Are Covid vaccine mandates ethical? Here’s what medical experts think

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  • In Austria, which has the second lowest COVID vaccination rate in Western Europe, vaccination against the virus has become mandatory from 1 February.
  • Austria is the first country in Europe to introduce a vaccine mandate for its entire population, but it is not the first country in the world to do so.

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As the latest wave of Covid-19 sweeps across Europe, governments in the region are tightening restrictions once again, some especially cracking down on their unvaccinated populations.

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In Austria, which has the second lowest COVID vaccination rate in Western Europe, vaccination against the virus has become mandatory from 1 February. Austria is the first country in Europe to introduce a vaccine mandate for its entire population, but it is not the first country in the world to do so.

Last February, Indonesia Kovid-19 vaccination made mandatory for its citizens. Turkmenistan, Saudi Arabia and the small island states of Micronesia have all introduced similar measures.

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Germany could be the next country to follow suit, with several German lawmakers Openly calling for compulsory vaccination to be introduced and a writing an op-ed About how such a mandate would “prevent 13 million adults from bringing an industrialized nation like Germany to the brink of desperation.”

moral justification

Julian Savulescu, director of Oxford University’s Uhiro Center for Practical Ethics, said the main premise of implementing coercive measures during the pandemic was to protect other people from harm.

“You are not entitled to shoot a gun in the air to harm other people and similarly, you cannot shoot a Kovid that can kill other people in a crowd,” he said in a phone call.

But according to Savulescu, four ethical conditions must be met to justify coercive policies such as the vaccine or mask mandate.

“First, the problem has to be significant, so you have to have a serious emergency or a real risk of harming people. Second, you have to have a safe and effective intervention,” he told CNBC. “Third, [the outcome] Less freedom should be better than more restrictive measures. And finally, the level of coercion should be proportional to the level of risk and the safety and effectiveness of the intervention.”

Savulescu said in his opinion, making COVID vaccines mandatory for the entire population does not meet those requirements. Because vaccinations are not 100% effective in reducing transmission, he said they do not provide the additional level of protection to others that warrants such an extreme level of coercion.

“But there is another way in which you can justify coercion, which is less common, and that is when you have a health system that will not stop people from getting sick, it will collapse.” “Then you can use coercion to prevent people from getting sick, not just to prevent them from infecting other people, but to prevent them from using that limited health resource in an emergency.”

This could be used to justify making Covid vaccines mandatory, he said, but only when the policy was applied to people who contracted the virus, requiring hospitalization or intensive care. .

Vivek Cherian, a physician at Amita Health, agreed that to be ethically justified, the overall benefit of a vaccine mandate needs to outweigh the risks involved.

“The ethical dilemma, especially in the United States, is the inherent conflict between the autonomy and freedom of an individual and the value of public health,” he said. “Given that if more people are vaccinated [it would] The cause of fewer deaths, is the moral justification of the overall good.”

But in the US, Cherian said, “there was almost zero chance that we were going to see a universally needed vaccine mandate.”

“That’s because we don’t currently have any vaccines for it,” he said. “What we will most likely see are some communities requiring them, such as federal workers, the military, or individual businesses. States will eventually mandate COVID vaccine requirements for attending public schools, in addition to many of the other vaccines that currently exist. are necessary.”

While countries introducing nationwide vaccine mandates are in the minority, several countries, including the UK, US and France, have made COVID vaccination mandatory for healthcare workers.

UK Health Minister Sajid Javid has clearly said Denied to expand vaccine mandate for the wider population of the country.

Al Dovey, professor of medical ethics and law at the University of Glasgow, said compulsory vaccination was not inherently controversial “based on the context”, given that doctors in the UK already expected to be vaccinated against common communicable diseases. Is.

“Coercion is morally justified when the risk to public health is sufficiently great,” he said in an email. “Health care is a risky event, and there should always be residual risk. The question is what level of risk is considered acceptable.”

coercion vs. encouragement

While some governments have opted for aggressive mandates, others have instead attempted to promote vaccination by incentivizing individuals to receive vaccinations.

For example, Ohio’s “wax-a-million” lottery scheme, which entered into a $1 million prize after people received their shot, was hailed as a “great success” by Governor Mike Devine. New York and Maryland later started your own lottery program to promote the vaccine, but one discovery Doctors at Boston University School of Medicine later found no evidence that Ohio’s lottery incentive had accelerated.

Alternative research has found that financial incentives can be useful in encouraging vaccination. a Swedish study published last month found that the amount of vaccination increased by 4% when people paid the equivalent of $24. Researchers told CNBC that it was “a little extra motivation to get the vaccine,” however, rather than a tool to change the minds of ardent skeptics.

During the pandemic, many governments, including America, Japan and Hong Kong, has given checks worth between $930 and $1,280 to millions of citizens in an effort to keep their economies afloat. Savulescu said he suspected that offering people a one-time payment with a similar price would increase vaccination rates and protect economies by preventing further lockdowns.

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“How effective these interventions are deemed to be, and will likely depend on, the culture, the level of incentive or coercion, the ability to implement it, and so on,” he said. “I think in general, it’s better to start with encouragement than with direct coercion.”

Cherian said that offering incentives to promote vaccination was not at its core an unethical strategy, but he was skeptical about the efficacy of both coercion and incentive tactics.

“Those who are in support of public health will be willing to receive the vaccine, regardless of the outcome or incentive,” he told CNBC. “Those who are on the fence may be encouraged. However, for individuals who are highly opposed to vaccination for whatever reason, coercive policies can actually have the opposite effect, and leave those individuals vulnerable to vaccines. can make the unbeliever more unbeliever.

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