In a recent article, ―The Lacuna of Hermeneutics: Notes on the Freedom of Thought, Marcia Sá Cavalcante Schuback raises an important question regarding the limitations of philosophical hermeneutics to be critical and attentive to the reality of current, concrete socio-political issues. In response, I claim that Gadamerian hermeneutics is well positioned to address current and controversial instances of epistemic injustice. In this article, I focus on the contemporary and controversial example of testimony of those who have been injured by (...) the COVID-19 vaccines. In turning to selections from Gadamer‘s Truth and Method, as well his lectures and essays on health and medicine, I argue that Gadamer‘s emphasis on hermeneutic openness and readiness, as well as an attunement to the linguistic and embodied experience of pain, allow us to consider a responsible approach to testimonies of the vaccine injured. Instead of providing a set of criteria or a particular method for distinguishing true from false testimony, Gadamerian hermeneutics calls for an examination and transformation of one‘s prejudices, especially prejudices which may impede one‘s ability to interpret and understand the subject matter in the first place. (shrink)

Some vaccine-hesitant people lack epistemic trust in the COVID-19 vaccine recommendation that because vaccines have been shown to be medically safe and effective, one ought to get vaccinated. Citing what I call exception information, they claim that whatever the general safety and efficacy of vaccines, the vaccines may not be safe and effective for them. Examples include parents citing information about their children's health, pregnant women's concerns about the potential adverse effects of treatment on pregnant women, (...) young people citing their relative invulnerability to extreme COVID-19 symptoms, or members of vulnerable racial groups citing epistemic injustice, such as a lack of representation in COVID-19 vaccine trials. This paper examines the extent to which a lack of epistemic trust in vaccine recommendations, based on such exemption information, is rational. (shrink)

COVID-19 vaccine refusal seems like a paradigm case of irrationality. Vaccines are supposed to be the best way to get us out of the COVID-19 pandemic. And yet many people believe that they should not be vaccinated even though they are dissatisfied with the current situation. In this paper, we analyze COVID-19 vaccine refusal with the tools of contemporary philosophical theories of responsibility and rationality. The main outcome of this analysis is that many vaccine-refusers (...) are responsible for the belief that they should not be vaccinated and epistemically rational in holding it. This is an important result because it provides insights into the legitimacy of certain public health policies. In particular, this result shows that a public health policy that would abandon the project of convincing certain vaccine-refusers with reasons – e.g., by simply making vaccination compulsory – is prima facie illegitimate. (shrink)

Many hypotheses have been advanced to explain the collective irrationality of COVID-19 vaccine hesitancy, such as partisanship and ideology, exposure to misinformation and conspiracy theories or the effectiveness of public messaging. This paper presents a complementary explanation to epistemic accounts of collective irrationality, focusing on the moral reasons underlying people’s decisions regarding vaccination. We argue that the moralization of COVID-19 risk mitigation measures contributed to the polarization of groups along moral values, which ultimately led to the (...) emergence of collective irrational behaviors. Collective irrationality arises from groups explicitly or implicitly endorsing values that ultimately harm both themselves and those around. The role of social media platforms in amplifying this polarization and contributing to the emergence of collective irrationality is also examined. Finally, potential strategies for addressing the moral sources of collective irrationality are discussed. (shrink)

Governments around the world have faced the challenge of how to respond to the recent outbreak of a novel coronavirus disease. Some have reacted by greatly restricting the freedom of citizens, while others have opted for less drastic policies. In this paper, I draw a parallel with vaccination ethics to conceptualize two distinct approaches to COVID-19 that I call altruistic and lockdown. Given that the individual measures necessary to limit the spread of the virus can in principle be achieved (...) voluntarily as well as through enforcement, the question arises of how much freedom governments ought to give citizens to adopt the required measures. I argue that an altruistic approach is preferable on moral grounds: it preserves important citizen freedoms, avoids a number of potential injustices, and gives people a much-needed sense of meaning in precarious times. (shrink)

This letter attempts to put some preliminary thoughts on the COVID-19 pandemic in relation to Foucault's writings on Biopower, critique of Capitalism, and global wealth injustice. The Letter concludes that schemes, such as COVAX, which are meant to overcome global wealth inequalities, serve better as visible symptoms of these inequalities.

