Abstract
Vaccinations are among the most effective and cost-effective means to reduce the burden of serious infectious diseases. As vaccination rates remain too low to realize the full potential to reduce morbidity and mortality, strategies to increase immunization rates are ethically and economically mandated. Questions to be addressed in this framework are: Which restrictions to individual decisions are ethically acceptable in order to achieve a sufficient protection of the community? Does the individual have an ethical obligation to get vaccinated? Which requirements do vaccines have to fulfill to be ethically acceptable? Five criteria are presented: Proven efficacy/effectiveness, favorable benefit-risk ratio, acceptable benefit-cost ratio, minimized restrictions of the individual, and fair and transparent decision procedures. Depending on how far the five ethical requirements are met, different strengths of recommendations result, from level 1 (do not offer vaccination) to level 5 (vaccination required by law). Ethical issues on the vaccination of children arise if the human right of parents to care for their child are in contrast to the human right of children to receive optimal protection from disease.
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