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Mandatory Vaccines

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Assignment Topic : Mandatory Vaccines
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Mandatory Vaccines

Introduction

Vaccines are effective methods of preventing populations from acquiring a particular disease. They are not a new topic to the world, with the British government passing the first mandatory vaccination law in the world in 1853. The compulsory vaccination was for smallpox, and it was recorded to have raised a lot of debate on its justification. Recently, a similar scenario has been presented by the Covid-19 pandemic. The world has been dramatically disrupted by the pandemic, with Covid-19 cases increasing rapidly. Despite the breakthrough in developing vaccines, the uptake by the populations is still slow globally. This has forced governments around the globe to discuss whether mandatory vaccinations might be considered and the ethical issues surrounding the topic. Mandatory vaccinations raise ethical concerns because they go against individual liberty or the right to freedom. People have the right over their autonomy to make decisions regarding what can be done to their bodies. A mandatory vaccination is only justified ethically under certain circumstances in which opponents and proponents argue over whether covid-19 meets the criteria to warrant a compulsory vaccination.  This document discusses the ethical justifications for mandatory vaccinations against covid-19 and the proponents.  

Proponents

Ethical justifications surrounding mandatory covid-19 vaccinations include its proportionality and necessity. A mandatory vaccination can be justified ethically if it is proportionate to or necessary for meeting a public health goal. Mandatory covid-19 vaccinations can be justified ethically because they are measures to meet herd immunity, a public health goal. Achieving herd immunity is an identified public health goal for many public authorities across the globe. Proponents for mandatory vaccination argue that using policy measures that interfere with individual autonomy and liberty should only be an option if the efforts increase prevention rates of risks (Bowen and Raffick, pg 421). These risks include mortality and morbidity caused by exposure to the disease. Covid-19 mandatory vaccination meets all the aspects warranting a mandatory policy. Proponents argue that the use of covid19 vaccines has been documented to decrease the infection rate by a significant amount(Bughin and Jacques pg 10). Millions of people have succumbed from Covid-19 attributed deaths globally. Early modeling, for instance, from the UK in 2020, predicted that half a million people would die of covid-19 if measures to prevent spread were not developed. After introducing a wide range of criteria such as highly restrictive lockdowns, among others, only 42, 000m people died by 30th September 2020 after four weeks of being tested positive.  Achieving herd immunity is critical for covid-19 as it is a severe threat to public health.

Vaccination for covid-19 should be made mandatory with policies including penalties like movement limitation and fines. Taking the vaccine ensures that an individual’s capacity to cause harm to others through spreading disease is significantly decreased. Therefore, mandatory vaccination prevents more significant harm which provides a solid ethical justification of compulsory vaccination. Through using vaccines such as Moderna, AstraZeneca, and Pfizer, which have proven efficacy of up to 95 percent in preventing infection from Covid-19, the risk of spreading the disease is also dramatically decreased.  Having a benefit like this will come at a small cost for individuals but will have a much more significant impact on their lives and others(Bowen and Raffick, pg 421). Mandatory vaccinations ensure that the burden and risk of achieving herd immunity are evenly distributed in the population.  Achieving herd immunity will benefit society collectively. Therefore, proponents argue that it should be a collective responsibility for everyone in community to get vaccinated.  Another ethical reason for justifying mandatory vaccination is that the government has already taken other mandatory measures to achieve similar results(Bughin and Jacques pg 15). A significant number of governments across the globe have employed a mandatory lockdown as they attempt to protect vulnerable populations from being exposed to Covid-19. Unlike mandatory lockdowns, which come at high costs for society and individuals, mandatory vaccines will come at lesser prices and will achieve more success than mandatory lockdowns (Bughin and Jacques pg 16). The use of these mandates should be re-evaluated regularly to ensure they remain proportionate and necessary for achieving public health goals.

