Balancing of Fundamental Rights by the Employer? Employer’s Margin of Manoeuvre to Order Mandatory Vaccination and to Terminate or Suspend the Labor Contract of Non-Vaccinated Employees

Call for Mandatory Flu Vaccination Grows

Vaccine Hesitancy Narratives

Mandatory COVID-19 vaccination for healthcare workers: A discussion paper

Despite difficult challenges during responses to the terrorist attacks of September 11, 2001, Hurricane Katrina, and the 2009 Pandemic Influenza A/H1N1 and severe acute respiratory syndrome outbreaks, no North American emergency to date has overwhelmed intensive care unit (ICU) services on a widespread basis since the modern development of the field of critical care. However, planners have recognized that in a future public health emergency we may not be so fortunate. To deal with very large emergencies involving many patients whose survival depends on immediate access to intensive care, an international Task Force for Mass Critical Care proposed recommendations in January 2007 to extend critical care resources for the adult population, referred to as the Emergency Mass Critical Care (EMCC) approach (1–5). The EMCC approach triples critical care capabilities for a period of up to 10 days in a very large public health emergency by focusing on immediately life-saving interventions, while delaying or forgoing less urgent care. Crisis standards of care in a large public health emergency would attempt to optimize population outcomes, rather than use unlimited efforts to maximize survival of each individual. Available resources would be substituted or adapted for equivalent or nearly equivalent unavailable resources. Resources would be conserved, reused, and reallocated to those patients most likely to benefit from them. Modest increases in stockpiles and major changes in the organization of care would be essential. While planners in the field acknowledge that mass critical care is a reasonable concept, we lack evidence that such an approach is feasible. However, failure to begin operational planning for mass critical care guarantees a failed response. As public health emergency planners begin to consider the EMCC framework, it is urgent that pediatric implications be detailed for integration into these developing plans. This supplement represents the discussions of a multidisciplinary panel convened by the Oak Ridge Institute for Science and Education (supported financially by the Centers for Disease Control and Prevention), and provides guidance for pediatric EMCC (PEMCC). Work of the PEMCC Task Force was directed by a 17-member Steering Committee selected on the basis of their expertise and experience, and included representatives from the Task Force for Mass Critical Care, World Federation of Pediatric Intensive and Critical Care Societies, American Academy of Pediatrics, American College of Critical Care Medicine, American College of Emergency Medicine, Royal College of Physicians (Canada), and National Commission on Children and Disasters, as well as several unaffiliated disaster preparedness experts. This Steering Committee led development of all manuscripts and selected individuals for the PEMCC Task Force. The full PEMCC Task Force comprised 44 experts from fields including bioethics, pediatric critical care, pediatric trauma and surgery, neonatology, obstetrics, general pediatrics, emergency medicine, pediatric emergency medicine, disaster preparedness and response, emergency medical services (EMS), infectious diseases, toxicology, military medicine, nursing (including critical care nursing), pharmacy, veterinary medicine, information sciences, public health law, maternal and child public health, and local, state, and federal government emergency planning and response agencies. Priority topics were organized on the basis of MEDLINE and Ovid database literature searches, bibliographies, state and federal government planning documents, after-action reports of recent medical responses to catastrophes, and through participation in local, state, and federal government working groups on hospital and disaster preparedness. Where evidence was available, it was utilized in formulating recommendations. Where evidence was lacking, recommendations represent expert opinion. Wherever possible, recommendations are consistent with and easily integrated into prior recommendations of the adult Task Force for Mass Critical Care. The Steering Committee produced draft outlines by synthesizing information obtained in the evidence-gathering process and convened October 6–7, 2009, to review and revise each outline. Eight draft manuscripts were subsequently developed from the revised outlines. The full PEMCC Task Force convened March 29–30, 2010, to present and discuss the draft manuscripts. Feedback on each manuscript was compiled and the Steering Committee modified the draft documents to reflect this input, in addition to updating the manuscripts based on the most current medical literature. The Steering Committee revised the manuscripts from March to October, 2010, working primarily via email and conference calls. New versions were electronically transmitted to all Task Force members to obtain concurrence with manuscript revisions. All authors and reviewers completed disclosure statements; there were no conflicts of interest. The authors were given complete autonomy by the Oak Ridge Institute for Science. The views expressed in these summaries are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention. Based on the recognition of the special needs of children during disasters and extensive discussion, the following recommendations are made by the PEMCC Task Force. These recommendations are described in detail in nine subsequent articles. Readers should refer to individual articles for all recommendations rather than those highlighted in this executive summary. Treatment and Triage Recommendations for PEMCC (p. S109) PEMCC in Pediatric Hospitals. These recommendations provide the basis for hospitals to prepare for PEMCC: Every hospital with a pediatric ICU or neonatal ICU should plan and prepare to provide PEMCC, and should do so in coordination with regional health planning efforts. Hospitals with ICUs should plan and prepare to provide PEMCC every day of the response for a total critically ill patient census at least double the pediatric ICU bed capacity and at least triple usual ICU capability. Hospitals should prepare to deliver PEMCC for 10 days without sufficient external assistance. Care should be coordinated with the emergency department for triage and transfer of patients to/from ICUs. All communities should develop a graded response plan for events across the spectrum from multiple casualties to catastrophic critical care events. To optimize medication availability and safe administration, the Task Force suggests that modified processes of care should be considered before an event, such as the following: rules for medication substitutions and restrictions; safe dose and frequency reduction; conversions from parenteral to oral/enteral administration; shelf-life extension; and use of length-based weight estimations. PEMCC for pediatric patients ideally should occur in hospitals or similarly designed and equipped structures with experience in providing critical care to pediatric patients. Principles for staffing models should include the following: strategies to achieve and maintain adequate staffing levels; patient care assignments for the unit should be managed by the most experienced clinician available; and assignments should be based on staff abilities and experience, with delegation of some duties and efforts to reduce care variability and complications. PEMCC in Nonpediatric Hospitals All hospitals must plan to care for children in their proportion to the population or for those affected by the mass casualty event. To facilitate such planning, nonpediatric hospitals should include a pediatrician or pediatric medical liaison in those committees responsible for disaster planning, appeals, and determining when crisis standards of care should be implemented. During a disaster, it may be more efficient to transfer skilled pediatric critical care teams to nonpediatric centers to support those facilities in providing care to critically ill pediatric patients. Nonpediatric hospitals may not have the pediatric equipment needed to sustain critically ill patients; therefore, these teams may need to take their own equipment. Establish referral network for pediatrics consultation or transfers to support hospitals that do not normally receive pediatric patients. Nonpediatric hospitals should preidentify hospital staff with experience in care of pediatric patients and