Fractured States: Smallpox, Public Health and Vaccination Policy in British India, 1800-1947 (review)

The emerging field of public health ethics

The EU Response to COVID-19: From Reactive Policies to Strategic Decision-Making.

Fractured States , part of an exciting series from Orient Longman entitled New Perspectives in South Asian History , provides a nuanced narrative of state vaccination policy and its implementation in different regions of India from the nineteenth century through to independence. The book succeeds in challenging the dominant historiography of state medicine in colonial India which has assumed on the one hand that the colonial state was monolithic and thus that its health policies were hegemonic, and on the other that the technology of vaccination was both uniform and efficacious. Fractured States is a political history of vaccination that argues for the contingent nature of the colonial state and its dependence upon an aggregate of local authorities with considerable influence and differing opinions. It de-emphasises the significance of religious and caste issues to the history of the successes and failures of state vaccination, focusing instead on administrative, technological and economic, rather than cultural, explanations for the development of particular vaccination policies and the ways in which they were put into practice. By studying the implementation of vaccination policies in a variety of regions at different historical moments, Fractured States suggests that colonial public health policies were inconsistently administered, constantly contested from both within and without the state medical services, and locally adaptable. This account allows for considerable agency on the part of both Indian public health officials and the civilian population in relation to how, when and if vaccination was performed. It also presents a much more complicated narrative of the operation of the colonial state which consistently changed its health care delivery strategies to adapt to regional differences and political exigencies.

Solidarity is a concept increasingly employed in bioethics whose application merits further clarity and explanation. Given how vital cooperation and community-level care are to mitigating communicable disease transmission, we use lessons from the COVID-19 pandemic to reveal how solidarity is a useful descriptive and analytical tool for public health scholars, practitioners, and policymakers. Drawing upon an influential framework of solidarity that highlights how solidarity arises from the ground up, we reveal how structural forces can impact the cultivation of solidarity from the top down, particularly through ensuring robust access to important social determinants of health. Public health institutions can support solidarity movements among individuals and communities by adopting a lens of social justice when considering public health priorities and, in turn, promote health equity.

Repurposing the Ladder

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The COVID-19 pandemic has had an extreme global impact, transforming our daily lives, educational systems, and healthcare systems. Healthcare workers' views on mandatory vaccination and experience with vaccines may play a pivotal role in vaccination rates and public health policy. The purpose of this study is to uncover the perspectives of pharmacy students, at Xavier University of Louisiana, concerning COVID-19 vaccination mandates in educational institutions and healthcare environments, specifically the ethical, legal, and logistical dimensions. Furthermore, it will also assess the varying perceptions of vaccine safety and its impact on herd immunity while analyzing demographic characteristics. A questionnaire survey. This cross-sectional study was conducted among students at Xavier University of Louisiana College of Pharmacy. Data were collected from the students using an online, anonymous questionnaire system named QualtricsXM. The survey was distributed to all 291 XULACOP students through email, text message, and GroupMe as a web link or QR code from August 25th to August 31st, 2023. Demographic data collected in the survey included age range, gender, and race/ethnicity. The 16-question survey assessed the students' understanding, opinions, and experiences regarding COVID-19 vaccines and mandates. The study sample included 151 students, reflecting a 52% response rate. Approximately, half of the study respondents believe the vaccine should be mandatory for the public, which was associated with opinions about students believing COVID-19 vaccines should be mandatory for school admissions were seven times more likely (OR = 7.33) and students believing mandatory vaccination infringes on personal freedom were 26% less likely (OR = 0.26) to support mandatory COVID-19 vaccines for the public(p = 0.000). When analyzing demographic characteristics, there was a significant difference in outcome between Black and non-Black students in their belief about mandatory vaccination for herd immunity (p = 0.016). The findings of this study indicate that half of the students support making the vaccine mandatory for the public. However, significant concerns about personal freedom and individual rights were expressed by those who opposed this view. Varying pharmacy student opinions among demographic groups on vaccine mandates and understanding the factors influencing these differences can offer valuable insights into public health policy.

