Who wants COVID-19 vaccination to be compulsory? The impact of party cues, left-right ideology, and populism

Vaccine hesitancy is one of the major obstacles for successfully combating the ongoing COVID-19 pandemic. To achieve a sufficiently high vaccination rate, calls for compulsory vaccinations have been discussed controversially. This study analyses what drives citizens’ attitudes towards compulsory vaccination during the COVID-19 pandemic. Specifically, we are interested in the impact of party- and expert cues on public attitudes. We further expect populist attitudes to be an important indicator of the rejection of compulsory vaccination due to their scepticism towards science. To test these expectations, we rely on a cueing experiment conducted on a sample of 2265 German citizens. We test for the effects of in-party and out-party cues as well as public health expert cues. We find evidence for in-party cues, meaning that respondents adjust their position on this issue in the direction of their most preferred party. Similar results can be found for public health expert cues. However, there is no evidence for out-party cues. Further analyses reveal that support for compulsory vaccinations is not affected by left-right placement directly. Instead, only the combination of right-wing attitudes and populism negatively affects support for compulsory vaccination.

A CULTURE OF SELFISHNESS AS A FACTOR IN THE CONTINUATION OF THE PANDEMIC

The pandemic, which lasts for two years, has significantly changed all aspects of people's social life due to restrictions on the usual forms of behavior of people in everyday life, public places, and at work. A person is put in a situation of choice: either continue to interact with relatives, friends, colleagues at work on the basis of stereotypes of behavior, but in a pandemic that poses a threat of unintentional infection with coronavirus, or strictly observe the rules of partial or complete isolation. The practice of organizing the behavior prescribed by the sanitary service of large groups of people has shown that a significant part of the population resists the requirements to wear personal protective equipment, to vaccinate with promptly created vaccines against coronavirus. Authorities are forced to impose increasingly stringent measures on violators of doctors' instructions. In the article, the clash of individual and public interests in a pandemic situation is analyzed from the point of view of a theory that reveals the essence and content of a culture of selfishness. It is a system created by people throughout the history of social development to increase the natural selfishness given to all living organisms, including humans. Some social groups, through cunning, lying, psychological and physical coercion, provide personal benefits, while others use these behaviors to preserve themselves, their families. The negative attitude of people to regulations that destroy traditional social ties, compulsory vaccination is considered as a manifestation of individual and group selfishness, formed on the basis of affirming the priority of personal freedom, their own ideas about how to protect the body from various diseases. In the actions of the part of the medical community that is trying not by the method of explanation, persuasion to develop a vaccination kit in people, but to force with the help of severe restrictions to force it, corporate selfishness is being implemented. Those who are guided by it attribute their possession of true knowledge to themselves, rejecting other options for combating the pandemic. The article states that acting on the basis of values and norms of a culture of cooperation, it is possible to achieve the desired success in suppressing coronavirus infection. The conditions for the transition of social subjects from the implementation of the rules of a culture of egoism to the adoption of values and norms of a culture of cooperation are revealed.

Covid-19 Vaccines and Institutional Trust

Major public and private laboratories entered into a race to find an effective Covid-19 vaccine. With the arrival of the vaccines, governments have to implement vaccination programs to achieve the necessary immunization levels to prevent further transmission of the disease. In this context, the ethical dilemma of compulsory vaccination vs. voluntary vaccination has been raised. Underlying this dilemma lies the problem of the ethical models on which the political decisions of governments in health matters based. The chapter proposes and argues the need to base health policy decisions on an ethical “first person” model, based on personal responsibility, that allows us to move from a normative ethic to an ethic of responsible behavior. This change in the ethical model, together with certain proposals for political action, will help us to restore institutional trust, so that the necessary levels of collective immunity against Covid-19 can be achieved through the voluntary vaccination of the citizens.

Compulsory vaccination: Public benefit or individual’s right limitation

Mass vaccination and its controversial assessments have become key issues under the covid-19 pandemic. Outbreaks of diseases and popularity of anti-vaccination movements require a study of legal foundations for medical interventions and freedom restrictions which are considered as the result of serious risks to health and sanitary-epidemiological well-being of the population. The question is what should be prioritized - paternalistic powers of the state or individual rights and freedoms to decide what risks to take. In terms of responsibility distribution, people often consider vaccines as more dangerous than infectious diseases [17], which makes compulsory vaccination a legal phenomenon of particular importance. In the contemporary legislation, there are various national approaches to the individual autonomy and freedoms. In some countries, vaccination is directly linked to the possibility to study (USA), in others it is associated with public health (Australia), financial sanctions (Poland) or freedoms limitations (Pakistan). In terms of public health ethics, vaccination is similar to the use of seat-belts in cars, and compulsory vaccination policy is ethically justified by the same reasons as mandatory seat-belt laws [8]: at first, they were met with great opposition; later the use of seat belts acquired the significance of not only a legal but also a social norm precisely because it was made mandatory [1]. The similar approach is applicable to vaccination: the policy of compulsory vaccination can make it a social norm. However, in the legal perspective, compulsory vaccination is a compulsory medical intervention which raises the question about whether it is possible to limit individual rights and freedoms in the name of public health safety. The article considers contradictory issues in the state policy of compulsory vaccination and its legal support. The author presents a definition of compulsory vaccination, identifies its types, describes the specifics of its national legal regulation and sanctions for the refusal to be vaccinated, and explains its social necessity and expediency as a public good.