The Covid-19 pandemic has fuelled indignation. People have been indignant about the breaking of lockdown rules, about the mistakes and deficiencies of government pandemic policies, about enforced mask-wearing, about vaccination programmes (or lack thereof), about lack of care with regards vulnerable individuals, and more. Indeed, indignation seems to have been particularly prevalent on social media platforms such as Twitter and Facebook, where indignant remarks are often accompanied by variations on the hashtag #WTF?! In this paper, I explore indignation’s distinctive (...) character as a form of moral anger, in particular suggesting that what is characteristic of indignation is not only that it discloses moral injustices but betrays our disbelief at the very occurrence of the offence. Having outlined the character of indignation, I consider how the structure of indignation impacts how we do, respond to, and receive indignation. I explore indignation in action, so to speak, in the context of Covid-19, with a particular emphasis on how indignation occurs ‘on the internet’. (shrink)

ABSTRACT What, if anything, should we do when someone says they don’t believe in anthropogenic climate change? Or that they worry that a COVID-19 vaccine might be dangerous? We argue that in general, we face an epistemic duty to object to such assertions, qua instances of science denial and science sceptical discourse, respectively. Our argument builds on recent discussions in social epistemology, specifically surrounding the idea that we ought to speak up against (epistemically) problematic assertions so as (...) to fulfil an important epistemic obligation – namely, preventing epistemic harms in others. We show that both science denial (SD) and vaccine hesitant (VH) discourses are harmful in a distinctively epistemic sense, and as such generate an especially strong duty to voice our disagreement. As we also argue, this obligation is nonetheless defeasible: depending on the situational features of those involved, voicing an objection to VH discourse may actually end up doing more harm than good. We conclude by tracing what seems like a promising path towards restoring well-placed public trust in scientific testifiers. Doing so is key in order to guarantee equitable access to warranted beliefs about important subject matters, such as the safety of vaccines, to all segments of society. (shrink)

Private funding of life sciences has been extensively criticized as lacking objectivity (e.g., Bekelman et al. 2003). However, it is also important to point out that public funding of life sciences faces many objections. In order to improve the system of publicly funded life sciences and its ability to respond to global health challenges such as the COVID-19 pandemic, we should focus on several aspects. First of all, providing existential stability for researchers, in turn, could result in the decrease (...) of academic misconduct. Secondly, COVID-19 vaccines come from all parts of the world and have to be distributed throughout the world, which is a strong argument in favor of the positive stimulation of global science conducted at less-known research institutions and throughout all countries. This brings us to the quest of working on epistemic decolonization and inclusion in contrast to the current elitist paradigm in science. Finally, publicly funded research, which is at the moment mainly focused on foundational questions, should also be extended to applied ones. Public funding of applied research would lead to its development independently of private financial interests. (shrink)

Ongoing and anticipated COVID-19 human challenge studies in the UK may advance our understanding of COVID-19 and facilitate the licensure of safe, effective, and easily deployable next-generation COVID-19 vaccines and boosters. We argue that international volunteer recruitment for COVID-19 human challenge trials can help promote diversity in these trials and ensure a sufficient number of eligible volunteers, both of which will increase the benefits of challenge research. We explore the ethical ramifications of dealing with unfair background (...) conditions of global vaccine injustice to expand medical research, and conclude that international recruitment for COVID-19 human challenge trials can be conducted ethically provided that several robust protections are in place for volunteers. (shrink)

Since the outbreak of the Coronavirus disease 2019 (Covid-19), tremendous efforts have been made by scientists, health professionals, business people, politicians, and laypeople around the world. Covid-19 vaccines are one of the most crucial innovations that help fight against the virus. This paper attempts to revisit the Covid-19 vaccines production process by employing the serendipity-mindsponge-3D creativity management theory. Vaccine production can be considered an information process and classified into three main stages. The first stage involved the (...) processes of absorbing information (e.g., digital data and open science) and rejecting unhelpful information (e.g., misinformation and fake news) for effectively acquiring useful insights. Useful insights were later employed by experts, enterprises, governments, and international organizations through interdisciplinary coordinated efforts for developing vaccines within a short period. Finally, the appearance of multiple types of vaccines enabled more strategic options for vaccine distribution and administration. Findings from this vaccine creativity management process could be used as critical lessons for further improvements of vaccination programs. (shrink)

We ask whether it is reasonable to delay or refuse to take COVID-19 vaccines that have been shown in clinical trials to be safe and effective against infectious diseases. We consider two kinds of vaccine hesitancy. The first is geared to scientifically informed open questions about vaccines. We argue that in cases where the data is not representative of relevant groups, such as pregnant women and ethnic minorities, hesitancy can be reasonable on epistemic grounds. However, we argue (...) that hesitancy is not reasonable if a vaccine has passed well-conducted clinical trials. The second kind of hesitancy is to do with beliefs about the institutions offering a successfully trialled vaccine and the justifiability of cooperating with those institutions. For example, in the UK, distrust of the UK Government or the National Health Service is identified as a factor in the vaccine hesitancy of minority ethnic populations. We ask whether this sort of hesitation is reasonable given normative requirements of fair co-operation, both with those institutions and the wider population. We suggest that the answer is not straightforward. Sometimes the hesitation is unreasonable but understandable. -/- . (shrink)

