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EXPLAINED: Why Switzerland rejects obligatory vaccinations for some professions

With the Delta variant sweeping through Switzerland and the number of coronavirus cases on the rise, several European countries are making Covid vaccinations mandatory in some professions. In Switzerland this is unlikely due to a variety of cultural and historical reasons.

EXPLAINED: Why Switzerland rejects obligatory vaccinations for some professions
To vaccinate or not to vaccinate — that is the question. Photo by Joseph Prezioso / AFP

The number of daily cases in Switzerland has exceeded the 1,000 mark on Tuesday for the first time since October 2020. At the same time, the pace of vaccinations is stagnating — with just over 48 percent of the population fully vaccinated, Switzerland lags behind neighbours Germany, Italy, Austria, and even Liechtenstein.

Swiss health officials say inoculations slowed down because of summer travel and hope the pace will pick up from September. But, as has been the case since the beginning of the campaign, vaccinations will remain voluntary, even for people in the so-called “frontline occupations” — those in close contact with vulnerable people, including the sick and the elderly.

While France will make vaccines mandatory for medical personnel from September 15th, Swiss authorities refuse to crank up pressure on healthcare workers — or anyone else, for that matter — preferring to continue their strategy of gentle persuasion.

Health Minister Alain Berset has repeatedly said that Covid vaccines, as all other inoculations, will remain voluntary.

Why is the Swiss government against making Covid vaccines mandatory?

Cultural and legal forces are at play here.

From the cultural point of view, Swiss people value highly their civil liberties, which include the constitutional right to “self-determination” — the freedom to choose one’s own destiny.  This is the very same right, by the way, that allows those living in Switzerland to decide the manner and time of their death — the famous (or infamous) assisted suicide.

This emphasis on independence and the importance of individual choice is especially prevalent among more conservative and traditional members of the population. The right-wing Swiss People’s Party, for instance, is adamantly opposed not only to compulsory vaccinations, but also to obligatory testing — that is, anything that is imposed rather than chosen freely.

As a Geneva daily, Le Temps, recently wrote in its editorial, “In Switzerland we will never see [president] Guy Parmelin haranguing the people and summoning them to be vaccinated. It is absolutely not in Swiss DNA. Here, we must take into account the different cantonal, cultural or societal sensitivities. The injunction does not work”.

READ MORE: Will unvaccinated people have to pay their own hospital costs in Switzerland?

But in an interview with Neue Zurcher Zeitung, Parmelin warned that individual liberty cannot encroach on the freedom of others. 

“The question arises as to whether the majority of the population who wants to be vaccinated must bear the consequences because a minority does not want it,” he said.

What does the law say?

The official website of the Swiss government’s coronavirus health plan says the following:

“A general obligation to vaccinate the population is fundamentally ruled out by law. Through transparent and comprehensible information, every person should be able to decide freely whether they want to be vaccinated.”

Berset reiterated this stance many times by insisting that “Swiss law does not allow us to force someone to get vaccinated against their will”. 

On the legal level, the law on epidemics gives the Federal Council the possibility – after consulting with the cantons – to make vaccination compulsory for people at risk or “carrying out certain activities” in the event of an “extraordinary situation”.

The cantons also have this prerogative “provided that a serious danger is established”.

Finally, the cantonal hospitals can take measures as well to protect their patients. Unvaccinated caregivers would, for example, be transferred to a less exposed service or assigned to administrative tasks without contact with patients.

READ MORE: Why are Switzerland’s Covid rates on the rise once again?

What about job-based obligation rather than a general one?

Specifically, could Switzerland impose vaccination on health caregivers, the way France did? 

While authorities made it clear that the general vaccine mandate is out of the question, Berset said immunisation could be obligatory for people in certain jobs, such as healthcare professionals and others whose work brings them in close contact with the public.

However, Swiss health officials and politicians still seem to be torn between the independence of care givers and the protection of patients.