Another ethical justification for mandatory vaccination is the safety of the vaccine. Ethical requirements of compulsory vaccination necessitate the availability of data to show the effectiveness of the vaccine among the mandated population. When safety data is lacking or is not sufficient, then it is impossible to ethically justify a vaccination mandate (Gostinet al., 533). Policy-makers must consider whether the vaccines can be used for conditional or emergency use, meeting the evidentiary threshold. Proponents argue that covid-19 vaccines have been proven effective in preventing acquiring of covid-19 and the spread of the disease. There is a significant amount of procedures and tests in place in many jurisdictions proving the safety of covid-19 vaccines. According to WHO, an effective and safe covid-19 vaccine reduces severe, moderate, and mild covid-19 cases(Gostinet al., 533). The current vaccines being advocated by the world health organization are safe and effective. Despite being proved safe, the uptake is still severely low, with a significant number of people not being likely to take the vaccines. As such, proponents support the notion of a mandatory vaccination since it can be ethically justified as being safe.

Proponents raise the issue of vaccine effectiveness and efficacy.  Similar to the safety issue, it is essential that there is sufficient data available to prove vaccine effectiveness and efficacy.  Evidence of covid-19 effectiveness and efficacy on the mandated population is available. If the governments were to mandate vaccines, whether, on the general population or a particular population, the move could be ethically justified if there is proof of effectiveness(Bowen and Raffick, pg 421). Covid-19 vaccines have been recorded to effectively reduce the spread of the virus and prevent individual infection. Proponents cite the efficacy and effectiveness of covid-19 vaccines as ethical justifications for mandatory vaccination.  

Additionally, to ethically justify a mandatory vaccination, there has to be a sufficient supply. The authorized vaccine should be reliable, adequate, and easily accessible for the mandated population. Governments will require the general population to receive mandatory vaccinations for the achievement of herd immunity(Bowen and Raffick, pg 421). For covid-19, there are sufficient vaccines to cater to global needs. Governments across the globe can easily ensure that there are enough vaccines for their populations; hence supply can ethically justify a mandatory vaccination. Additionally, there are reasonably little to no barriers to people accessing the vaccine(Gostinet al., 534). Sufficiency of the covid-19 authorized vaccines ensures that the threat of social inequality in healthcare access is sorted, at least for covid-19 cases.  

Proponents of mandatory vaccination state the ethical decision-making process as an argument. It is critical that the process of compulsory vaccination is approached with stepwise decision-making and transparency. There should be a reasonable effort to engage all stakeholders and understand their perspectives. Currently, health organizations and governments across the world have taken and are taking sufficient measures to ensure that all stakeholders are engaged in all decisions on covid-19. Transparency has been critical in advocating for Covid-19 vaccination and will remain vital in ethically justifying a mandatory vaccination.

Opponents

Mandatory vaccinations on the general adult populations rarely occur. It is impossible to ethically justify a mandatory vaccination that is not inclusive of all general public members. Opponents state that despite there being a sufficient supply of vaccines, policy-makers should consider the variations created by local context (Albert al., pg 376). A mandatory vaccine could be safe, effective, reliable, and adequate in supply but could threaten public trust. Additionally, proponents mention that having mandatory vaccination does not increase the vaccine uptake level among the population.  An EU-funded program found no relation between mandatory vaccination and an increase in vaccine uptake levels (Neumann-Böhme and Sebastian, pg 2 ). In the report, they stated that in cases where vaccination was made mandatory, the levels of uptake had no significant difference compared to similar or neighboring countries with no mandatory vaccination policies. Therefore proponents are against mandatory vaccinations because it will not improve the uptake level significantly and exposes the government to potentially losing public trust.  

Opponents of a mandatory vaccination argue on the safety and effectiveness of covid-19 vaccines. They raise concerns of testing of the vaccine being rushed; hence their efficacy and safety can be questioned.  No country has ever developed a coronavirus prior to the recent pandemic; therefore there are risks associated. Proponents argue that mandating vaccination should not happen because the risks of newly formulated vaccines may be more than established vaccines(Albert al., pg 377). Despite the tests taken, proponents argue that there has been rushing in developing and testing the vaccine; hence some of the side effects may not have been observed. They state that some side effects may take longer to show; thus mandating the vaccine is not the right move.  A mandatory vaccine can be ethically justified if it is 100 percent safe which cannot be proved by the covid-19 vaccine. The pressure of health organizations and scientists to develop a vaccine and the speed of producing the vaccine raises the mentioned concerns causing opponents to mandatory vaccination.