create key positions in which these individuals would serve. The Task Force was unable to recommend a protocol for allocating scarce pediatric critical care resources (tertiary triage) during PEMCC. However, they suggest that: Resources should be allocated on the basis of need, benefit, the conservation of resources, and finally lottery or queuing. Younger children should not be discriminated against based on age alone. While a validated pediatric scoring system is being developed, tertiary triage should be based on expert opinion and conducted by triage teams, including experienced trauma surgeons and/or intensivists, using their best medical judgment as is the current standard of practice. The Task Force recommends that the American Academy of Pediatrics and the Institute of Medicine, bodies with subject-matter expertise and necessary positioning, develop a set of research priorities for disaster pediatric medicine such that the evidence base can be established to facilitate the development of necessary tools (i.e., decision matrices). Supplies and Equipment for PEMCC (p. S120) This chapter focuses on strategies and paradigms for purchasing and stockpiling equipment that will be necessary in PEMCC. This includes specific equipment (not including personal protective equipment, which is beyond the scope of this chapter) and supply lists necessary to triple pediatric ICU capacity for up to 10 days for a scenario in which the surge includes patients across all ages, and another scenario in which most patients are from a single age group. Recommendations include the deployment of mechanical ventilators including specifications (see p. 128 for further details), ventilation ancillary equipment (including equipment that could be disinfected or sterilized between patient uses in a pandemic situation), other options for assisted ventilation and nonconventional ventilation, suggestions for a ventilator inventory, equipment for hemodynamic management, and supplies for sedation, analgesic, antimicrobials, and nutrition. Additional equipment and supply recommendations necessary for various types of pediatric hospitals to prepare for disasters have been provided by the New York City Department of Health and Mental Hygiene's Pediatric Hospital Disaster Toolkit (http://www.nyc.gov/html/doh/html/bhpp/bhpp-focus-ped-toolkit.shtml); the toolkit has been positively viewed and is an additional resource that should be considered. Neonatal and Pediatric Regionalized Systems in PEMCC (p. S128) This chapter outlines the present system of care in the United States and Canada, and the systems likely to be available for providing mass critical care. Topics discussed in this manuscript include: gaps between anticipated needs and existing resources, changes in functioning of regional systems necessary for PEMCC, protocols for patient transfer, agreements with healthcare institutions that primarily provide adult care, just-in-time training of healthcare workers, transport systems for patients, and allocating staff to other healthcare facilities. Recommendations are provided for operational planning integrated across jurisdictions necessary to implement PEMCC. All preparations for mass critical care for the general population must include pediatric aspects. For this to occur, pediatric experts must be involved in all aspects of emergency and disaster planning. States and Regions. States and regions should: Facilitate PEMCC by providing legal protections for those involved in PEMCC. Reaffirm ethical norms in PEMCC. Ensure that all hospitals are prepared to provide care for children in a mass casualty scenario, including a level or scope of care beyond what they might ordinarily provide during normal operating conditions. Plan to share scarce resources with neighboring states and ensure effective public-private collaboration to meet the needs of a pediatric patient surge and optimize pediatric critical care capacity in a mass casualty event. Develop pediatric-specific performance criteria to hold regional systems accountable for PEMCC preparations and responses. Perform vulnerability analyses to estimate anticipated pediatric mass critical care needs, including especially vulnerable populations. Inventories of functional resources (space, equipment, supplies, and staff) for mass critical care must be performed at every hospital with an ICU. State information systems must be developed to track critical care needs and resources in real time during public health emergencies. Integrate operational plans for mass critical care and triage allocation (rationing) across all jurisdictional levels and all response agencies, and integrated with all aspects of emergency preparedness planning. Define regional mechanisms to direct the distribution of patients and resources in a public health emergency. Federal. Action at the federal level should include: Plans for federal involvement are consistent with state plans for mass critical care and triage allocation (rationing). Federal expertise and guidance to promote consistency in informing state laws and regulations regarding mass critical care and triage allocation (rationing) in public health emergencies. Federal incentives, specific readiness requirements, readiness, and performance measures germane to pediatric care capabilities and capacity to ensure that all states prepare sufficiently for mass critical care and triage allocation (rationing). Federal support for research on best practices ahead of time, as well as real-time surveillance, epidemiologic research, and clinical trials during a public health emergency, which will result in better evidence-based practices at the level of regional systems of care, and better clinical care. Education in a PEMCC setting (p. S135) Prospective and just-in-time training modules for pediatric critical care providers and the public are discussed within this article. Recommended topics for skilled clinicians, particularly those who do not typically treat pediatric patients, include: training in pediatric triage, administration of EMCC coordination and planning, and training in use of nonstandard equipment. As part of comprehensive emergency preparation, educational needs should be identified and addressed. Practitioners should work to maintain their basic pediatric care levels pertinent to their job, and contemplate whether additional training might benefit them in preparation for potential mass critical care events. If they are likely to be involved in a PEMCC response, they should seek out additional proactive training. Hospitals should: identify team leaders and pediatric care providers and encourage them to receive additional training and stay current in the management of critically ill children; identify just-in-time resources that could be used in times of need, and contemplate how they could best implement those resources, particularly if infrastructure, such as internet access, is compromised; and, if they do not have pediatric critical care capabilities, establish a relationship with a regional children's hospital to look for potential educational and training collaboration and offer these courses to their hospital staff. Regional pediatric critical care centers should: maintain an active educational role in both self-education in management of critically ill children and in regional education in their usual referral network; identify potential local hospitals that could help with surge capacity and ensure that those hospitals are receiving necessary training to manage potential surge patients; and work to develop just-in-time resources for remote assistance in training, such as telemedicine or telephone consultation. State/federal/professional societies should fund and develop additional training courses for pediatric mass critical care, both proactive courses and for development, evaluation, and distribution of just-in-time training modules. PEMCC: The role of community preparedness in conserving critical care resources (p. S141) This section of the supplement addresses the role of the wider community in preparing for disasters and PEMCC. Community preparedness reduces extraneous use of hospital resources and conserves scarce critical care resources by delivering population-based care in the community by utilizing the following: citizens, hotlines/healthlines, EMS/9-1-1, alternate care facilities, pediatric-specific agencies and organizations (i.e., schools, daycares, after-school programs), and integration with a health emergency operations center linked to community incident command systems. The Task Force recommends the following actions by pediatric leadership (those who represent, care for, and advocate for children): Actively