For instance, Geneva’s health minister Mauro Poggia, pointed out that Switzerland has so far relied on a strategy based on conviction and not on coercion, and “we must maintain this course”.

While no such decision can be made on the federal level, the way it was in France, the cantons and individual health care facilities do have this prerogative.

UPDATED: Can you be fired in Switzerland if you refuse the Covid-19 vaccine?

They can, for example, transfer unvaccinated caregivers to less “exposed” services or assign them to administrative tasks without contact with patients.

To date, professional associations have also abstained from telling their members point blank that they must get vaccinated — or else.

While the Swiss Association of Nurses (ASI) “strongly recommends” vaccination to its members, it does not support the introduction of an obligation.

“Our profession is based on science and the vaccine is effective in combating the pandemic,” said Roswitha Koch, care development manager at ASI.

“However, individual freedom and autonomy are cardinal values in our country, and healthcare professionals should not be treated any differently from the rest of the population. “

But Claire, a nurse at Vaud University Hospital (CHUV) doesn’t quite see it this way.

“If it were up to me, I’d make it compulsory. In this job, you can’t hide behind the freedom of choice. Lives of patients and our own health are at stake”, she told The Local.

She did add that most of her colleagues are not in favour of compulsory obligation or, for that matter, vaccines.

In the meantime, Poggia announced on Wednesday that the canton’s medical employees who refuse the vaccine will have to get frequent tests.

.”It is the responsibility of the institution not to leave vulnerable patients in doubt as to the potential dangers represented by the unvaccinated caregivers”, he said, adding that Geneva will be the first canton to impose this measure in Switzerland.”

READ MORE: Why Switzerland is not considering new measures despite rising Covid case numbers

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What to know about changes to free Covid testing in Switzerland

From January 2023, people in Switzerland will generally have to pay for Covid-19 tests. Here's a look at the changes.

What to know about changes to free Covid testing in Switzerland

What’s happening?

The Swiss Parliament says that from January 1st 2023, the costs of Covid-19 tests will no longer be paid for by the government. 

It means that anyone who wants a Covid test will have to pay for it themselves. 

However, Covid-19 tests ordered by a doctor will be met by health insurance costs “provided the test is required to determine any further medical action,” the Federal Office of Public Health (FOPH) said in a statement.

“Such costs will also, however, be subject to the insurance’s deductible and copayment provisions,” said the FOPH. The test result has no influence on the reimbursement.

Why are the rules changing?

Since the early days of the pandemic, the Swiss government has been covering the cost of Covid tests – at least most of the time.

But testing is expensive – the government spent 2.1 billion francs on tests in 2021, and 1.6 billion this year up to the start of December.

“The continuation of reimbursement for tests that benefit public health would have cost around CHF 100 million in the 1st quarter of 2023, according to estimates by the FOPH, based on a 20 to 30 percent higher test volume than in the past weeks,” the FOPH says.

However, keeping tests free of charge could also lead to additional costs in other areas – such as a potentially greater burden on doctors’ practices and hospitals, the FOPH said.

What’s the reaction?

For infection specialist Jan Fehr, the end of free testing is happening at a bad time.

At the moment, it is difficult to keep track of which respiratory tract infections are having a significant burden on the health system with respiratory syncytial virus (RSV), influenza and Covid all circulating at the same time, he told Swiss broadcaster SRF.

“Charging for corona tests from January will lead to even fewer people getting tested and is currently incomprehensible from an epidemiological point of view,” said Fehr.

Santésuisse, the industry association of Swiss health insurers, urged the state to take over the costs of tests again if the Covid situation worsens in future. 

What else should I know?

According to the FOPH, Covid tests are possible in the same facilities as before, such as doctors’ surgeries, pharmacies, hospitals, retirement and nursing homes, as well as in test centres.

Despite tests not being free of charge unless a doctor has ordered them, vaccinations against Covid-19 will continue to be free for people in Switzerland in 2023.