Skeptical Cambodians face mandatory vaccinations

No pollster has yet done the research, but anecdotal evidence suggests a large number of Cambodians are skeptical about being vaccinated against Covid-19. 

As the country suffers its worst wave of the pandemic, which began on February 20 and has now resulted in 24 deaths, the government is threatening to punish those who refuse vaccination with dismissal from their jobs.  

On Tuesday, Prime Minister Hun Sen warned that soldiers and civil servants risk dismissal in the future if they are not vaccinated, noting that while it remains voluntary for now, “in the future it is clear that the vaccine will become mandatory.”

“I would like to inform civil servants who do not want to be vaccinated that when all institutions have been vaccinated more than 70%, those unvaccinated officials may not go to work. Just sleep at home,” said Hun Sen, one of the world’s longest-ruling leaders. 

“Getting vaccinated is to protect your own life and join the fight to protect against Covid-19. [If] you can’t do it, it’s unnecessary to continue to be a soldier, police or civil servant,” he added.

He also intimated that vaccinations may be mandatory for residents of Phnom Penh and Kandal province, two of the most densely populated and worst-hit areas of the country. 

The Royal Cambodian Armed Forces’ commander-in-chief, Vong Pisen, also this week appealed for troops to register for vaccination, warning that those who don’t will not be allowed to enter their barracks. 

On Wednesday, Labor Ministry spokesperson Heng Sour said workers in Cambodia’s vital garment manufacturing sector, which accounts for the majority of the country’s exports, could also face dismissal if they refused to be vaccinated. 

Applying pressure?

He asserted that about 280,000 of the country’s estimated 700,000 garment workers had volunteered to get inoculated after a vaccination campaign for the sector started this week.

Questions have been raised about whether the government’s threat to make vaccination mandatory and punishable by unemployment is merely intended to pressure greater numbers of people to apply for vaccination or is an actual policy the authorities want to introduce.  

Interest in vaccinations appears to be growing, although clearly not by the rates the government desires. According to the latest Health Ministry data, released on April 7, since the vaccination campaign started in early February, a total of 600,970 people have volunteered to receive a jab, of which 566,420 have been vaccinated and 34,508 have been rejected because of health concerns.

A total of 142,400 people have also received their second dose. 

On top of that, the Ministry of Defence said on April 7 that it had vaccinated 190,106 people with the first dose and 112,723 with a second dose. The Ministry of Health and Ministry of Defence have divided vaccines between themselves. 

The number of people volunteering for vaccination rose by 34% between April 4 and April 7, while the number of people being vaccinated jumped 35%, according to Asia Times analysis of Health Ministry data.

This comes as the latest and worst wave of the pandemic worsens in Cambodia, which is “now facing a very important moment to push back the virus,” Western Pacific regional director of the WHO, Takeshi Kasai, reportedly warned at a press conference on Wednesday. 

Two people died of Covid-19 on April 7, bringing the total number of fatalities up to 24, all of whom have passed away since the outbreak on February 20.

Infection numbers rising

A Ministry of Health statement released in the morning of April 8 noted that case numbers rose by 113 over the previous 24 hours, the largest daily increase since March 27, bringing the total active cases up to 1,085. Unconfirmed reports on Friday morning said the number of infected had risen substantially.

There are fears that infection numbers could spike next week as the country celebrates Khmer New Year, a major holiday in which much of the population usually travels to their hometown in the countryside. In anticipation of this, on Tuesday the government imposed a two-week travel ban to prevent travel between provinces. 

The same day, Hun Sen ordered the health ministry to prepare plans to treat Covid-19 patients at home, as a surge to more than 1,000 patients in hospital has pushed the country’s underfunded healthcare system to the brink. 

The WHO’s Western Pacific regional director, Kasai, warned on Tuesday that “there will be more surges. The virus is still circulating, and we simply can’t let down our guard – not yet.”

Hun Sen intimated that dismissal may apply to civil servants who aren’t vaccinated only after 70% of the population has been inoculated. Heng Sour, the Labour Ministry spokesperson, said this week that the government’s target is to have 10 million people – or 60% of the population – vaccinated by June 2022. 

