently health workers are broadly covered by a three-dose COVID-19 vaccine mandate and the state government has indicated those requirements will not change with the end of the declaration.
Zana Bytheway — the chief executive of employment rights community legal centre JobWatch — said shifting vaccination requirements away from government mandates and into the hands of employers could lead to more legal challenges.
"With the mandate, everybody knew where they stood," she said.
"Employers had the protection to say: 'I am obligated to do this, there's a government directive.'"
"Now the area will become more grey and we may in fact be getting more calls as employees say: 'Hang on a minute, we know the government doesn't require this, why are you doing this?'"
Ms Bytheway said the COVID-19 pandemic had created a new workplace "landscape".
"People are still being dismissed, people are being made redundant and people are also challenging a return to the office," she said.
