Vaccination: Hesitancy, compulsion and immunity passports

Question 1

What is meant by vaccination compulsion?

Answer 1

People must get vaccinated, cannot refuse

Question 2

What is the general ethical problem when considering public health vs individual liberty, regarding vaccination compulsion?

Answer 2

Can the state override the patient/parent’s decisions (restrict their liberties) to protect general public through herd immunity

Question 3

What is the ethical problem when considering parental autonomy over refusing child vaccinations?

Answer 3

Do parents have right to risk to harm their child if they aren’t vaccinated or can parental autonomy be overridden

Question 4

What is the ethical problem when considering possible harm done to child if parents refused their vaccinations?

Answer 4

Is failure to vaccinate child a form of abuse or neglect

Question 5

What is the ethical problem when considering consistency of parental autonomy, especially for vaccinations?

Answer 5

If healthcare professionals override parental autonomy about vaccinations should they also override parental autonomy for their children’s education, food, religion

Question 6

What did John Stuart Mill, On Liberty (1859) suggest about vaccination compulsion?

Answer 6

‘…the only purpose for which power can be rightfully exercised over any member of a civilised community, against his will, is to prevent harm to others.’

Suggests that vaccination compulsion can be used for herd immunity/to prevent harm

Question 7

What is the advantage of vaccination compulsion, from a beneficence view?

Answer 7

Vaccination is good for individual as it can protect against disease

Question 8

What is the advantage of vaccination compulsion, from a utilitarian view?

Answer 8

Produces herd immunity which overall leads to less suffering in population

Question 9

What is the advantage of vaccination compulsion, from a non-maleficence view?

Answer 9

Unvaccinated people are more at risk of harm

Question 10

What is the advantage of vaccination compulsion, from a justice view?

Answer 10

Compromising herd immunity by refusing to be vaccinated/have own children vaccinated isn’t fair to other people

Question 11

What is the disadvantage of vaccination compulsion, from a autonomy view?

Answer 11

People should have right to choose if they/their children receive vaccinations

Question 12

What is the disadvantage of vaccination compulsion, from a non-maleficence view?

Answer 12

Side effects of vaccination can lead to harm

Question 13

How could vaccine compulsion cause anti-vaccine activists to respond?

Answer 13

Anti-vaccine activists can be forceful and sometimes violent

Question 14

Define vaccination hesitancy?

Answer 14

Delay in acceptance or refusal of vaccines despite availability of vaccination services

Question 15

What could parents consider when deciding whether or not to vaccinate their child, in terms of the harms and benefits of the vaccine to the child?

Answer 15

Will vaccination harm or benefit their child more

Question 16

Do all vaccinations have some risk, however rare?

Answer 16

Yes

Question 17

What could parents consider when deciding whether or not to vaccinate their child, in terms of safety?

Answer 17

Are healthcare professionals certain that vaccination is safe and won’t cause harm

Question 18

When parents question the safety of a vaccine, how should healthcare professionals respond?

Answer 18

Be reasonable and focus on how risks are rare, so overall benefits for community and child outweighs risks

eg. ‘Your child is more likely to die of measles than to be harmed by the MMR vaccine’

Question 19

Why do parents think that possible risks of harm from receiving vaccine are worse then from not receiving vaccine?

Answer 19

Parents view causing harm by a positive act (child getting vaccine) differently than risking harm by omission (child not getting vaccine)

Question 20

According to Clements and Ratzan 2003, why must healthcare professionals know fully the scientific facts and the societal issues surrounding vaccine safety?

Answer 20

They will largely interact with and influence parents’ decision making

Question 21

What could parents consider when deciding whether or not to vaccinate their child, in terms of trusting the healthcare profession and their goal to protect community?

Answer 21

Can parent trust that healthcare is not getting money or other incentives in exchange for vaccinating their child

Question 22

What did Rosamund Rhodes state about the importance of earning patient/parent trust?

Answer 22

Trust is a necessary condition for medical practice so should ‘seek trust and deserve it’

Question 23

What could parents consider when deciding whether or not to vaccinate their child, in terms of the relevance of their child to herd immunity?

Answer 23

Why should parent have to put their child at risk in order to produce herd immunity

Question 24

What did John Locke, Second Treatise of Civil Government (1690) suggest about parental autonomy over child vaccinations?

Answer 24

Identified children as God’s workmanship and did not believe parents have absolute authority over their offspring

Isn’t implied that parents have complete choice whether their children are vaccinated

Question 25

What did Immanuel Kant, Groundwork for a Metaphysics of Morals, suggest about parental autonomy over child vaccinations?

Answer 25

“I ought never to act except in such a way that I can also will that my maxim should become a universal law.”

So if you do an action, then everyone else should also be able to do it

Therefore if parents get vaccinations themselves they shouldn’t refuse to let children get vaccinations

Question 26

What is an Immunity/vaccine passport?

Answer 26

Certificate attesting that its bearer has a degree of immunity to a contagious disease, permitting access to venues and transport eg.

Question 27

Does everyone have an immunity/vaccine passport, and what give 3 results of this?

Answer 27

No, as not everyone can be vaccinated

could lead to alienation from services and professions, discrimination against groups without vaccinations, feeling forced to get vaccine