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.

Ethics of vaccine refusal

2021 ◽  
pp. medethics-2020-107026
Author(s):  
Michael Kowalik
Keyword(s):  
Public Health ◽  
Moral Obligation ◽  
A Priori ◽  
Free Agent ◽  
Vaccine Refusal ◽  
Vaccine Mandates ◽  
Ethical Norms ◽  
Mandatory Vaccination ◽  
Ethical Basis ◽  
Do So

Proponents of vaccine mandates typically claim that everyone who can be vaccinated has a moral or ethical obligation to do so for the sake of those who cannot be vaccinated, or in the interest of public health. I evaluate several previously undertheorised premises implicit to the ‘obligation to vaccinate’ type of arguments and show that the general conclusion is false: there is neither a moral obligation to vaccinate nor a sound ethical basis to mandate vaccination under any circumstances, even for hypothetical vaccines that are medically risk-free. Agent autonomy with respect to self-constitution has absolute normative priority over reduction or elimination of the associated risks to life. In practical terms, mandatory vaccination amounts to discrimination against healthy, innate biological characteristics, which goes against the established ethical norms and is also defeasible a priori.

scholarly journals Libertarianism and collective action: is there a libertarian case for mandatory vaccination?

2018 ◽  
Vol 45 (1) ◽  
pp. 71-74
Author(s):  
Charlie T Blunden
Keyword(s):  
Collective Action ◽  
Moral Obligation ◽  
Herd Immunity ◽  
Disease Outbreaks ◽  
Coercive Measures ◽  
Collective Risk ◽  
The Individual ◽  
Mandatory Vaccination

In his paper ‘A libertarian case for mandatory vaccination’, Jason Brennan argues that even libertarians, who are very averse to coercive measures, should support mandatory vaccination to combat the harmful disease outbreaks that can be caused by non-vaccination. He argues that libertarians should accept the clean hands principle, which would justify mandatory vaccination. The principle states that there is a (sometimes enforceable) moral obligation not to participate in collectively harmful activities. Once libertarians accept the principle, they will be compelled to support mandatory vaccination. In my paper, I argue that the cases Brennan uses to justify this principle are disanalogous to the case of non-vaccination and that they are not compelling to libertarians. The cases Brennan offers can be explained by a libertarian using the individual sufficiency principle: which states that if an individual’s action is sufficient to cause harm, then there is a (sometimes enforceable) moral obligation not to carry out that action. I argue that this principle is more appropriate to Brennan’s examples, and more appealing to the libertarian, than the clean hands principle. In order to get libertarians to accept the clean hands principle, I present a modified version of one of Brennan’s cases that is analogous to the case of non-vaccination. Using this case, I argue that whether the clean hands principle will justify mandatory vaccination is dependent on whether the herd immunity rate in a given population is approaching a threshold after which a collective risk of harm will be imposed onto others.

Vaccine Credentials in the Developing World

2021 ◽  
Vol 46 (4) ◽  
pp. 2-4
Author(s):  
Nicanor Pier Giorgio Austriaco ◽  
Keyword(s):  
Public Health ◽  
Yellow Fever ◽  
Common Good ◽  
Developing World ◽  
Herd Immunity ◽  
International Travel ◽  
Global Public Health ◽  
Global Pandemic ◽  
The World ◽  
Developed World

Although COVID-19 vaccine credentials for international travel are an unwelcome or dangerous concept to some in the developed world, such measures are an essential component of global public health in some of the poorest countries of the world, in particular to prevent the spread of yellow fever. If one accepts the liceity of vaccine credentials for yellow fever in the developing world, then one has to do the same with similar credentials for COVID-19. A COVID-19 vaccine credential will allow developing countries to reopen their borders and economies long before they can attain herd immunity. It will be a lifeline for economies that have been ravaged by the global pandemic. It will be part of the global common good.

scholarly journals The path to herd immunity: is mandatory vaccination the answer?