promote programs to ensure, before and during a crisis, an informed citizenry and the education of children and families in the Centers for Disease Control and Prevention guidelines on community mitigation strategies. Advocate for a community level of preparedness that leads to empowered self-awareness, knowledge of the information that best prepares the public to provide basic lifesaving information and self-care, and builds physical and mental health resilience. Advocate for the establishment of permanent national- and state-level call systems and disease- and child-specific healthlines as crucial adjuncts during public health emergencies. Advocate for 9-1-1 telephone triage with pre-established criteria and protocols for the proper use and safety of EMS and EMS-sanctioned transportation during pandemics. Work with community planners to identify the logistic support necessary for establishing and operating alternate care facilities, and identify and create protocol-driven, patient management objectives based on assumptions about the types of patients that would be managed in such facilities. Advocate for creative operational concepts that provide guidance and protocols sensitive to the needs of the pediatric population. Legal Considerations during PEMCC events (p. S152) Liability is a significant concern for healthcare practitioners and facilities during PEMCC. While many of the legal issues associated with providing PEMCC are not unique within the context of disaster health care, the scope of parens patriae power of state, principles of informed consent, and security should be considered in PEMCC planning and response efforts since parents and legal guardians may be unavailable to participate in decision making during disasters. This article describes the legal considerations inherent in planning for and responding to catastrophic emergencies and makes recommendations for PEMCC legal preparedness. To address gaps in existing liability protections for public health and PEMCC emergency responses, the Task Force recommends strengthening several areas of legal preparedness. As outlined in the Institute of Medicine crisis standards of care guidance (6): Necessary legal protections must be provided for healthcare practitioners and institutions that implement crisis standards of care plans. Unless comprehensive, national liability protections are implemented, state governments must link existing health practitioner and entity liability protections to crisis standards of care. Courts and other adjudicators should consider whether adherence to the Institute of Medicine guidance provides evidence of meeting the standard of care and "the legal effect of changing standards of care during emergencies" in medical malpractice claims. In addition to the Institute of Medicine recommendations, the following suggestions should be considered for PEMCC preparedness: PEMCC disaster protocols should be properly vetted and accepted; when providing pediatric mass critical care, practitioners who follow such accepted and vetted protocols in good faith should be protected from civil liability (5–7). PEMCC protocols should be included in state disaster plans. Health facilities should ensure that their pediatric disaster plans are consistent with state plans and, to the extent possible, with neighboring health facilities. Facilities that care for pediatric patients should develop specific informed consent and security protocols to incorporate into their disaster plans. Facilities that do not normally care for pediatric patients or that do not routinely provide care for critically ill pediatric patients should also consider incorporating such planning or partnering with other facilities that provide such care in the event that pediatric patients arrive at their facilities during emergencies. PEMCC: Focus on family-centered care (p. S157) Family-centered care (FCC) is especially a concern and challenge in PEMCC. This article addresses the tension between offering FCC and effective disaster treatment/triage. It offers a list of practical suggestions for incorporating FCC principles into each of the following healthcare settings during a disaster, including a PEMCC event: EMS transport, emergency departments, pediatric ICUs, general pediatric wards, and alternative sites. Disaster and PEMCC responses must incorporate FCC principles to the extent possible in a variety of healthcare settings. Family-Centered Care in EMS Care of Children. Practical suggestions have been developed for EMS professionals planning for and responding to mass casualty/pandemic events that involve children. These include encouraging families, local pediatricians, and local groups (champions) to engage in every stage of planning and preparation for disasters. FCC in Emergency Departments and ICUs in a Mass Event. Overcrowding, panic, security concerns, staff stress, and separation of families during triage make practicing FCC an imperative and demanding task. The fundamental precepts of FCC, such as attention to the as a of and of the health of the critical to the of disaster The following are some recommendations for emergency department professionals as they plan and to the needs of children and their families in a mass event: possible, EMS and emergency should a to with the child during the triage and This may providing care for parents in addition to children. The local triage and tools should for a and should a of including at least date of and should be obtained as and as possible, and if necessary to the National for and Children an by the government to with families in a mass Mental health professionals in triage and emergency of children should be available on the In the pediatric and of a liaison such as a child or nursing to and general information of to families could reduce on the and skilled medical to the acute needs of critically or patients. FCC in should include a for children with families and proper for children. The Task Force also recommends planning for FCC during PEMCC at alternative and a medical strategies to establishing of when families are and and families, including those with and in PEMCC (p. The specific is ethical issues unique to children in disasters to their and It that children should be not in proportion to existing resources, to their proportion of the general population or those affected by the event. While the ethical principles of triage the for and the lack of a validated pediatric scoring system on expert opinion. The article the to individuals between and of capacity for children should be based on their proportion of the population, or in proportion to those or likely to be affected by the mass critical care event, rather than in proportion to existing standards are to be resources should be allocated on the basis of medical need, medical benefit, and the conservation of resources. the of a validated pediatric the recommends the use of expert opinion. lists are to the Resources should not be allocated based on the complete or on or to in this is essential. The of PEMCC in the developing (p. care in developing is as well as the that can be for offering mass critical care in developed during disasters. in scarce resource and routinely make difficult allocation This article and recommendations for providing the most good with resources through with existing healthcare and using available resources to The of pediatric critical care should include "the of the child with a or in without for the and including emergency, and intensive to disasters in developing have to take into the available resources and (i.e., to provide special needs care that as a of immediate lifesaving The response in these needs to be to the stage of development of the health services and resources. In the must be on care, and basic emergency care, in care should without care resources. in preparing for a pandemic in a developing from public health and and developing strategies for community and mitigation strategies. care strategies must on using the United Health guidelines and for of and of and assistance is provided to during through provided by the Health of 2007 and the Regional emergency response capabilities and their through the Regional with international such as for government (Canada), Department for and will the deployment of scarce resources. are many issues to PEMCC that are such as of triage and decision making and research priorities that need to be addressed. institutions need to make use of these recommendations as guidelines to their readiness and in preparation for PEMCC. The Pediatric Emergency Mass Critical Care Task Force the American Academy of Pediatrics and Disaster for their review and to this

