Ethical Challenges in Mandatory Vaccination Against Covid-19

Abstract

"The current COVID-19 pandemic creates unique and unmatched challenges to healthcare system worldwide. For vulnerable hosts such as immunodeficient individuals, older people, and those with additional comorbidities, SARS-CoV-2 infection primary raises high risk of death outcome. The population should be protected from the further distribution of SARS-CoV-2 through contact distancing, the using of protective masks and other hygiene measures, but also through vaccination, since vaccinations are one of the most important primary prevention tools. Therefore, vaccine is anticipated to protect the vaccinated person from severe disease if infected by the specific pathogen the vaccine was targeted against. On 11th March 2020 the World Health Organization (WHO) declared COVID-19 as pandemic, yet in 2019, the vaccine hesitancy was named by the WHO as one of the top 10 threats to global health. Acceptance of the vaccine is critical to its success and with the rise of the anti-vaxxer movement; continuous increasing public awareness is needed without any delay. Mandatory vaccination, including for COVID-19, could be ethically justified if the threat to public health is serious, the confidence in efficacy and safety is high, the anticipated utility of mandatory vaccination is superior to the alternatives, but also if the penalties or charges for non-compliance are balanced. Besides, one can argue that vaccination isn’t just an individual preference, namely vaccination protects those who can’t be vaccinated. So, although vaccine mandates for adults may be legal, so far they have been applied restrictively to select groups, such as health care providers, but also in businesses that require in-person attendance, education-related sectors, or in long-distance travel businesses, rather widely enforced. As for the vaccination hesitancy, the results of majority of studies indicated vaccine safety, efficacy, protection duration, and potential side effects as the most important reasons for COVID-19 vaccination hesitancy. Apart from vaccine-specific concerns, reasons for vaccine hesitancy also included a need for more information, antivaccine attitudes or beliefs, and a lack of trust. Taking into account the need to keep the world population over the herd immunity threshold, a continuous action is going to be expected from public health authorities to maintain trust and reduce COVID-19 vaccine hesitancy. "