Acceptance of COVID-19 Vaccination among Healthcare and Non-Healthcare Workers of Hospitals and Outpatient Clinics in the Northern Region of Slovakia

The purpose of this study was to analyse attitudes, motivation, and reasons for hesitancy toward COVID-19 vaccination among healthcare workers (HCWs) in northern Slovakia. A cross-sectional study was conducted between 30 August 2021 and 30 September 2021. An anonymous questionnaire was administered. The study was completed by 1277 employees. Multivariate logistic regression was used to identify predictors of COVID-19 vaccination status. A total of 1076 (84.3%) were vaccinated, and 201 (15.7%) were unvaccinated. Physician job type (OR = 1.77; CI95 1.13–2.78), history of COVID-19 (OR = 0.37; CI95 0.26–0.37), influenza vaccination at any time (OR = 1.97; CI95 1.12–3.46), compulsory vaccination for HCWs (OR = 9.15; CI95 2.92–28.62), and compulsory vaccination for selected groups (OR = 9.71; CI95 2.75–34.31) were the predictors significantly associated with COVID-19 vaccination acceptance. Non-physician HCWs, employees in hospitals, and employees without a history of COVID-19 significantly more distrusted the efficacy of vaccines against COVID-19. Results of our study confirmed that physicians have higher vaccination rates and lower hesitance to get vaccinated than non-physician HCWs. HCWs play an important role in influencing vaccination decisions and can be helpful in vaccine advocacy to the general public.

Gewetensbezwaarden onder vuur

Conscientious objectors under fire. Vaccine refusal among orthodox-Protestant soldiers in the Dutch Armed Forces, 1945-1950 During the Indonesian War of Independence (1945-1949), the Dutch government deployed 220,000 soldiers in the Indonesian archipelago. Among them was a group of conservative Christian soldiers who refused vaccinations against smallpox for religious reasons. Initially this caused no problems, but the situation changed after the outbreak of a smallpox epidemic in Indonesia in 1948. The non-vaccinated soldiers could not return to the Netherlands due to international restrictions. Although compulsory vaccination was abolished in 1939, some soldiers were forced to accept vaccination. In the Netherlands, representatives of the Reformed Political Party (SGP) and the conservative churches accused the Army of illegal actions. The central question in the debate was the space for religious minorities and divergent views on vaccination in the Dutch Armed Forces. This article studies the process of negotiation between the Dutch Armed Forces and the political and ecclesiastical representatives of this conservative religious group. Finally, this article argues for more research into religious diversity in the Dutch Armed Forces.

Ethics of vaccination prioritization and compulsory vaccination: An integrative approach

Vaccine scarcity and availability distinguish two central ethics questions raised by the Covid-19 pandemic. First, in situations of scarcity, which groups of persons should receive priority? Second, in situations where safe and effective vaccines are available, what circumstances and reasons can support mandatory vaccination? Regarding the first question, normative approaches converge in prioritizing most-vulnerable groups. Though there is room for prudential judgement regarding which groups are most vulnerable, the human dignity principle is most relevant for prioritization consideration of both medical and non-medical issues. The second question concerning mandates is distinct from considerations about persons’ individual moral duty to receive vaccines judged reasonably safe and critical for individual and public health. While there is consensus regarding the potential normative support for mandated vaccination, the paternalistic government intervention of vaccine mandates requires a high bar of demonstrated vaccine safety and public health risk. We discuss stronger and weaker forms of paternalism to deal with the Covid-19 pandemic from an “integrative” approach that integrates leading normative approaches. We argue against a population-wide compulsory vaccination and support prudential measures to 1) protect vulnerable groups; 2) focus upon incentivizing vaccine participation; 3) maintain maximum-possible individual freedoms, and 4) allow schools, organizations, and enterprises to implement vaccine requirements in local contexts.

Introduzione di un obbligo vaccinale contro il Covid-19: profili di criticità

SOMMARIO: 1. L’epidemia nel Codice civile italiano - 2. “Una brutta notizia, avvolta in una proteina” - 3. Le misure di contenimento dell’epidemia da Covid-19 adottate e l’esordio di vaccini anti-Covid-19 - 4. La vaccinazione obbligatoria: precedenti storici italiani - 5. La vaccinazione obbligatoria contro il Covid-19, oggi: una mappa mondiale - 6. La vaccinazione contro il Covid-19 in Italia: obbligo, diritto od onere? 7. Il problema della compatibilità dell’obbligo vaccinale con il quadro normativo costituzionale ed europeo - 8. Conclusioni. The introduction of a compulsory vaccination in Italy: critical profiles ABSTRACT: The multiple Covid-19 vaccines developed until now are typically thought of as the only means to meet the challenges posed by the current pandemic. The Italian legal system offers a composite framework for the regulation of vaccinations against Covid-19 and more precisely provides for the burden of vaccination for many categories of people (including healthcare workers). The purpose of this paper is to verify the legitimacy of a compulsory vaccination in the light of Italian and European sources of law. In this perspective, the Author argues that a compulsory vaccination against Covid-19 could be considered not consistent with both the Italian Constitution and the European legislation. Furthermore, the Author focuses on the phenomenon of vaccine esitancy, questioning whether a policy of mandatory vaccination is the proper tool for supporting the effective implementation of vaccination strategies.