Reluctance to adopt mask-wearing as a preventive measure is widely observed in many Western societies since the beginning of the COVID-19 pandemics. This reluctance toward mask adoption, like any other complex social phenomena, will have multiple causes. Plausible explanations have been identified, including political polarization, skepticism about media reports and the authority of public health agencies, and concerns over liberty, amongst others. In this paper, we propose potential explanations hitherto unnoticed, based on the framework of epistemic injustice. We (...) show how testimonial injustice and hermeneutical injustice may be at work to shape the reluctant mask adoption at both the societal and individual levels. We end by suggesting how overcoming these epistemic injustices can benefit the global community in this challenging situation and in the future. (shrink)

The global rollout of Covid-19 vaccination has amplified concerns regarding vaccination hesitancy, which presents a formidable challenge for public health authorities. While widespread vaccination is imperative for containing the virus, hesitancy arises from multiple factors, including apprehensions about potential long-term vaccine side-effects and misconceptions about vaccination. This has prompted discussions about the feasibility of mandating Covid-19 vaccination, especially for specific groups like healthcare professionals and the general public. This paper critically examines the tension between a paternalistic approach (...) and individual autonomy, advocating for a balanced strategy that considers both public health imperatives and individual rights. Drawing insights from existing literature, the study emphasizes the need for a nuanced and pragmatic approach to address vaccine hesitancy effectively. (shrink)

Faced with current urgent calls for more trust in experts, especially in high impact and politically sensitive domains, such as climate science and COVID-19, the complex and problematic nature of public trust in experts and the need for a more critical approach to the topic are easy to overlook. Scepticism – at least in its Humean mitigated form that encourages independent, questioning attitudes – can prove valuable to democratic governance, but stands in opposition to the cognitive dependency entailed by (...) epistemic trust. In this paper, we investigate the tension between the value of mitigated scepticism – understood as the exercise of reason-based doubt in a particular domain – and the need for trust in experts. We offer four arguments in favour of mitigated scepticism: the argument from loss of intellectual autonomy; the argument from democratic deficit; the argument from the normative failures of science; and the argument from past and current injustices. These arguments highlight the tension between the requirements for trust and justified scepticism about the role of experts. One solution, which we reject, is the idea that reliance, rather than trust, is sufficient for the purposes of accommodating experts in policy matters. The solution we endorse is to create a ‘climate of trust’, where questioning experts and expertise is welcomed, but the epistemic trust necessary for action upon information which the public cannot obtain first-hand is enabled and encouraged through structural, institutional, and justice-based measures. (shrink)

Contributions to COVID-19 vaccination programmes promise valuable collective goods. They can support public and individual health by creating herd immunity and taking the pressure off overwhelmed public health services; support freedom of movement by enabling governments to remove restrictive lockdown policies; and improve economic and social well-being by allowing businesses, schools, and other essential public services to re-open. The vaccinated can contribute to the production of these goods. The unvaccinated, who benefit from, but who do not contribute to these (...) goods can be morally criticised as free-riders. In this paper defends the claim that in the case of COVID-19, the unvaccinated are unfair free-riders. I defend the claim against two objections. First, that they are not unfair free-riders because they lack the subjective attitudes and intentions of free-riders; second, that although the unvaccinated may be free-riders, their free-riding is not unfair. (shrink)

This article discusses the triage response to the COVID-19 delta variant surge of 2021. One issue that distinguishes the delta wave from earlier surges is that by the time it became the predominant strain in the USA in July 2021, safe and effective vaccines against COVID-19 had been available for all US adults for several months. We consider whether healthcare professionals and triage committees would have been justified in prioritising patients with COVID-19 who are vaccinated above those (...) who are unvaccinated in first-order or second-order triage. Given that lack of evidence for a correlation between short-term survival and vaccination, we argue that using vaccination status during first-order triage would be inconsistent with accepted triage standards. We then turn to notions of procedural fairness, equity and desert to argue that that there is also a lack of justification for using vaccination status in second-order triage. In planning for future surges, we recommend that medical institutions base their triage decisions on principles meant to save the most lives, minimise inequity and protect the public’s trust, which for the time being would not be served by the inclusion of vaccination status. (shrink)

Bioethics, Volume 36, Issue 6, Page 687-698, July 2022.

The rare but severe cerebral venous thrombosis occurring in some AstraZeneca vaccine recipients has prompted some governments to suspend part of their COVID-19 vaccination programmes. Such suspensions have faced various challenges from both scientific and ethical angles. Most of the criticisms against such suspensions follow a consequentialist approach, arguing that the suspension will lead to more harm than benefits. In this paper, I propose a rights-based argument against the suspension of the vaccine rollouts amid this highly time-sensitive (...) combat of COVID-19. I argue that by suspending a vaccine rollout, a government infringes people's right to take the risks they deem worth taking for their health. I also consider four potential objections to my argument and explain why none of them undermines my argument. (shrink)

