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Herd Protection as a Public Good: Vaccination and Our Obligations to Others

In Angus Dawson & Marcel Verweij (eds.), Ethics, Prevention, and Public Health. Oxford University Press (2009)

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  • Listening to vaccine refusers.Kaisa Kärki - 2022 - Medicine, Health Care and Philosophy 25 (1):3-9.
    In bioethics vaccine refusal is often discussed as an instance of free riding on the herd immunity of an infectious disease. However, the social science of vaccine refusal suggests that the reasoning behind refusal to vaccinate more often stems from previous negative experiences in healthcare practice as well as deeply felt distrust of healthcare institutions. Moreover, vaccine refusal often acts like an exit mechanism. Whilst free riding is often met with sanctions, exit, according to Albert Hirschman’s theory of exit and (...)
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  • Influenza Vaccination Strategies Should Target Children.Ben Bambery, Thomas Douglas, Michael J. Selgelid, Hannah Maslen, Alberto Giubilini, Andrew J. Pollard & Julian Savulescu - 2018 - Public Health Ethics 11 (2):221-234.
    Strategies to increase influenza vaccination rates have typically targeted healthcare professionals and individuals in various high-risk groups such as the elderly. We argue that they should focus on increasing vaccination rates in children. Because children suffer higher influenza incidence rates than any other demographic group, and are major drivers of seasonal influenza epidemics, we argue that influenza vaccination strategies that serve to increase uptake rates in children are likely to be more effective in reducing influenza-related morbidity and mortality than those (...)
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  • Public Health and Normative Public Goods.Richard H. Dees - 2018 - Public Health Ethics 11 (1):20-26.
    Public health is concerned with increasing the health of the community at whole. Insofar as health is a ‘good’ and the community constitutes a ‘public’, public health by definition promotes a ‘public good’. But ‘public good’ has a particular and much more narrow meaning in the economics literature, and some commentators have tried to limit the scope of public health to this more narrow meaning of a ‘public good’. While such a move makes the content of public health less controversial, (...)
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  • Discusión en torno a la vacunación profiláctica contra el virus del papiloma humano.Robert Anthony Gamboa Dennis - 2019 - Revista de Bioética y Derecho 2019 (45):111-125.
    En el presente artículo se aborda la problemática en torno al virus del papiloma humano —el cual causa diversos cánceres, destacando el cáncer cervicouterino—, y la vacunación para prevenir contra dicha infección. Primero, se describen la morbilidad y la mortalidad del virus y las características de las vacunas. Segundo, se discuten los problemas referentes a la eficacia y la seguridad de las vacunas. Tercero, se discuten dos problemas éticos en torno a la vacunación contra el VPH: ¿debe ser obligatoria u (...)
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  • Vaccinating for Whom? Distinguishing between Self-Protective, Paternalistic, Altruistic and Indirect Vaccination.Steven R. Kraaijeveld - 2020 - Public Health Ethics 13 (2):190-200.
    Preventive vaccination can protect not just vaccinated individuals, but also others, which is often a central point in discussions about vaccination. To date, there has been no systematic study of self- and other-directed motives behind vaccination. This article has two major goals: first, to examine and distinguish between self- and other-directed motives behind vaccination, especially with regard to vaccinating for the sake of third parties, and second, to explore some ways in which this approach can help to clarify and guide (...)
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  • Three Harm-Based Arguments for a Moral Obligation to Vaccinate.Viktor Ivanković & Lovro Savić - 2021 - Health Care Analysis 30 (1):18-34.
    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 (...)
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  • Vaccination Policies: Between Best and Basic Interests of the Child, between Precaution and Proportionality.Roland Pierik - 2020 - Public Health Ethics 13 (2):201-214.
    How should liberal-democratic governments deal with emerging vaccination hesitancy when that leads to the resurgence of diseases that for decades were under control? This article argues that vaccination policies should be justified in terms of a proper weighing of the rights of children to be protected against vaccine-preventable diseases and the rights of parents to raise their children in ways that they see fit. The argument starts from the concept of the ‘best interests of the child involved’. The concept is (...)
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  • The moral obligation to be vaccinated: utilitarianism, contractualism, and collective easy rescue.Alberto Giubilini, Thomas Douglas & Julian Savulescu - 2018 - Medicine, Health Care and Philosophy 21 (4):547-560.
    We argue that individuals who have access to vaccines and for whom vaccination is not medically contraindicated have a moral obligation to contribute to the realisation of herd immunity by being vaccinated. Contrary to what some have claimed, we argue that this individual moral obligation exists in spite of the fact that each individual vaccination does not significantly affect vaccination coverage rates and therefore does not significantly contribute to herd immunity. Establishing the existence of a moral obligation to be vaccinated (...)
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  • Adding justice to the clinical and public health ethics arguments for mandatory seasonal influenza immunisation for healthcare workers.Lisa M. Lee - 2015 - Journal of Medical Ethics 41 (8):682-686.
