Immunization and Ethics: Beneficence, Coercion, Public Health, and the State

2019 ◽  
pp. 434-447
Author(s):  
James Colgrove
Keyword(s):  
Public Health ◽  
Adverse Events ◽  
Herd Immunity ◽  
Medical Intervention ◽  
Healthy People ◽  
Historical Overview ◽  
Indirect Benefit ◽  
Direct Benefit ◽  
Medical Products ◽  
Compulsory Vaccination

As medical products given to healthy people (mostly children) at least partly for the benefit of others, vaccines raise challenging ethical questions. A vaccine provides a dual benefit: a direct benefit to the person receiving it, and an indirect benefit to other members of the community through the creation of herd immunity. As with any medical intervention, immunization also carries risks of adverse events. The collective implications of immunization have led governments to enact policies designed to achieve high rates of coverage among their populations. This article provides a historical overview of vaccine use and considers ethical questions related to compulsory vaccination, coercion, vaccine rationing, and compensation for vaccine-related adverse events.

scholarly journals The Importance of Advancing Severe Acute Respiratory Syndrome Coronavirus 2 Vaccines in Children

2020 ◽  
Author(s):  
Carol M Kao ◽  
Walter A Orenstein ◽  
Evan J Anderson
Keyword(s):  
Severe Acute Respiratory Syndrome ◽  
Herd Immunity ◽  
Target Population ◽  
Indirect Benefit ◽  
Direct Benefit ◽  
Potential Barriers ◽  
Community Protection ◽  
Role Based ◽  
Childhood Vaccines

Abstract While the role of children in the transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) remains to be defined, children likely play an important role based on our knowledge of other respiratory viruses. Children are more likely to be asymptomatic or have milder symptoms and less likely to present for healthcare and be tested for SARS-CoV-2. Thus, our current estimates are likely under-representative of the true burden of SARS-CoV-2 in children. Given the potential direct benefit of a SARS-CoV-2 vaccine in children and the substantial indirect benefit through community protection, or “herd immunity,” we argue that planning and implementation of SARS-CoV-2 vaccines should include children. Furthermore, community protection occurred after widespread implementation of prior childhood vaccines against Streptococcus pneumoniae, rubella, and rotavirus. We detail considerations for vaccine clinical trials, potential barriers to the implementation of widespread vaccination and argue why children would be an ideal target population for vaccination.

ADDRESSING THE ISSUE OF СOVID-19, SARS-COV-2 VIRUS AND THE DISEASE

2020 ◽  
Vol 99 (6) ◽  
pp. 15-31
Author(s):  
A.A. Korenkova ◽  
◽  
E.M. Mayorova ◽  
V.V. Bahmetjev ◽  
M.V. Tretyak ◽  
...  
Keyword(s):  
Public Health ◽  
Immune Responses ◽  
Molecular Mechanisms ◽  
Herd Immunity ◽  
Significant Problem ◽  
Prevention Measures ◽  
Optimal Therapy ◽  
The World ◽  
Public Health Challenge ◽  
Coronavirus Infection

The new coronavirus infection has posed a major public health challenge around the world, but new data on the disease raises more questions than answers. The lack of optimal therapy is a significant problem. The article examines the molecular mechanisms of SARS-CoV-2 infection and the pathogenesis of COVID-19, special attention is paid to features of pathological processes and immune responses in children. COVID-19 leads to a wide diversity of negative outcomes, many of which can persist for at least months. Many of the consequences have yet to be identified. SARS-CoV-2 may provoke autoimmune reactions. Reinfection, herd immunity, vaccines and other prevention measures are also discussed in this review.

scholarly journals Designer Benzodiazepines: A Review of Toxicology and Public Health Risks

2021 ◽  
Vol 14 (6) ◽  
pp. 560
Author(s):  
Pietro Brunetti ◽  
Raffaele Giorgetti ◽  
Adriano Tagliabracci ◽  
Marilyn A. Huestis ◽  
Francesco Paolo Busardò
Keyword(s):  
Public Health ◽  
Adverse Events ◽  
Health Risks ◽  
Drug Market ◽  
Driving Under The Influence ◽  
Self Administration ◽  
Public Health Risks ◽  
Drug Offense ◽  
Legal Sanctions ◽  
Designer Benzodiazepines

The rising use of designer benzodiazepines (DBZD) is a cat-and-mouse game between organized crime and law enforcement. Non-prohibited benzodiazepines are introduced onto the global drug market and scheduled as rapidly as possible by international authorities. In response, DBZD are continuously modified to avoid legal sanctions and drug seizures and generally to increase the abuse potential of the DBZD. This results in an unpredictable fluctuation between the appearance and disappearance of DBZD in the illicit market. Thirty-one DBZD were considered for review after consulting the international early warning database, but only 3-hydroxyphenazepam, adinazolam, clonazolam, etizolam, deschloroetizolam, diclazepam, flualprazolam, flubromazepam, flubromazolam, meclonazepam, phenazepam and pyrazolam had sufficient data to contribute to this scoping review. A total of 49 reports describing 1 drug offense, 2 self-administration studies, 3 outpatient department admissions, 44 emergency department (ED) admissions, 63 driving under the influence of drugs (DUID) and 141 deaths reported between 2008 and 2021 are included in this study. Etizolam, flualprazolam flubromazolam and phenazepam were implicated in the majority of adverse-events, drug offenses and deaths. However, due to a general lack of knowledge of DBZD pharmacokinetics and toxicity, and due to a lack of validated analytical methods, total cases are much likely higher. Between 2019 and April 2020, DBZD were identified in 48% and 83% of postmortem and DUID cases reported to the UNODC, respectively, with flualprazolam, flubromazolam and etizolam as the most frequently detected substances. DBZD toxicology, public health risks and adverse events are reported.