By 20 October 2021, the U.S. Food and Drug Administration (FDA) had amended its Emergency Use Authorizations for immunocompetent adults who previously received the Pfizer-BioNTech, Moderna, or Johnson & Johnson COVID-19 vaccines. For the 2-dose Pfizer-BioNTech and Moderna vaccines, the FDA permitted a single booster dose for adults aged 65 years or older and adults aged 18 to 64 years at high-risk for severe COVID-19 or at high risk for occupational or institutional COVID-19 exposure. For the single-dose (...) Johnson & Johnson vaccine, the FDA permitted a single booster dose for all adults aged 18 or older. These eligibility schemes were endorsed by the Centers for Disease Control and Prevention shortly after FDA approval. (shrink)

It is widely accepted that a liberal state has a general duty to protect its people from undue health risks. However, the unprecedented emergent measures against the COVID-19 pandemic taken by governments worldwide give rise to questions regarding the extent to which this duty may be used to justify suspending a vaccine rollout on marginal safety grounds. -/- In this chapter, I use the case of vaccination to argue that while a liberal state has a general duty to (...) protect its people’s health, there is a limit to the measures this duty can be used to justify. First, I argue that since every available option involves different risks and benefits, the incommensurability of the involved risks and benefits forbids the prioritisation of a particular vaccine. Second, I argue that given epistemic limitations and uncertainty, policies that favour certain vaccines are not only epistemically ill-founded but also morally unacceptable. I conclude that in a highly uncertain situation such as the unfolding pandemic, the duty a liberal state ought to uphold is to properly communicate the knowns and unknowns to the general public and help people decide which option to choose for themselves. I call this duty the duty to facilitate risk-taking. (shrink)

When hospitals face surges of patients with COVID-19, fair allocation of scarce medical resources remains a challenge. Scarcity has at times encompassed not only hospital and intensive care unit beds—often reflecting staffing shortages—but also therapies and intensive treatments. Safe, highly effective COVID-19 vaccines have been free and widely available since mid-2021, yet many Americans remain unvaccinated by choice. Should their decision to forgo vaccination be considered when allocating scarce resources? Some have suggested it should, while others disagree. We (...) offer a framework for evaluating when it is ethical and briefly discuss its legality in American law. (shrink)

This essay offers a philosophical analysis of the increased rates of hesitancy among Black Americans regarding treatment for Covid-19. I argue that public health researchers have identified epistemic norms pertaining to the credibility and trustworthiness of public health institutions in Black communities. In other words, norms of credibility have developed in Black communities as a result of the mistreatment of Black Americans by public health institutions and organizations. To make this argument, Section 2 argues that the “origin” or (...) historical circumstances regarding the emergence of an institution are salient to the formation of institutional trust. Section 3 develops an account of epistemic normativity as derived from the work of Antti Kauppinen, Miranda Fricker, and Catherine Elgin. Section 4 applies the arguments from the previous sections to show that absent a “clean origin,” norms of credibility regarding institutional functionality have formed in Black communities that have prevented medical treatment for Covid-19. (shrink)

In this paper I argue for the relevance of the philosophy of Hans-Georg Gadamer for contemporary feminist scholarship on epistemic injustice and oppression. Specifically, I set out to argue for the Gadamerian notion of hermeneutical openness as an important hermeneutic virtue, and a potential remedy for existing epistemic injustices. In doing so I follow feminist philosophers such as Linda Martín Alcoff and Georgia Warnke that have adopted the insights of Gadamer for the purpose of social and feminist philosophy. (...) Further, this paper is positioned in relation to a recent book chapter by Cynthia Nielsen and David Utsler in which they argue for the complementarity, and intersecting themes and concerns of Gadamer's hermeneutics and Miranda Fricker's work on epistemic injustice. However, Nielsen and Utsler solely focus on Fricker's conception of epistemic injustice and the two forms of epistemic injustice, testimonial injustice and hermeneutical injustice, that she identifies. In this paper I expand their analysis by considering other forms of epistemic injustice such as wilful hermeneutical ignorance and contributory injustice. Thus, this paper contributes to the budding literature on the relevance of Gadamer's work for the debates pertaining to epistemic injustice and oppression by expanding such analysis to other forms of epistemic injustice, and by further arguing for the strength of Gadamer's work in terms of offering relevant insights for the reduction and remedy of existing epistemic injustices. (shrink)

This article proposes the comparison of two methods of analysis, semiotics, and hermeneutics, to address contemporary issues in ethical and political philosophy, through the study of the phenomenon of epistemic injustice. Conceptualized by Fricker (2007), epistemic injustice is synonymous with the denial of the value of knowledge that an individual possesses because of prejudices about the social group to which he or she belongs or is affiliated. When epistemic injustice is studied in the empirical world, it poses (...) some crucial issues in terms of interpreting the meaning that the individual gives to the experience of injustice that he or she experiences. Although the interpretation of injustice is central to the understanding of the phenomenon itself, little research in ethical and political philosophy addresses these aspects, because of the failure to sufficiently mobilize analytical methods such as semiotics and hermeneutics. However, these two methods, usually used in other fields to deal with these aspects, allow us to question the treatment and the interpretative scope of the epistemic injustice by the different interlocutors involved in the interaction in which it is reconducted. The comparison of these two methods in the analysis of epistemic injustice finally allows us to argue in favor of the hermeneutic method, as defined by Gadamer and rethought by Code (2003), to enhance Gadamer's legacy through the analysis of ethical and political issues in human sciences research. (shrink)

Monetary incentives to increase COVID-19 vaccinations are widely used. Even if they work, whether such payments are ethical is contested. This paper reviews ethical arguments for and against using monetary incentives that appeal to utility, liberty, civic responsibility, equity, exploitation, and autonomy. It concludes that in low-income nations and nations with meagre safety nets and income inequality, policy-makers should proceed with caution.