A Public Health Reset Through Contractualism

Global Perspective on Hepatitis B Virus Infections in the Era of Effective Vaccines

BackgroundMaximizing vaccination uptake is crucial in generating herd immunity and preventing infection incidence (Quach et al., Am J Infect Control 11:1017–23, 2013). Vaccination of healthcare personnel (HCP) against influenza is vital to influenza infection control in healthcare settings, given the consistent exposure of HCP to high-risk patients like: those with compromised immune systems, children, and the elderly (Johnson & Talbot, Curr Opin Infect Dis 24: 363–369, 2011). Influenza vaccination uptake among HCP remains suboptimal: in 2017–18, 47.6% of HCP who worked in settings where influenza vaccination was not mandatory were vaccinated against influenza in United States (Black et al., Morb Mortal Wkly Rep 67: 1050, 2018). Mandatory vaccination policies result in HCP influenza vaccination uptake rates substantially higher than opt-in influenza vaccination campaigns (94.8% vs. 47.6%) (Black et al., Morb Mortal Wkly Rep 67: 1050, 2018).GoalsThe Israel Journal of Health Policy Research has published articles focused on the issues of influenza vaccination (Yamin et al., Isr J Health Policy Res 3: 13, 2014), improving influenza vaccination coverage of HCP (Weber et al., Isr J Health Policy Res 5: 1–5, 2016), influenza vaccination motivators among HCP (Nutman and Yoeli, Isr J Health Policy Res 5: 52, 2016), legal imposition of vaccination (Kamin-Friedman, Isr J Health Policy Res 6:58, 2017), and mandatory vaccination (Gostin, Cell Biosci 8: 1-4, 2018). Each article explores factors influencing disease prevention from different angles within an Israeli context. This article attempts to fuse these topics by investigating how to apply aspects of American mandatory influenza vaccination policy targeted at HCP in an Israeli context.MethodsCritical document analysis was conducted on relevant literature and policy discussing influenza prevention interventions among HCP within the United States. Mandatory vaccination policies were highlighted. A discussion of the professional responsibility of HCP to vaccinate against influenza serves as background. Case studies of hospitals in the United States that implemented mandatory vaccination policies for their employees are analyzed. The article concludes with analysis exploring how qualities of mandatory influenza vaccination policy of HCP could take shape in Israel, giving contextual limitations, urging Israeli health policy makers to reflect on lessons learned from the American case study.Main findings and conclusionMandatory HCP influenza vaccination policies in comparison to non-mandatory interventions are most effective in obtaining maximum influenza vaccination uptake among HCP (Black et al., Morb Mortal Wkly Rep 67: 1050, 2018). Many HCP cite individual objections to influenza vaccination rooted in personal doubts and ethical concerns. The ethical responsibility of HCP to their patients and work environments to prevent and lower influenza infection incidence arguably overrules such individual objections. Mandatory HCP influenza vaccination policies are an effective method of maximizing HCP influenza vaccine uptake and minimizing the spread of the influenza virus within healthcare settings. Still, cultural, social and political sensitivity must be taken into consideration when implementing both full-on mandatory HCP influenza vaccination policies and/or aspects of mandatory policies, especially within an Israeli context.

Public health policies often require individuals to make personal sacrifices for the sake of protecting other individuals or the community at large. Such requirements can be more or less demanding for individuals. This paper examines the implications of demandingness for public health ethics and policy. It focuses on three possible public health policies that pose requirements that are differently demanding: vaccination policies, policy to contain antimicrobial resistance, and quarantine and isolation policies. Assuming the validity of the ‘demandingness objection’ in ethics, we argue that states should try to pose requirements that individuals would have an independent moral obligation to fulfil, and therefore that are not too demanding. In such cases, coercive measures are ethically justified, especially if the interventions also entail some benefits to the individuals; this is, for example, the case of vaccination policies. When public health policies need to require individuals to do something that is too demanding to constitute an independent moral obligation, states have an obligation to either provide incentives to give individuals non-moral reasons to fulfil a certain requirement – as in the case of policies that limit antibiotic prescriptions – or to compensate individuals for being forced to do something that is too demanding to constitute an independent moral obligation – as in the case of quarantine and isolation policies.

Public Health Law and Public Health Policy

Human papillomavirus vaccination programmes

Public health law and public health policy: Dual tools for public health

The brave new world of pandemic resilience.