That may suggest the government’s apparent threat to deny employment to garment workers and soldiers would also only be enforced after that date. 

Vong Pisen, the military chief, and Hun Sen both stressed that mandatory vaccinations and the threat of unemployment would only apply to those who can actually be inoculated against Covid-19, therefore not affecting individuals who are prevented from inoculation because of existing health concerns. 

Health concerns

It is understood that the authorities will demand an official document from a doctor to explain why someone wasn’t able to be vaccinated. 

Just over 6% of people who have volunteered for a vaccination with the Ministry of Health by April 4 were rejected because of health concerns, but this fell to 5.7% by April 7, Asia Times’ analysis of Health Ministry data found. 

This decrease was likely because of a shift from Sionpharm vaccines, which are not considered safe for over-60s, to the Sinovac and Covax-donated AstraZeneca vaccines (“Covishield”) vaccines. 

Indeed, a 10th of people who volunteered for the Sinopharm vaccine were rejected because of health concerns, compared with only 4.3% for the Sinovac and 2.5% for the Covax-donated Covishield vaccines, Asia Times’ analysis found. 

“The Cambodian government certainly has the capacity to make this mandatory for all civil servants,” said a source with knowledge of government policy, who asked not to be named. 

The long-ruling Cambodian People’s Party (CPP) has greatly expanded its power since 2017, when it forcibly dissolved the country’s largest opposition party over spurious claims of plotting a coup. After the 2018 general election, the CPP now governs in a de-facto, one-party state.

“The CPP regime has consolidated its power over the years – and that includes all state employees,” the source added. “While not nearly at the level of China or Vietnam in terms of [personnel] management, on the question of vaccinations – not a problem.”

However, it’s less obvious that the government could enforce mandatory vaccinations and punishments for workers in the garment sector.

Information, not pressure, needed

Yang Sophorn, president of the Cambodia Alliance of Trade Unions, told local media this week that the government should focus on providing workers with better information about the vaccines – especially as there are still concerns about the efficacy of the Sinopharm and Sinovac jabs from China – rather than pressuring or threatening them into vaccination.

“I think it’s insane and totally like the actions of a country that does not respect human rights, which is what Cambodia has walked right into whether awake or asleep,” said Sophal Ear, associate professor of diplomacy and world affairs at Occidental College at Los Angeles.

“It’s not okay to make being jabbed a requirement of employment, unless we’re talking about healthcare workers who are at very high risk of exposure. And of course, folks are scared and talking about Sinovac, the Chinese vaccine, being given to them. The efficacy and safety of which people still doubt, so why not make it voluntary and not mandatory?”

Although the WHO has praised the Cambodian government for its handling of the pandemic since last year, concerns have been raised over how the crisis has allowed the ruling CPP to greatly expand its authority over society. 

In mid-February, the Ministry of Post and Telecommunications and Ministry of Health initiated a QR Code system, which allows people entering establishments or institutions to scan and record their data with a central database, allowing authorities to know who was present if an outbreak is recorded at that location.

“Cambodia’s QR Code system is ripe for rights abuses because it lacks privacy protections for personal data,” said Phil Robertson, deputy Asia director, in a statement this week. 

“These concerns are heightened by the government’s stepped-up online surveillance of Cambodians since the outset of the pandemic, putting government critics and activists at greater risk.”

However, the major problem facing the government is not disinterest or skepticism by the public over vaccinations, but the authorities’ ability to vaccinate enough people to achieve its targets. 

Figures released by the ministries of health and defense on April 7 state that, so far, 1.01 million vaccines have been administered, either as a first or second dose. But that is less than a third of the total number of vaccines Cambodia currently has. 

At the time of writing, Cambodia received 1.3 million doses of the Chinese Sinopharm vaccines for free, paid US$15 million for 1.5 million doses of the Chinese Sinovac and received a first tranche of 324,000 doses from the Covax facility.  

Within a few months, it also expects to receive another 4 million Sinovac vaccines, for which it will pay $40 million, as well as another tranche of hundreds of thousands of Covax-donated vaccines.