Some placebo-controlled trials can continue ethically after a candidate vaccine is found to be safe and efficacious.

With the limited initial availability of COVID-19 vaccines in the first months of 2021, decision-makers had to determine the order in which different groups were prioritized. Our aim was to find out what normative approaches to the allocation of scarce preventive resources were embedded in the national COVID-19 vaccination schedules. We systematically reviewed and compared prioritization regulations in 27 members of the European Union, the United Kingdom, and Israel. We differentiated between two types of priority categories: groups that (...) have increased infection fatality rate (IFR) compared to the average for the general population and groups chosen because their members experience increased risk of being infected (ROI). Our findings show a clear trend: all researched schedules prioritized criteria referring to IFR (being over 65 years old and coexisting health conditions) over the ROI criteria (eg occupation and housing conditions). This is surprising since, in the context of treatment, it is common and justifiable to adopt different allocation principles (eg introducing a saving more life-year approach or prioritizing younger patients). We discuss how utilitarian, prioritarian, and egalitarian principles can be applied to interpret normative differences between the allocation of curative and preventive interventions. (shrink)

The net benefit of vaccinating children is unclear, and vulnerable people worldwide should be prioritised instead, say Dominic Wilkinson, Ilora Finlay, and Andrew J Pollard. But Lisa Forsberg and Anthony Skelton argue that covid-19 vaccines have been approved for some children and that children should not be disadvantaged because of policy choices that impede global vaccination.

We argue that the universal recommendations against “off-label” pediatric use of approved COVID-19 issued by the FDA, CDC, and AAP are overbroad. Especially for higher-risk children, vaccination can be ethically justified even before FDA authorization or approval – and similar reasoning is relevant for even younger patients. Legal risks can also be managed, although the FDA, CDC, and Department of Health and Human Services (HHS) should move quickly to provide clarity.

The case describes researchers who are seeking ethics guidance on communicating with participants in a phase-1 COVD-19 vaccine trial about FDA-authorized COVID-19 vaccines (Wilfond, Duenas, and Johnson 2023). The researchers want help choosing among three options they have identified for encouraging participants to obtain one of the authorized vaccines. We argue that research ethics consultants should consider going beyond this question to address another ethics concern the researchers might have overlooked.

Background: Adequate immunity to COVID-19 apparently cannot be attained in Germany by voluntary vaccination alone, and therefore the introduction of mandatory COVID-19 vaccination is still under consideration. We present findings on the potential acceptance of such a requirement by the German population, and we report on the reasons given for accepting or rejecting it and how these reasons vary according to population subgroup. -/- Methods: We used representative data from the Socio-Economic Panel for the period January to December (...) 2021. We linked the respondents’ answers concerning mandatory COVID-19 vaccination to information about their sociodemographic characteristics, state of health, political attitudes, and degree of confidence in the judicial and political systems. We analyzed these data using univariate, bivariate, and multivariate statistical methods. -/- Results: Just over half of the respondents (50.44% [49.08%; 51.79%]) favored mandatory COVID-19 vaccination. Among the supporters, the reason most frequently given (95.22% [94.45; 96.00]) was that, without such a requirement, not enough people would be vaccinated. Among the opponents of mandatory COVID-19 vaccination (49.56% [48.21%; 50.92%]), by far the most common reason given for opposing it was a desire to uphold individual freedom (91.36% [90.31%; 92.40%]). Persons supporting mandatory COVID-19 vaccination, on average, older than those who opposed it; they less commonly had an education beyond secondary school, were less healthy, tended to have no children, had centrist political views, and expressed more confidence in the political system. The largest difference between the two groups was that about 90% of supporters of mandatory COVID-19 vaccination were themselves vaccinated, compared to only about 62% of opponents. -/- Conclusion: The lack of consensus on this issue among politicians and physicians in Germany is reflected in a similar lack of consensus in the German population as a whole. A discussion of the appropriate understanding of individual freedom would be the most promising way to widen the acceptance of mandatory COVID-19 vaccination. A commonly expressed conception of freedom that permits the deliberate endangerment of other people’s health seems morally questionable. -/- DOI: 10.3238/arztebl.m2022.0174. (shrink)

Conclusion: Needle-free vaccination is a promising technology for the next generation of vaccines, but we found that intramuscular injection was still the most acceptable immunization route in this survey. One major reason might be that most people lack knowledge about needle-free vaccination. We should strengthen the publicity of needle-free vaccination technology, and thus improve the acceptance and coverage of vaccination in different populations.