Opponents also argue over the utility derived from using a mandatory vaccination and utility derived from other alternatives.  As stated earlier, there is evidence that using a mandatory vaccination does not lead to a significant increase in the uptake of vaccines.  There are several alternatives to using mandatory vaccination. Opponents disqualify the argument on reaching herd immunity as justifying mandatory vaccinations since research shows that herd immunity can be achieved without needing a mandatory vaccination (Sear and Richard, pg 8). This opinion is especially prevalent among medical professionals.  Additionally, some populations cannot be vaccinated due to medical reasons such as immune problems, allergies, or other medical reasons. With time, immunity wanes, and as such, even the previously vaccinated populations can become vulnerable with time.  In instances where herd immunity is achieved, local areas can fall back over time leading to outbreaks. This has been the case with measles recently, where there was an outbreak despite the being a mandatory vaccination for the disease. Therefore more than herd immunity will be required to mitigate covid-19 in all locations and over time. As such, a significant number of people are against mandatory vaccination because it fails to meet the ethical justification to allow it.  

Opponents state that according to NCB( Nuffield Council of Bioethics), justification of mandatory vaccination can only happen for severe and highly contagious diseases. Covid-19is contagious, but some authorities, such as England’s Public Health, do not consider Covid-19 as an infectious disease with high consequences because of its low fatality level(Sear and Richard, pg 8). Additionally, the disease is strongly associated with age, with children having a death rate of 0.0016 percent and people over 80 at 7.8 percent(Albert al., pg 379).  In liberal and democratic societies, having a mandatory vaccination for healthy and young people is unethical. These populations perceive themselves as being of low risk in getting covid-19; hence forcing vaccination raises great ethical concerns. Mandatory vaccines are problematic because anti-vaxxers o not trust the government or experts.  Having a government mandate for covid-19 vaccination will not only meet defiance but wil also help recruit anti-vaxxers.

To sum up,  covid-19 vaccines should be mandatory because the benefits outweigh the disadvantages raised by opponents. Vaccines have been proven to reduce the spread and chance of getting infected; hence their effectiveness is guaranteed.  Additionally, the health sector has proved authorized vaccines as being safe, and they have been honest on the possible side effects. Mandatory vaccination will lead to more numbers vaccinated; hence achieving herd immunity is significantly boosted. Having mandatory vaccines will ensure the burden of achieving herd immunity is shared by all populations. As such, governments across the globe should consider putting in place mandatory vaccines for covid-19 as they have been proved as effective and safe. They help meet public health, which is among the mentioned reasons for ethically justifying mandatory vaccines.

Works cited

Albert, Michael R., Kristen G. Ostheimer, and Joel G. Breman. “The last smallpox epidemic in Boston and the vaccination controversy, 1901–1903.” (2001): 375-379.

Bowen, Raffick AR. “Ethical and organizational considerations for mandatory COVID-19 vaccination of health care workers: a clinical laboratorian’s perspective.” Clinica Chimica Acta; International Journal of Clinical Chemistry 510 (2020): 421.

Bughin, Jacques, et al. Vaccination Or NPI?: A Conjoint Analysis of German Citizens’ Preferences. iCite-International Centre for Innovation, Technology and Education Studies, Université libre de Bruxelles, 2021.

Gostin, Lawrence O., Daniel A. Salmon, and Heidi J. Larson. “Mandating COVID-19 vaccines.” Jama 325.6 (2021): 532-533.

Sear, Richard F., et al. “Quantifying COVID-19 content in the online health opinion war using machine learning.” Ieee Access 8 (2020): 91886-91893.

Neumann-Böhme, Sebastian, et al. “Once we have it, will we use it? A European survey on willingness to be vaccinated against COVID-19.” (2020): 1-6.

Appendices

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