The philosophical, moral, and ethical arguments around vaccine mandates have been a point of contention since the invention of inoculation. For example, the English Smallpox vaccine mandate back in 1853 was met with widespread protest and conspiracy, with Mahatma Gandhi calling it a ‘barbaric practice’.
The announcement that several nations around the world are mandating the COVID-19 vaccine for (mainly) health and social care workers, therefore, have thrust this debate back into the spotlight.
Countries including France, Britain, Poland, and Greece have implemented legislation that penalises health and social care workers who refuse to take the vaccine. This includes those that are not medically trained, such as cleaners and porters. Italy has gone one step further by mandating vaccination of all employees regardless of what sector they are in, and are hinting at extending this to the whole of the population.
‘We are extending the obligation of the green pass to the entire world of work, public and private’, Italy’s health minister Roberto Speranza announced, ‘and we are doing so for two essential reasons: to make these places safer and to make our vaccination campaign even stronger’.
Punishment for non-compliance ranges by country. Whilst some nations have imposed fines, others have suspended employees without pay or even asked for resignations. For example, France suspended almost 3,000 vaccine sceptic healthcare employees last week following the 15th September deadline.
Do no harm
Mass vaccination is required to reap the benefits of herd immunity. This makes mandatory vaccination a viable avenue to ensure whole populations receive a vaccine and public health is protected. Examples of mandates in the name of public health and safety abound, including drink driving and indoor smoking bans. They are implemented with the aim of overriding sub-optimal individual decision-making.
In terms of healthcare workers, mandating vaccination is rooted in the Hippocratic oath. This is the expectation to do no harm to their patients. Refusing the vaccine may facilitate the spread of the virus to vulnerable or elderly patients and, therefore, may harm patients. It is this sense of duty that leaders appear to be appealing to when implementing this legislation.
‘I am aware of what I am asking of you’ Emmanuel Macron said when introducing the legislation, ‘and I know that you are ready for this commitment. This is, in a way, of your sense of duty’.
Individual rights vs public health
On the other hand, mandating vaccination has been accused of being intrusive legislation that impedes individual human rights. This is because public health ethics principles deem vaccine mandates in adults to be a last resort. Similarly, both the Universal Declaration of Human Rights and the European Convention of Human Rights uphold the right to private life, something that vaccine mandates interfere with. Penalising healthcare workers for denying the vaccine, therefore, may be unethical and coercive.
However, recent court proceedings and rulings suggest that this may not be enough to outweigh the protection it provides to wider society. For example, the European Court of Human Rights ruled in favour of mandatory vaccines for children in the Czech Republic. Interestingly, the court acknowledged that it interferes with individual and private rights but ultimately concluded this interference is justified by the benefit to society and public health. This may set a precedent for the COVID-19 vaccine.
Is it effective?
One important factor to consider is whether vaccine mandates for health and social care workers are effective in increasing vaccination levels, or whether they cause labour shortages in an already under pressure sector.
The evidence so far suggests that it is highly effective. Following Emmanual Macron’s announcement, for example, the website for vaccination bookings in France crashed because of the number of people trying to access it. France went from being one of the most vaccine sceptic countries in the world, with just 40 per cent of the nation stating they would take the vaccine, to being a world leader in vaccine uptake at over 90 per cent. Although a range of factors may have been involved in this, mandating vaccination of health and social care workers was certainly a contributing factor. Similarly, pre-COVID Italy was renowned for being a highly vaccine-hesitant country but now has vaccinated over two-thirds of its population.
However, just because these policies appear to be efficacious and widespread does not mean they are not in violation of human rights. Only time, and future court cases, will tell whether these policies are both effective and ethical.
About the Author: Jessica Culnane
Jessica Culnane is a contributing Features Writer with in-depth knowledge of policy, politics, and economics. She’s interested in technological advancements, business developments, data, and culture.
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