On the basis of the problem of the possible compulsory nature of vaccines against Covid-19, this paper considers the sources that allow us to justify the imposition of collective measures. The social contract theory provides a rational basis for the universality of ethical and natural law obligations, including conditional respect for a protected domain of individual physical and moral integrity. However, the practical application of the covenant is subject to the uncertainty of what effective consequences the policies have. Ethical (...) principles show the problem of application in the environment of epistemological uncertainty. Only in a free society, with free scrutiny and deliberation, can justified knowledge be achieved that allows social measures to be agreed upon. The characteristics of the case that is the subject of this article lead to the conclusion that Covid-19 vaccines are not ethically obligatory, universally, but they can generate reasoned health measures, promotion, and limitations, based on proven positive effects, as a technical matter. (shrink)

As is the case in other situations of deep uncertainty, the unknowns related to the COVID-19 pandemic have aroused a great deal of attention in the media. Drawing insights both from mediatization theory and ignorance studies, we discuss the coverage of the AstraZeneca vaccine controversies to develop a new concept that we call the mediatization of ignorance. In doing so, we conceptualize the procedure through which unknowns become mediatized as a three-step process that results from a combination of (...) logics from the areas of politics, health, and science/industry. Moreover, we argue that the mediatization of ignorance may have promoted vaccine hesitancy at a moment when vaccination was crucial for addressing the COVID-19 pandemic. We conclude by suggesting the need to explore in further detail the role that ignorance plays not only in the management of the COVID-19 crisis but also in different areas of society. (shrink)

We argue that the ethical case for instituting vaccine benefit programs is justified by 2 widely recognized values: (1) reducing overall harm from COVID-19 and (2) protecting disadvantaged individuals. We then explain why they do not coerce, exploit, wrongfully distort decision-making, corrupt vaccination's moral significance, wrong those who have already been vaccinated, or destroy willingness to become vaccinated. However, their cost impacts and their effects on public perception of vaccines should be evaluated.

This paper presents a comprehensive analysis of the SEIRS COVID-19 pandemic model with saturated incidence rate. By modifying the existing model and proposing a new simplified version, we investigate the dynamics of disease transmission, including the impact of saturation terms on disease spread. Through stability analysis at disease-free and endemic equilibria, we aim to enhance understanding of the spread of COVID-19 and inform effective control strategies. Drawing on mathematical models and epidemiological insights, this study contributes to the ongoing (...) efforts to combat the global pandemic. (shrink)

Introduction: There is currently no binding, internationally accepted and successful approach to ensure global equitable access to healthcare during a pandemic. The aim of this ethical analysis is to bring into the discussion a legally regulated vaccine allocation as a possible strategy for equitable global access to vaccines. We focus our analysis on COVAX (COVID-19 Vaccines Global Access) and an existing EU regulation that, after adjustment, could promote global vaccine allocation. -/- Methods: The main documents discussing the (...) two strategies are examined with a qualitative content analysis. The ethical values reasonableness, openness and transparency, inclusiveness, responsiveness and accountability serve as categories for our ethical analysis. -/- Results: We observed that the decision-making processes in a legal solution to expand access to vaccines would be more transparent than in COVAX initiative, would be more inclusive, especially of nation states, and the values responsiveness and accountability could be easily incorporated in the development of a new regulation. -/- Discussion: A legal strategy that offers incentives to the pharmaceutical industry in return for global distribution of vaccines according to the Fair Priority Model is an innovative way to achieve global and equitable access to vaccines. However, in the long term, achieving the Sustainable Development Goals will require from all nations to work in solidarity to find durable solutions for global vaccine research and development. Interim solutions, such as our proposed legal strategy for equitable access to vaccines, and efforts to find long-term solutions must be advanced in parallel. (shrink)

Ethical considerations play a key role in the proposed frameworks for COVID-19 vaccine allocation. Based on a set of ethical principles, these frameworks make recommendations on those who should be prioritized for vaccination. WHO Strategic Advisory Group of Experts of Immunization (SAGE)1, the National Academy of Medicine (NAM)2, and the Johns Hopkins Center for Health Security (JHCHS)3 have issued frameworks for allocation and prioritization of COVID-19 vaccination. None of these frameworks have made any recommendations as to the (...) prioritization of those who have not yet been infected with SARS-CoV-2 (non-infected group) over those who have been infected previously (infected group). Does this imply that giving priority to the non-infected group is not justified from the ethical perspective of these frameworks? In the following, we review the ethical foundations of these frameworks and show that prioritization of the non-infected group is not only consistent with, but also implied by, these ethical foundations. (shrink)