Health Disparities and the Law: Wrongs in Search of a Right

2003 ◽  
Vol 29 (2-3) ◽  
pp. 363-380
Author(s):  
Mary Anne Bobinski
Keyword(s):  
Public Health ◽  
Health Planning ◽  
Healthy People ◽  
Public Action ◽  
Traditional Health ◽  
Obesity And Diabetes ◽  
Wide Range ◽  
State Coercion ◽  
Healthy People 2010 ◽  
Over Time

Healthy People 2010 provides our Nation with the wide range of public health opportunities that exist in the first decade of the 21st century. With 467 objectives in 28 focus areas, Healthy People 2010 will be a tremendously valuable asset … . Healthy People 2010 reflects the very best in public health planning—it is comprehensive, it was created by a broad coalition of experts from many sectors, it has been designed to measure progress over time, and, most important, it clearly lays out a series of objectives to bring better health to all people in this country.The current responses to the traditional health perils … have been weakened. At the same time, it seems to this outsider as though the entire public health establishment is united around the proposition that massive public action should be taken to deal with the new “epidemics,” such as obesity and diabetes … . But the use of the term “epidemic” is just the wrong way to think about this issue. There are no noncommunicable epidemics … . Yet the designation [of] obesity as a public health epidemic is designed to signal that state coercion is appropriate … .

scholarly journals Ethics of Vaccination in Childhood—A Framework Based on the Four Principles of Biomedical Ethics

Vaccines ◽  
2021 ◽  
Vol 9 (2) ◽  
pp. 113
Author(s):  
Meta Rus ◽  
Urh Groselj
Keyword(s):  
Public Health ◽  
Moral Obligation ◽  
Common Good ◽  
Herd Immunity ◽  
Ethical Analysis ◽  
Biomedical Ethics ◽  
Responsibility To Protect ◽  
Ethical Aspects ◽  
Respect For Autonomy ◽  
Mandatory Vaccination

Although vaccination is recognised as the top public health achievement of the twentieth century, unequivocal consensus about its beneficence does not exist among the general population. In countries with well-established immunisation programmes, vaccines are “victims of their own success”, because low incidences of diseases now prevented with vaccines diminished the experience of their historical burdens. Increasing number of vaccine-hesitant people in recent years threatens, or even effectively disables, herd immunity levels of the population and results in outbreaks of previously already controlled diseases. We aimed to apply a framework for ethical analysis of vaccination in childhood based on the four principles of biomedical ethics (respect for autonomy, nonmaleficence, beneficence and justice) to provide a comprehensive and applicable model on how to address the ethical aspects of vaccination at both individual and societal levels. We suggest finding an “ethical equilibrium”, which means that the degree of respect for parents’ autonomy is not constant, but variable; it shall depend on the level of established herd immunity and it is specific for every society. When the moral obligation of individuals to contribute to herd immunity is not fulfilled, mandatory vaccination policies are ethically justified, because states bear responsibility to protect herd immunity as a common good.

Understanding vaccine hesitancy: the evidence

2021 ◽  
Vol 32 (7) ◽  
pp. 282-287
Author(s):  
Alison While
Keyword(s):  
Public Health ◽  
Health Professionals ◽  
Herd Immunity ◽  
Public Health Intervention ◽  
Health Intervention ◽  
Vaccine Hesitancy ◽  
Important Public Health ◽  
Positive Attitudes ◽  
The Uk

Vaccine hesitancy is a concern both globally and within the UK. Alison While reviews the evidence relating to vaccine hesitancy, its underlying factors and the sociodemographic variations Vaccination is an important public health intervention, but its effectiveness depends upon the uptake of vaccination reaching sufficient levels to yield ‘herd’ immunity. While the majority of the UK hold positive attitudes about vaccination, some people, including health professionals, decline vaccinations. This article reviews the evidence relating to vaccine hesitancy, its underlying factors and the sociodemographic variations.

scholarly journals Healthy People 2020 Objectives for Violence Prevention and the Role of Nursing

2014 ◽  
Vol 19 (1) ◽  
Author(s):  
Thomas Simon ◽  
Kimberly Hurvitz
Keyword(s):  
Public Health ◽  
Violence Prevention ◽  
Partner Violence ◽  
Youth Violence ◽  
Public Health Problem ◽  
The United States ◽  
Healthy People ◽  
Public Health Approach ◽  
Prevention Strategies ◽  
Healthy People 2020

Violence, including child maltreatment, youth violence, intimate partner violence, and sexual violence, is a significant public health problem in the United States. A public health approach can help providers understand the health burden from violence, evaluate evidence for prevention strategies, and learn where to turn for information about planning and implementing prevention strategies for this preventable problem. For the past three decades, the U.S. Department of Health and Human Services has published “Healthy People” objectives for the next decade. The Healthy People 2020 initiative includes 13 measurable objectives related to violence prevention, one of which was selected as a Healthy People 2020 Leading Health Indicator. Progress to achieve these objectives can save thousands of lives, reduce the suffering of victims and their families, and decrease financial cost to the law enforcement and healthcare systems. The role that nurses can and do play in violence prevention is critical and extends beyond just caring for victims to also include preventing violence before it happens. This article summarizes the violence prevention objectives in Healthy People 2020 and the resources for prevention available to support nurses and others as they move prevention efforts forward in communities to stop violence before it starts.

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