The article examines the issue of legal regulation of mandatory preventive vaccinations in Ukraine through the prism of judicial practice, in particular, taking into account the decisions of the Supreme Court in cases concerning restrictions on access to education and work in connection with the refusal to be vaccinated. Given the growing importance of public interest in the field of health care, in particular in the context of pandemic threats, the problem of achieving a balance between individual rights of the person (the right to education, the right to work, the right to physical integrity) and the needs of society (protection of public health) has acquired particular legal complexity. The article analyzes key categories of litigation: cases regarding the refusal to enroll children in preschool educational institutions due to the lack of mandatory vaccinations; cases regarding the restriction of the right to education for unvaccinated children; cases regarding the suspension of employees from work in connection with the refusal to be vaccinated, in particular against COVID-19. In each of these categories, the courts formulate their own legal positions, which gradually develop into stable law-enforcement approaches. The Supreme Court of Ukraine, analyzing the circumstances of the cases, consistently recognizes mandatory vaccinations as a lawful and proportionate condition for admission to the educational process. A number of rulings indicate a clear understanding by the judiciary of the importance of protecting epidemiological well-being as a legitimate goal that justifies temporary restrictions on certain rights of the child. The judicial reasoning is based on the application of the proportionality test, taking into account the priority of the public interest and the need to ensure a balance between the rights of an individual and the rights of other participants in the educational environment. At the same time, in cases concerning the suspension of employees from work due to refusal to undergo mandatory vaccination, there is a development of national judicial practice: from recognizing violations by employers in the event of insufficient regulatory certainty to confirming the legality of interference with labor rights in the presence of an appropriate legislative basis. The Supreme Court emphasizes the need to comply with the requirements of legal certainty, legality and proportionality, and also applies the provisions of Article 8 of the Convention for the Protection of Human Rights and Fundamental Freedoms as a guideline for the legal assessment of interference with personal rights. It is concluded that the judicial practice in Ukraine in cases regarding mandatory vaccinations forms a balanced approach to the distinction between private and public interest. Court decisions play a key role in the legal provision of stability and predictability in the field of health care, and also contribute to the harmonization of national legislation with international standards for the protection of human rights.