To achieve herd immunity against Covid-19, the willingness of residents to get vaccinated and successful vaccination policies go hand in hand. This paper aims to understand the perceptions, acceptance, hesitation, and refusal of Covid-19 vaccines in Nghe An, Vietnam. We used an online survey to collect data during March of 2021. The Bayesian regression model (BRM) was used to identify the factors affecting vaccination decisions. The empirical results show that respondents’ livelihoods were considerably affected by the Covid-19 (...) pandemic, and there was a subtle difference in Covid-19 impacts on the lives of urban residents and their rural counterparts. In addition, respondents reported an overall positive attitude towards Covid-19 vaccination in which 84.28% were willing to get vaccinated, 14.85% were hesitant, and 0.87% refused vaccination. Their vaccination decisions were associated with vaccine side effects, information, income, job type, gender, and trust in government. Our findings offer policy implications for devising strategies for vaccine distribution in the study area and beyond. (shrink)

COVID-19 vaccination of children has begun in various high-income countries with regulatory approval and general public support, but largely without careful ethical consideration. This trend is expected to extend to other COVID-19 vaccines and lower ages as clinical trials progress. This paper provides an ethical analysis of COVID-19 vaccination of healthy children. Specifically, we argue that it is currently unclear whether routine COVID-19 vaccination of healthy children is ethically justified in most contexts, given the minimal direct (...) benefit that COVID-19 vaccination provides to children, the potential for rare risks to outweigh these benefits and undermine vaccine confidence, and substantial evidence that COVID-19 vaccination confers adequate protection to risk groups, such as older adults, without the need to vaccinate healthy children. We conclude that child COVID-19 vaccination in wealthy communities before adults in poor communities worldwide is ethically unacceptable and consider how policy deliberations might evolve in light of future developments. (shrink)

Vaccination against various diseases has been widely practised for more than a century and on a more limited scale its use in a variety of forms stretches back far longer. During earlier eras disease spread more slowly along shipping lanes on water and traditional transport routes on land. Today, in an era of air transport, contagion spreads far more rapidly. Travelling far more rapidly (indeed instantaneously) is the spread of misinformation that hinders vaccination which can, in the instance of (...) class='Hi'>Covid-19, reduce disease impacts, including rates of severe illness and death. This paper explores the ethical issue of informed consent in the context of the contest between personal choice and the greater public welfare. It also makes reference to a number of low, middle and high income countries where vaccine hesitance, and to a lesser extent refusal, has been fed by misinformation on a scale not previously observed but made possible by the proliferation of modern technology. This campaign of ignorance has further undermined trust in governmental health bodies and their attempts to implement quarantine and other measures such as vaccination that had already been damaged by early variations and vacillation in governmental approaches around the globe due in part to a reluctance by some governments to take actions that would have economic repercussions but also by the necessary evolution of their approaches as more became known about the disease and its variants. The paper examines the historical background and the current situation and finds that more must be done to restore or increase trust levels between citizens and governmental authorities, including the dissemination of high quality accurate information in a form relevant to readers/viewers. While potential side-effects of vaccines must be disclosed to ensure informed consent, their incidence should also be clearly communicated (e.g., in vaccine information statements) so that clients/patients are aware that a risk is 1 in 100 or 1in 1000 or 1 in 2 million etc. Governments are urged to learn from their experience and better prepare for inevitable future pandemics to minimise vaccine hesitancy and refusal and maximise its acceptance where evidence is overwhelming as to the benefit to the community. Informed consent is part of the context of efforts to use vaccination to contain or eradicate any disease. Nevertheless, while better information for clients/patients/consumers may reduce vaccine hesitancy/refusal, it is unlikely that it would but eliminate the need for mandating vaccination in some circumstances for the benefit of the broader community, although strict quarantine of those reluctant to accept it is an alternative but one not generally accepted by those reluctant to be vaccinated. The information war is one that needs to be won to increase the voluntary uptake of vaccination in the context of voluntary informed consent. (shrink)

This article analyses the phenomenon of epistemic injustice within contemporary healthcare. We begin by detailing the persistent complaints patients make about their testimonial frustration and hermeneutical marginalization, and the negative impact this has on their care. We offer an epistemic analysis of this problem using Miranda Fricker's account of epistemic injustice. We detail two types of epistemic injustice, testimonial and hermeneutical, and identify the negative stereotypes and structural features of modern healthcare practices that generate them. We (...) claim that these stereotypes and structural features render ill persons especially vulnerable to these two types of epistemic injustice. We end by proposing five avenues for further work on epistemic injustice in healthcare. (shrink)

Epistemic injustice has become one of the most widely discussed topics in social epistemology, and has revived interest in issues in the intersections between epistemology and ethics and political philosophy. Much of the impetus for this recent explosion of interest has been the influential work of Miranda Fricker; however, Fricker’s framework and terminology for discussing the phenomena and the kinds of examples she’s interested in has not always been cleanly separated from the phenomena themselves. This chapter examines what’s distinctive (...) of Fricker’s treatment of the phenomena she labels epistemic injustice, focusing on the two varieties that her discussion highlights, testimonial injustice and hermeneutical injustice. Once the distinctive elements of Fricker’s treatment are clearer, we will be better placed to assess which of them are plausible and which implausible, and to consider alternative theoretical frameworks for thinking about the phenomena, such as that developed by Kristie Dotson. (shrink)