2021 ◽  
pp. 82-89
Author(s):  
Steven Cheng ◽  
Bianca Lepe
Keyword(s):  
Public Health ◽  
Infectious Disease ◽  
Herd Immunity ◽  
The United States ◽  
Vaccination Rate ◽  
Vaccination Policy ◽  
Health Measure ◽  
Disease Mortality ◽  
Mandatory Vaccination

Vaccination is a public health measure that is routinely performed to reduce the risk of contracting a particular infectious disease. Taking advantage of the body’s immune system, vaccination can confer immunity against disease-causing pathogens. Though vaccination generally is not able to yield absolute immunity, the procedure has nonetheless improved public health and reduced infectious disease mortality globally, saving millions of lives each year [1]. If a high enough proportion of a population obtains immunity to a particular pathogen such that the spread of the associated disease has slowed and members of the population without immunity are also protected, then herd immunity has been achieved. Consequently, there have been a number of debates about using policymaking tools to achieve this high population vaccination rate, including policies of mandatory vaccination. Here, we discuss the scientific background of vaccination, present frameworks for understanding the arguments for and against mandatory vaccination policies, and highlight data and a case study in support of these arguments within the context of the United States. We hope to better inform the policymaking community of the factors that must be weighed when considering a mandatory vaccination policy.

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.

An Overview of Ethics and Environmental Health

2019 ◽  
pp. 697-703
Author(s):  
David B. Resnik
Keyword(s):  
Public Health ◽  
Environmental Health ◽  
Environmental Ethics ◽  
Ethical Issues ◽  
Biomedical Ethics ◽  
Public Health Ethics ◽  
Social Utility ◽  
Toxic Substances ◽  
Health Ethics ◽  
Wide Range

This chapter provides an overview of the ethics of environmental health, and it introduces five chapters in the related section of The Oxford Handbook of Public Health Ethics. A wide range of ethical issues arises in managing the relationship between human health and the environment, including regulation of toxic substances, air and water pollution, waste management, agriculture, the built environment, occupational health, energy production and use, environmental justice, population control, and climate change. The values at stake in environmental health ethics include those usually mentioned in ethical debates in biomedicine and public health, such as autonomy, social utility, and justice, as well as values that address environmental concerns, such as animal welfare, stewardship of biological resources, and sustainability. Environmental health ethics, therefore, stands at the crossroads of several disciplines, including public health ethics, environmental ethics, biomedical ethics, and business ethics.

Dilemmas of nudging in public health: an ethical analysis of a Danish pamphlet

2020 ◽  
Author(s):  
Jacob Busch ◽  
Emilie Kirstine Madsen ◽  
Antoinette Mary Fage-Butler ◽  
Marianne Kjær ◽  
Loni Ledderer
Keyword(s):  
Public Health ◽  
Ethical Issues ◽  
Screening Programme ◽  
Screening Program ◽  
Ethical Analysis ◽  
Choice Making ◽  
The Face ◽  
Information Materials ◽  
The Individual ◽  
To Receive

Summary Nudging has been discussed in the context of public health, and ethical issues raised by nudging in public health contexts have been highlighted. In this article, we first identify types of nudging approaches and techniques that have been used in screening programmes, and ethical issues that have been associated with nudging: paternalism, limited autonomy and manipulation. We then identify nudging techniques used in a pamphlet developed for the Danish National Screening Program for Colorectal Cancer. These include framing, default nudge, use of hassle bias, authority nudge and priming. The pamphlet and the very offering of a screening programme can in themselves be considered nudges. Whether nudging strategies are ethically problematic depend on whether they are categorized as educative- or non-educative nudges. Educative nudges seek to affect people’s choice making by engaging their reflective capabilities. Non-educative nudges work by circumventing people’s reflective capabilities. Information materials are, on the face of it, meant to engage citizens’ reflective capacities. Recipients are likely to receive information materials with this expectation, and thus not expect to be affected in other ways. Non-educative nudges may therefore be particularly problematic in the context of information on screening, also as participating in screening does not always benefit the individual.

scholarly journals Would Parents Get Their Children Vaccinated Against SARS-CoV-2? Rate and Predictors of Vaccine Hesitancy According to a Survey over 5000 Families from Bologna, Italy

