Balancing benefits and potential risks of vaccination: the precautionary principle and the law of unintended consequences

2021 ◽  
pp. bmjebm-2021-111773
Author(s):  
David Robert Grimes
Keyword(s):  
Public Health ◽  
Precautionary Principle ◽  
Unintended Consequences ◽  
Vaccine Hesitancy ◽  
Public Health Issue ◽  
Public Confidence ◽  
The Precautionary Principle ◽  
Life Saving ◽  
Potential Risks ◽  
Risk And Benefit

Vaccination is a life-saving endeavour, yet risk and uncertainty are unavoidable in science and medicine. Vaccination remains contentious in the public mind, and vaccine hesitancy is a serious public health issue. This has recently been reignited in the discussion over potential side effects of COVID-19 vaccines, and the decision by several countries to suspend measures such as the AstraZeneca vaccine. In these instances, the precautionary principle has often been invoked as a rationale, yet such heuristics do not adequately weigh potential harms against real benefits. How we analyse, communicate and react to potential harms is absolutely paramount to ensure the best decisions and outcomes for societal health, and maintaining public confidence. While balancing benefits and risks is an essential undertaking, it cannot be achieved without due consideration of several other pertinent factors, especially in the context of vaccination, where misguided or exaggerated fears have in the past imperilled public health. While well meaning, over reactions to potential hazards of vaccination and other health interventions can have unintended consequences, and cause lingering damage to public trust. In this analysis, we explore the challenges of assessing risk and benefit, and the limitations of the precautionary principle in these endeavours. When risk is unclear, cautious vigilance might be a more pragmatic and useful policy than reactionary suspensions.

scholarly journals Avoiding a spiral of precaution in mental healthcare

2006 ◽  
Vol 12 (1) ◽  
pp. 1-4 ◽  
Author(s):  
Jonathan Green
Keyword(s):  
Health Policy ◽  
Precautionary Principle ◽  
Critical Appraisal ◽  
Mental Healthcare ◽  
Unintended Consequences ◽  
Face Validity ◽  
Clinical Protocols ◽  
The Precautionary Principle ◽  
Potential Risks

The precautionary principle has high face validity, but it can favour indeterminate future risks over potential current benefits. It can also have unintended consequences when applied to the design of clinical protocols and health policy. Contemporary pressures in mental healthcare may amplify the precautionary principle in practice. To mitigate against these disadvantages, we need trial designs that assess all risks (including the risk of no treatment) and also the possibility that potential risks may be successfully managed. Critical appraisal of clinical protocols and their impact are also necessary.

Unbinding Regulations

2019 ◽  
pp. 167-180
Author(s):  
Arthur M. Diamond
Keyword(s):  
Precautionary Principle ◽  
Firm Behavior ◽  
Occupational Licensing ◽  
The Precautionary Principle ◽  
Financial Regulations ◽  
Steady Growth ◽  
Life Saving ◽  
Fda Regulations

The steady growth in imposed regulations, often defended on the basis of the precautionary principle (which forbids innovations until there is proof that they will cause no harm), increases the risks and costs of innovation for the entrepreneur. Many important innovations of the last century would not have occurred if the precautionary principle had been in operation. Organic regulation of the marketplace (including tort actions and private ratings firms) can counter injuries due to irresponsible firm behavior, without stifling innovation. OSHA regulations did not reduce workplace deaths; financial regulations did not stop the Crisis of 2008, and may have made it worse. Occupational licensing regulations protect incumbents, and reduce opportunity for the least well-off. By slowing new life-saving drugs, FDA regulations cause more deaths than they prevent. The Vodnoy paradox suggests that we favor regulations in areas where we are ignorant and oppose them in areas where we are knowledgeable.

Public Engagement and Policy Entrepreneurship on Social Media in the Time of Anti-Vaccination Movements

2020 ◽  
pp. 60-80
Author(s):  
Melodie Yunju Song
Keyword(s):  
Public Health ◽  
Public Space ◽  
Public Engagement ◽  
Public Discourse ◽  
Vaccine Hesitancy ◽  
Public Health Issue ◽  
Competing Values ◽  
Mmr Vaccine ◽  
The Public ◽  
Coverage Rates

North America has experienced a resurgence of measles outbreak due to unprecedentedly low Mumps-Measles and Rubella vaccination coverage rates facilitated by the anti-vaccination movement. The objective of this chapter is to explore the new online public space and public discourse using Web 2.0 in the public health arena to answer the question, ‘What is driving public acceptance of or hesitancy towards the MMR vaccine?' More specifically, typologies of online public engagement will be examined using MMR vaccine hesitancy as a case study to illustrate the different approaches used by pro- and anti-vaccine groups to inform, consult with, and engage the public on a public health issue that has been the subject of long-standing public debate and confusion. This chapter provides an overview of the cyclical discourse of anti-vaccination movements. The authors hypothesize that anti-vaccination, vaccine hesitant, and pro-vaccination representations on the online public sphere are reflective of competing values (e.g., modernism, post-modernism) in contemporary society.

scholarly journals A Canadian Framework for Applying the Precautionary Principle to Public Health Issues

2010 ◽  
Vol 101 (5) ◽  
pp. 396-398 ◽  
Author(s):  
Erica Weir ◽  
Richard Schabas ◽  
Kumanan Wilson ◽  
Chris Mackie
Keyword(s):  
Public Health ◽  
Precautionary Principle ◽  
Health Issues ◽  
The Precautionary Principle

scholarly journals Reconciling civil liberties and public health in the response to COVID-19

FACETS ◽  
2020 ◽  
Vol 5 (1) ◽  
pp. 887-898
Author(s):  
Colleen M. Flood ◽  
Vanessa MacDonnell ◽  
Bryan Thomas ◽  
Kumanan Wilson
Keyword(s):  
Public Health ◽  
Civil Rights ◽  
Precautionary Principle ◽  
Civil Liberties ◽  
Burden Of Proof ◽  
Political Rights ◽  
The Precautionary Principle ◽  
Response Strategies ◽  
The Right ◽  
Health Discourse

The COVID-19 pandemic has highlighted the challenges governments face in balancing civil liberties against the exigencies of public health amid the chaos of a public health emergency. Current and emerging pandemic response strategies may engage diverse rights grounded in civil liberties, including mobility rights, freedom of assembly, freedom of religion, and the right to liberty and security of the person. As traditionally conceived, the discourses of civil rights and public health rest on opposite assumptions about the burden of proof. In the discourse of civil and political rights of the sort guaranteed under the Canadian Charter of Rights and Freedoms, the onus rests on government to show that any limitation on rights is justified. By contrast, public health discourse centers on the precautionary principle, which holds that intrusive measures may be taken—lockdowns, for example—even in the absence of complete evidence of the benefits of the intervention or of the nature of the risk. In this article, we argue that the two principles are not so oppositional in practice. In testing for proportionality, courts recognize the need to defer to governments on complex policy matters, especially where the interests of vulnerable populations are at stake. For their part, public health experts have incorporated ideas of proportionality in their evolving understanding of the precautionary principle. Synthesizing these perspectives, we emphasize the importance of policy agility in the COVID-19 response, ensuring that measures taken are continually supported by the best evidence and continually recalibrated to avoid unnecessary interference with civil liberties.

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