    Ethical considerations from both the clinical and public health perspectives have been used to examine whether it is ethically permissible to mandate the seasonal influenza vaccine for healthcare workers (HCWs). Both frameworks have resulted in arguments for and against the requirement. Neither perspective resolves the question fully. By adding components of justice to the argument, I seek to provide a more fulsome ethical defence for requiring seasonal influenza immunisation for HCWs. Two critical components of a just society support requiring vaccination: (...)
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  • Liberty, Fairness and the ‘Contribution Model’ for Non-medical Vaccine Exemption Policies: A Reply to Navin and Largent.Giubilini Alberto, Douglas Thomas & Savulescu Julian - 2017 - Public Health Ethics 10 (3).
    In a paper recently published in this journal, Navin and Largent argue in favour of a type of policy to regulate non-medical exemptions from childhood vaccination which they call ‘Inconvenience’. This policy makes it burdensome for parents to obtain an exemption to child vaccination, for example, by requiring parents to attend immunization education sessions and to complete an application form to receive a waiver. Navin and Largent argue that this policy is preferable to ‘Eliminationism’, i.e. to policies that do not (...)
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  • The Sexual Ethics of HPV Vaccination for Boys.Jeroen Luyten, Bart Engelen & Philippe Beutels - 2014 - HEC Forum 26 (1):27-42.
    Human papillomavirus (HPV) is one of the most common sexually transmitted infections. It is a leading cause of cervical cancer in women but the virus is increasingly being linked to several other cancers in men and women alike. Since the introduction of safe and effective but also expensive vaccines, many developed countries have implemented selective vaccination programs for girls. Some however argue that these programs should be expanded to include boys, since (1) HPV constitutes non-negligible health risks for boys as (...)
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  • ‘Take the Pill, It Is Only Fair’! Contributory Fairness as an Answer to Rose’s Prevention Paradox.Jay A. Zameska - 2021 - Public Health Ethics 14 (3):221-232.
    One proposal to significantly reduce cardiovascular disease is the idea of administering a ‘polypill’—a combination of drugs that reduce the risk of heart disease and carry few side effects—to everyone over the age of 55. Despite their promise, population strategies like the polypill have not been well-accepted. In this article, I defend the polypill by appealing to fairness. The argument focuses on the need to fairly distribute the costs to individuals. While the fact that population strategies like the polypill impose (...)
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  • Vaccination, Risks, and Freedom: The Seat Belt Analogy.Alberto Giubilini & Julian Savulescu - 2019 - Public Health Ethics 12 (3):237-249.
    We argue that, from the point of view public health ethics, vaccination is significantly analogous to seat belt use in motor vehicles and that coercive vaccination policies are ethically justified for the same reasons why coercive seat belt laws are ethically justified. We start by taking seriously the small risk of vaccines’ side effects and the fact that such risks might need to be coercively imposed on individuals. If millions of individuals are vaccinated, even a very small risk of serious (...)
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  • The Steward of the Millian State.Angus Dawson & Marcel Verweij - 2008 - Public Health Ethics 1 (3):193-195.
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  • Public Health and the Rights of States.A. Miklos - 2009 - Public Health Ethics 2 (2):158-170.
    When exercising their public health powers, states claim various rights against their subjects and aliens. The paper considers whether public health considerations can help justify some of these rights, and explores some constraints on the justificatory force of public health considerations. I outline two arguments about the moral grounds for states’ rights with regard to public health. The principle of fairness emphasizes that those who benefit from public health measures ought to contribute their fair share in upholding them. Alternatively, states’ (...)
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  • Is Prevention Better than Cure? A Re-evaluation of the Potential Use of Nicotine Conjugate Vaccine in Children.K. McMahon-Parkes - 2011 - Public Health Ethics 4 (2):121-128.
    Despite worldwide efforts to reduce the consumption of tobacco, legislative and educational measures have failed to eradicate the practice of cigarette smoking. Indeed, in many populations, particularly in the developing world, its prevalence is increasing. Consequently were alternative strategies to become available to address the problem, they would deserve serious consideration. One potential strategy which may become a real possibility in the future might be the vaccination of children against the pleasurable effects of nicotine. Were such a vaccine to become (...)
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  • Public Health Ethics and the Justification of HIV Screening.Angus Dawson - 2011 - American Journal of Bioethics 11 (4):48-49.
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  • Risk perceptions and ethical public health policy: MMR vaccination in the UK.Angus Dawson - 2005 - Poiesis and Praxis 3 (4):229-241.
    This paper is concerned with how public health policy makers should respond to the public’s perception of risks. I suggest that we can think of this issue in terms of two different models of responding to the public’s view of such perceived risks. The first model I will call the public perception view (PP view) and the second the public good view (PG view). The PP view suggests that the public’s perception of any risks is so important that public health (...)
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