In a recent article in this journal, Kowalik argues that compulsory vaccination unjustifiably infringes on the autonomy of vaccine refusers. While accepting Kowalik’s central premises, we argue that, when appropriately expanded in scope, autonomy considerations do not undermine the justifiability of compulsory vaccination. Vulnerable individuals—including the very old, the very young and those with compromised immune systems—face an omnipresent risk of contracting a potentially fatal vaccine-preventable illness and are thus prevented from accessing public goods by coercive pressure. Consequently, when we (...) consider an appropriately broad scope of autonomy constraints, autonomy considerations do not undermine the case for mandating vaccination. (shrink)

The potential for vaccines to prevent the spread of infectious diseases is crucial for vaccination policy and ethics. In this paper, I discuss recent evidence that the current COVID-19 vaccines have only a modest and short-lived effect on reducing SARS-CoV-2 transmission and argue that this has at least four important ethical implications. First, getting vaccinated against COVID-19 should be seen primarily as a self-protective choice for individuals. Second, moral condemnation of unvaccinated people for causing direct harm to others is unjustified. (...) Third, the case for a harm-based moral obligation to get vaccinated against COVID-19 is weak. Finally, and perhaps most significantly, coercive COVID-19 vaccination policies (e.g., measures that exclude unvaccinated people from society) cannot be directly justified by the harm principle. (shrink)

Arguments for mandatory or compulsory vaccination must justify the coercive infringement of bodily integrity via the injection of chemicals that permanently affect a body’s inner constitution. Four arguments are considered. The allegedly libertarian argument declares unvaccinated persons a threat; accordingly, vaccination could take the form of justifiable defence of self and others. This argument conflates material and statistical threats. The harsh coercive measures permissible in defence against the former are not permissible in prevention of the latter. The argument from tax (...) evasion claims that people can be permissibly coerced into bearing their fair financial burdens of community life and likens this to sharing burdens in the face of a viral threat. The argument fails to demonstrate that vaccination would be fair, permissible in spite of potential lethal side-effects, and sufficiently similar to taxation despite the categorical difference between temporary deprivation of money and permanent deprivation of one’s original inner bodily constitution. The argument from ‘social liberty’ claims that the loss of freedom due to mandatory vaccination is only apparent, namely outweighed by corresponding gains in freedom. This argument conflates freedom as the absence of coercion with freedom as the presence of options for action. It fails to give the former its due weight and to demonstrate that persons may be coerced into increasing the options of others. The argument from the priority of life elevates the protection of life to an absolute value. This is unwarranted and leads to counterintuitive implications. Without better arguments, mandatory vaccination must be rejected. (shrink)

The rapid development of widely available and effective vaccines has been integral to the international response to the COVID-19 pandemic. However, a significant minority of those offered vaccination have refused, often due to their adherence to ‘anti-vax’ beliefs. These beliefs include that vaccines are dangerous, render the recipient magnetic or contain government microchips.During the pandemic, numerous calls were made for those voluntarily refusing vaccination to be deprioritised when allocating scarce healthcare resources. While these calls were rejected, the likelihood of the (...) same calls being made during future pandemics necessitates a thorough examination of the ethical implications entailed by such a policy.Here, I consider an intuitive argument for the use of vaccination status when allocating healthcare resources. This argument claims that, by avoiding vaccination, vaccine refusers are failing to fulfil a social obligation to protect those around them from harm by facilitating herd immunity. They are, therefore, less deserving of healthcare than their vaccinated peers.I explore three objections to this argument. While a first objection, asserting that no individual can be held responsible for a failure to develop herd immunity, fails, I find two further responses, respectively asserting the primacy of patient autonomy and highlighting the harms deprioritising vaccine refusers would cause to disadvantaged minorities, compelling. I, therefore, conclude that vaccination status should not be considered during healthcare resource allocation, as such discrimination would disproportionately harm marginalised communities. (shrink)