The article discusses the interpretative directive in dubio pro vita humana (Latin: „when in doubt, favour human life”), as well as its popularization, including encouraging public administration bodies and courts to apply it more widely. The article aims to answer the following research problems: What are the main sources of the in dubio pro vita humana directive in the Polish legal system? What is its content and its key assumptions? What are the potential implications of its application in legal practice? What is the object-related scope of its application? The formal-dogmatic method is used in the study. The interpretative directive in dubio pro vita humana is rooted in the constitutional protection of human dignity, life and health. It is confirmed in the views expressed by legal scholars, as well as in the case law of the Constitutional Tribunal and administrative courts. However, in order to increase the scale of its application in practice, it should be regulated by law. The content of the directive is such that it requires any possible doubts about the protection of human life to be resolved in favour of this protection. Applying this directive is pivotal for ensuring institutional healthcare in Poland by choosing such a result of interpretation of provisions of law that maximizes the protection of human life and health. Its object-related scope of application is most strongly linked to healthcare law, but it is also applicable to the interpretation of provisions in other branches of law (for example, in criminal or welfare law), even if prima facie they do not seem directly related to the protection of human health and life. The results are important not only for Polish law, but also for the interpretation of foreign laws and EU law. It seems that this directive may also find its application outside the legal system – for solving ethical problems. An offshoot of this study is the possibility of referring at least part of the comments made to the legal protection of animals, which may contribute to its strengthening and to development of legal science in this area (in dubio pro vita animalium).

