As coronavirus continues to claim lives in the world, three vaccines offer new hope. Over 90% effective against the virus, they could provide the herd-immunity needed for a return to normalcy. News outlets have hailed the vaccines as a “silver bullet”, “light at the end of the COVID-19 tunnel”, and “the beginning of the end of the pandemic”. Yet rising vaccine-hesitancy - “the reluctance or refusal to vaccinate despite the availability of vaccines” - implies that this is increasingly unlikely to be the case.
Studies conducted by King’s College London and Ipsos MORI relay that 53% of Britons would “definitely get vaccinated” while ⅙ state that “they are unlikely or definitely won’t get a vaccine if one becomes available”. The World Health Organization believes an “infodemic” of misinformation is to blame. As citizens opt for stories, tweets, and TikTok videos in lieu of traditional news media, they overlook facts for fake news. A worrying number ascribe to the notion of a “Plandemic” - that COVID-19 is not real and a vaccine for it is designed to kill. Many insist that Bill Gates and Big Pharma are conspiring to microchip the masses in pursuit of a global health dictatorship. Others worry that the speed of vaccine development may have come at the cost of its safety.
As anti-vaccine and anti-government sentiment runs higher, a voluntary immunisation programme may fall short of the 80-90% public participation needed to offer sufficient protection against the virus. In view of this, physicians and policy-makers alike ponder whether the continued public health threat of COVID-19 could justify mandatory vaccination. Indeed, UK Health Secretary, Matt Hancock, has refused to rule out compulsory immunisation in the future. While the Danish government’s new “epidemic law” now allows for state-enforced treatment and vaccine mandates, the United Kingdom’s Coronavirus Act 2020 does not.
A policy of compulsion has long been deemed unethical in its violation of individual freedom, bodily autonomy, and informed consent. However, medical ethicists argue that human rights are equally, if not further, undermined by the restrictive measures enforced in the absence of herd-immunity. Douglas et al. convey that isolation, quarantine, and lockdown constitute a “severe interference with free movement and association”. Contrastingly, vaccination entails a “moderate interference with bodily integrity”. The extent to which one is more ethically permissible than the other is a matter for debate.
Professor Julian Savulescu, Director of the Oxford Uehiro Centre for Practical Ethics, asserts that mandatory vaccination is ethical insofar as the public health benefits of vaccination outweigh its harms. Certainly, the Pfizer, Moderna and Oxford vaccines have been demonstrated to be safe and effective in preventing COVID-19. They pose a negligible risk to the population, compared to the individual, social, and economic consequences of a prolonged pandemic.
Opponents of mandatory vaccination argue that the necessary vaccine uptake can be achieved through educational programmes and public health campaigns designed to nudge citizens in the right direction. While such initiatives are vital at this time, there are fears that these efforts may be too little, too late.
If you would like to join the discussion on mandatory vaccination, the Imperial College Debating Society is holding a public debate on the topic with experts in public health and medical ethics from 6:30 - 7:30 pm on Wednesday, December 2nd 2020.
You can sign up here: https://forms.gle/bcAf8cjJrnXTK7Sj9
Submit questions in advance of the Q&A here: https://forms.gle/XserUHBiS1f6TB1e7
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