Throughout the COVID-19 pandemic, shortages of scarce healthcare resources consistently presented significant moral and practical challenges. While the importance of vaccines as a key pharmaceutical intervention to stem pandemic scarcity was widely publicized, a sizable proportion of the population chose not to vaccinate. In response, some have defended the use of vaccination status as a criterion for the allocation of scarce medical resources. In this paper, we critically interpret this burgeoning literature, and describe a framework for thinking about (...) class='Hi'>vaccine-sensitive resource allocation using the values of responsibility, reciprocity, and justice. Although our aim here is not to defend a single view of vaccine-sensitive resource allocation, we believe that attending critically with the diversity of arguments in favor (and against) vaccine-sensitivity reveals a number of questions that a vaccine-sensitive approach to allocation should answer in future pandemics. (shrink)

Epistemic injustices are wrongs that agents can suffer in their capacity as knowers. In this article, I offer a conceptualisation of a phenomenon I call anticipatory epistemic injustice, which I claim is a distinct and particularly pernicious type of epistemic injustice worthy of independent analysis. I take anticipatory epistemic injustice to consist in the wrongs that agents can suffer as a result of anticipated challenges in their process of taking up testimony-sharing opportunities. I distinguish my account (...) from paradigmatic cases of epistemic injustice, such as Miranda Fricker’s concepts of testimonial injustice and hermeneutical injustice; additionally, I differentiate my view from Kristie Dotson’s account of testimonial smothering. I argue, ultimately, that anticipatory epistemic injustice is a useful addition to our current taxonomy of epistemic injustices, as it has promising explanatory potential for a range of non-standard cases of epistemic injustice. (shrink)

This paper considers the obligation higher income countries have to lower and middle income countries during a global pandemic. Further considers which reforms are needed to the global supply-chain of medical resources. The short-comings in distribution and medical infrastructure have exacerbated the health crisis in developing countries. Global justice demands radical redistribution of medical resources in order to prevent mass casualties. This is argued first by highlighting that the COVID-19 pandemic should be acknowledged as an issue of global justice, (...) secondly, higher income countries ought to account for distribution inequity as a matter of rectifying past injustices, and thirdly argue for reform in distribution while considering the vaccine rollout as a prime example. We aim to show how the differences from country to country in response capabilities are a result of the economic foundation colonialism established and a direct result of cyclical poverty, which wealthy countries perpetuate to this day. (shrink)

Several vaccines against COVID-19 have now been developed and are already being rolled out around the world. The decision whether or not to get vaccinated has so far been left to the individual citizens. However, there are good reasons, both in theory as well as in practice, to believe that the willingness to get vaccinated might not be sufficiently high to achieve herd immunity. A policy of mandatory vaccination could ensure high levels of vaccination coverage, but its legitimacy is (...) doubtful. We investigate the willingness to get vaccinated and the reasons for an acceptance (or rejection) of a policy of mandatory vaccination against COVID-19 in June and July 2020 in Germany based on a representative real time survey, a random sub-sample (SOEP-CoV) of the German Socio-Economic Panel (SOEP). Our results show that about 70 percent of adults in Germany would voluntarily get vaccinated against the coronavirus if a vaccine without side effects was available. About half of residents of Germany are in favor, and half against, a policy of mandatory vaccination. The approval rate for mandatory vaccination is significantly higher among those who would get vaccinated voluntarily (around 60 percent) than among those who would not get vaccinated voluntarily (27 percent). The individual willingness to get vaccinated and acceptance of a policy of mandatory vaccination correlates systematically with socio-demographic and psychological characteristics of the respondents. We conclude that as far as people’s declared intentions are concerned, herd immunity could be reached without a policy of mandatory vaccination, but that such a policy might be found acceptable too, were it to become necessary. (shrink)

For the past three years, Coronavirus-19 (Covid-19) has become one of the major global health problems. Unlike any previous virus in the past decades, Covid-19 has shown its unprecedented spreading speed, infection rate, fatality rate, etc. Under this urgent disease outbursting event, scientists around the globe, through the myriad of research and experiments, successfully developed effective vaccines. However, like many other medical innovations, Covid-19 vaccines are categorized as intellectual properties and a scarce resource. As a consequence, the (...) citizens of developed and developing countries face an imbalanced distribution of affordable vaccines. The formation of this issue is not only due to manufacturing, transportation, and other infrastructures, but also strongly correlated with aspects in the legal field, such as intellectual property rights (IPRs). With a humane common sense of vaccination many people, through comparative research method, this article aims to discuss the conflicts between the global crisis of Force Majeure and the interests of certain countries or corporations, possible solutions to resolve this conflict, and future coping strategies that ought to be published. (shrink)