Abstract
A particularly strong reason to vaccinate against transmittable diseases, based on considerations of harm, is to contribute to the realization of population-level herd immunity. We argue, however, that herd immunity alone is insufficient for deriving a strong harm-based moral obligation to vaccinate in all circumstances, since the obligation significantly weakens well above and well below the herd immunity threshold. The paper offers two additional harm-based arguments that, together with the herd immunity argument, consolidates our moral obligation. First, we argue that individuals should themselves aim not to expose others to risk of harm, and that this consideration becomes stronger the more non-vaccinated people there are, i.e., the further we are below herd immunity. Second, we elaborate on two pragmatic reasons to vaccinate beyond the realization of herd immunity, pertaining to instability of vaccination rates and population heterogeneity, and argue that vaccinating above the threshold should serve as a precautionary measure for buttressing herd immunity. We also show that considerations of harm have normative primacy in establishing this obligation over considerations of fairness. Although perfectly sound, considerations of fairness are, at worst secondary, or at best complementary to considerations of harm.
Highlights
Owing to a considerable drop in the vaccination coverage of children (34% over the span of 5 years), the Dubrovnik-Neretva county in southern Croatia suffered a significant outbreak of measles in 2018 [31]
In the previous two sections, we have spelled out two arguments grounding an individual obligation to vaccinate when rates are close to the herd immunity threshold and well below it
Accounts centered on harm have already been flagged, mainly by their own proponents, for their problems with grounding the obligation to vaccinate once the good of herd immunity has been obtained. Dawson argues against such an obligation because vaccinating above the herd immunity threshold produces no additional benefit to others, since herd immunity will have already minimized potential risks of harm; individuals who vaccinate in these circumstances are exposed to unnecessary risk given vaccination’s possible adverse effects [12: 171–177]
Summary
Owing to a considerable drop in the vaccination coverage of children (34% over the span of 5 years), the Dubrovnik-Neretva county in southern Croatia suffered a significant outbreak of measles in 2018 [31]. This paper offers two additional harm-based arguments, which show our individual obligations to vaccinate to be strong even when the population is well below a herd immunity threshold, or well above it.
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