Vaccines ◽  
2021 ◽  
Vol 9 (4) ◽  
pp. 366
Author(s):  
Marco Montalti ◽  
Flavia Rallo ◽  
Federica Guaraldi ◽  
Lapo Bartoli ◽  
Giulia Po ◽  
...  
Keyword(s):  
Online Survey ◽  
Vaccination Campaign ◽  
Herd Immunity ◽  
Vaccine Hesitancy ◽  
Web Based ◽  
Safe School ◽  
Efficacy Trials ◽  
Adolescent Vaccination ◽  
Web Social ◽  
Mandatory Vaccination

In the near future, COVID-19 vaccine efficacy trials in larger cohorts may offer the possibility to implement child and adolescent vaccination. The opening of the vaccination for these strata may play a key role in order to limit virus circulation, infection spreading towards the most vulnerable subjects, and plan safe school reopening. Vaccine hesitancy (VH) could limit the ability to reach the coverage threshold required to ensure herd immunity. The aim of this study was to investigate the prevalence and determinants of VH among parents/guardians toward a potentially available COVID-19 vaccination for children and adolescents. An online survey was performed in parents/guardians of children aged <18 years old, living in Bologna. Overall, 5054 questionnaires were collected. A vast majority (60.4%) of the parents/guardians were inclined to vaccinate, while 29.6% were still considering the opportunity, and 9.9% were hesitant. Highest vaccine hesitancy rates were detected in female parents/guardians of children aged 6–10 years, ≤29 years old, with low educational level, relying on information found in the web/social media, and disliking mandatory vaccination policies. Although preliminary, these data could help in designing target strategies to implement adherence to a vaccination campaign, with special regard to web-based information.

Mandatory vaccination against COVID-19 would be supported by less than fifty per cent: A Twitter poll analysis on public health opinion. (Preprint)

2021 ◽  
Author(s):  
Valentin Ritschl ◽  
Fabian Eibensteiner ◽  
Erika Mosor ◽  
Maisa Omara ◽  
Lisa Sperl ◽  
...  
Keyword(s):  
Public Health ◽  
Social Media ◽  
Vaccination Coverage ◽  
Digital Health ◽  
Developed Countries ◽  
Vaccination Rate ◽  
World Health ◽  
Vaccination Coverage Rate ◽  
Twitter Users ◽  
Mandatory Vaccination

BACKGROUND On January 30, 2020, the World Health Organization (WHO) Emergency Committee declared the rapid worldwide spread of Coronavirus Disease 2019 (COVID-19) a global health emergency. By December 2020, the safety and efficacy of the first COVID-19 vaccines had been demonstrated. However, global vaccination coverage rates have remained below expectations. Mandatory vaccination is now being controversially discussed and has been enacted in some developed countries, while the vaccination rate is very low in many developing countries. We used the Twitter survey system as a viable method to quickly and comprehensively gather international public health insights on mandatory vaccination against COVID-19. OBJECTIVE The purpose of this study was to understand better the public's perception of mandatory COVID-19 vaccination in real-time utilizing Twitter polls. METHODS Two Twitter polls were developed to seek the public's opinion on the possibility of mandatory vaccination. The polls were pinned to the Digital Health and Patient Safety Platform's Twitter timeline for one week in mid-November 2021, three days after the official public announcement of mandatory COVID-19 vaccination in Austria. Twitter users were asked to participate and retweet the polls to reach the largest possible audience. RESULTS Our Twitter polls revealed two extremes on the topic of mandatory vaccination against COVID-19. Almost half of the respondents (49% [1,246/2,545]) favour mandatory vaccination, at least in certain areas. This attitude is in contrast to the 45.7% (1,162/2,545) who categorically reject mandatory vaccination. 26.3% (621/2,365) of participating Twitter users said they would never get vaccinated, which is reflected by the current vaccination coverage rate. Concatenating interpretation of these two polls needs to be done cautiously as participating populations might greatly differ. CONCLUSIONS Mandatory vaccination against COVID-19 (in at least certain areas) is favoured by less than 50%, whereas it is vehemently opposed by almost half of the surveyed Twitter users. Since (social) media strongly influences public perceptions and views through and social media discussions and surveys specifically susceptible to the "echo chamber effect", the results can be seen as a momentary snapshot. Therefore, the results of this study need to be complemented by long-term surveys to maintain their validity.

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.

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