The article examines the role of the ECJ in the balancing of fundamental rights within the EU legal order. In particular, it reflects on the consequences of the pronouncements of the Court of Justice in the Promusicae and Satamedia cases in the field of data protection. It argues that the ‘deferential approach’ adopted by the Court might affect the coherence of the internal market and fundamental freedoms. More importantly, it contends that it might also have negative implications for the equivalent protection of fundamental rights within the EU legal order. The article goes on to discuss the role that the Court of Justice, as the constitutional court of the EU, should play when ‘tough constitutional questions’, such as the balancing of fundamental rights, is at stake.

As the Covid -19 continues to ravage human population since December 2019, medical professionals and people from other turfs of human knowledge have remained awake, with a view to nipping the spread of the virus in the bud. As early as 30th January 2020, WHO declared the virus a Public Health Emergency of International Concern (PHEIC) and an epidemic, with relentless efforts to arrest its spread. Yet, the virus nibbled away a large fortune in the global economy. While the virus becomes hydra-headed with its variants, vaccines have been developed to curtail its morbidity and mortality. Vaccinations are acknowledged as one of the most important and successful public health interventions. Nonetheless, there are legal hurdles to be crossed as vaccines are deployed to fight Covid-19 across the globe. Consent and fundamental rights of the individuals to be vaccinated sometimes conflict with the public health emergency needs, resulting in mandatory vaccination of every member of a given population. The two sides of the divide have their respective legal backings as inherent in the two locus classicus of Jacobson v. Massachusetts and Schloendorff v. Society of New York Hospital. The former established the principle of mandatory vaccination on account of public health emergency, while the principles of informed consent and self-determination have their roots in the latter. Subsequent cases, including Nigerian decisions in recent years have upheld the principle of informed consent and self-determination in medical treatment. The main thrust of this paper is to examine the effect of corona virus vaccination and Covid-19 status certificate on self-determination and human rights in Nigeria. The paper concludes that with deep rooted trust and transparency, suspicion and mistrust, which are the bedrock of the anti- vaccination movement will fizzle out and the legal conundrum ease off.

Religious Exemptions

Right to Be Forgotten in the European Court of Justice Google Spain Case: The Right Balance of Privacy Rights, Procedure, and Extraterritoriality

The COVID-19 pandemic and the issues related to health emergency management have raised concerns about fundamental rights protection. One of the most complex and contentious issues in doctrine and jurisprudence is the introduction of mandatory COVID-19 vaccination for specified categories of subjects, such as healthcare workers and individuals of a specific age range, as occurred in Italy. The debate in Italy over the mandatory COVID-19 vaccination requirement focuses on whether this obligation interferes with the individual's fundamental right to free self-determination as guaranteed by Article 32 of the Italian Constitution. In jurisprudence and doctrine, conflicting opinions are noted concerning this topic. Part of the doctrine argue that mandatory COVID-19 vaccination compromises some fundamental rights guaranteed by the Italian Constitution, such as the right to free self-determination and respect for human dignity. Other opinions find the basis of the vaccination in the community's best interests, citing Article 32 of the Italian Constitution, which allows for the imposition of compulsory health treatment to safeguard citizens' health. In this regard, the issue of mandatory COVID-19 vaccination requires a reflection on the balance of two fundamental rights: the individual right to free self-determination and the community's interest in terms of protecting public health.

The COVID-19 pandemic and the issues related to health emergency management have raised concerns about fundamental rights protection. One of the most complex and contentious issues in doctrine and jurisprudence is the introduction of mandatory COVID-19 vaccination for specified categories of subjects, such as healthcare workers and individuals of a specific age range, as occurred in Italy. The debate in Italy over the mandatory COVID-19 vaccination requirement focuses on whether this obligation interferes with the individual’s fundamental right to free self-determination as guaranteed by Article 32 of the Italian Constitution. In jurisprudence and doctrine, conflicting opinions are noted concerning this topic. Part of the doctrine argue that mandatory COVID-19 vaccination compromises some fundamental rights guaranteed by the Italian Constitution, such as the right to free self-determination and respect for human dignity. Other opinions find the basis of the vaccination in the community’s best interests, citing Article 32 of the Italian Constitution, which allows for the imposition of compulsory health treatment to safeguard citizens’ health. In this regard, the issue of mandatory COVID-19 vaccination requires a reflection on the balance of two fundamental rights: the individual right to free self-determination and the community’s interest in terms of protecting public health.

The coronavirus crisis has covered the world and threatened the major benefits of humanity: life, health and democracy. In one of the statements, the UN Secretary General calls this crisis as the human crisis. Unlike the United Kingdom, in the course of the pandemic in Georgia, a list of effective measures and appropriate mechanisms were not created, through which the growth of unemployment in the country would have been minimized and the standard of protection of workers' rights would be raised. In the near future problematic issue in the form of labor disputes arising from the pandemic will stand to Georgia's judiciary. According to this scientific work I will raise a new issue: are the judges able to evaluate to what extent the company, which fi red employee due to economic circumstances, had the opportunity to take alternative measures, adapting its bud- get to the current economic situation, to manage finances more efficiently, to avoid the financial crisis and the need to reduce the workforce. I suggest following: ● Judges should be trained in this area; ● An appropriate qualified team should be set up in court. However, the management of the pandemic, the protection of human life and health, in some periods led to the restriction of some of the basic rights guaranteed by the Constitution of Georgia and the European Convention. Which is the triad of fundamental rights that has been overshadowed by the pandemic? On what grounds can these rights be restricted? What does the consequential result of the restriction of a fundamental right mean? What is the difference between freedom of movement and freedom of assembly? What does the specific proviso of the law mean? Does the proviso set any priority from the hierarchy of normative acts of Georgia and namely the proviso: the interference should be carried out on the basis of law? In my opinion, the Constitutional Court of Georgia should take the responsibility of the key mission such as: introducing precise definitions and interpretations of fundamental rights for both lawyers and civil society. My scientific work suggests how the foregoing may be achieved. "Freedom is a conscious necessity”. - Georg Wilhelm Friedrich Hegel.

At the time of writing, COVID-19 no longer constitutes a public health emergency of international concern. However, the compatibility of coronavirus vaccines with the interests of the European Court of Human Rights (ECtHR) is still worth mentioning. In 2020 and 2021, while humanity struggled with the pandemic, the long list of fundamental rights dilemmas expanded – with the issue of human rights certainly generating the most relevant public resonance. Alongside curfews and less stringent restrictions on the freedom of movement was the compulsory vaccination against COVID-19. Therefore, the decision of the ECtHR in Vavřička et al. v. the Czech Republic could hardly be more timely in helping us to take stock of the conditions under which compulsory coronavirus vaccination may be compatible with human rights law. Therefore, this paper seeks to provide a focused case analysis on the only decision of the court related to compulsory vaccines – and uses analogy to make conclusions on the compatibility of coronavirus vaccines with the European Convention on Human Rights (ECHR).

This chapter tackles the ever increasing need for EU institutions to reconcile fundamental rights with the fundamental freedoms set by the founding treaties. The tendency to subordinate the former to the latter is apparent from the case-law of the Court of Justice in which, notwithstanding the development of a system of protection of fundamental rights, there is a general failure to grant them hierarchical priority. On the other hand, the transformation of the EU Charter of Fundamental Rights from a mere political declaration to binding primary law is believed to grant constitutional force to fundamental rights, placing them on a par with the fundamental economic freedoms enshrined in the Treaty on the functioning of the European Union. The author suggests that the Charter may lead the ECJ to a revirement jurisprudentiel triggering the development of case-law based on an equal balancing of fundamental rights and economic freedoms.