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eleven - A call for clearer vaccine exemption typology to improve population health

Published online by Cambridge University Press:  05 July 2022

Stephen Peckham
Affiliation:
University of Kent
Alison Hann
Affiliation:
Swansea University
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Summary

This chapter explores a central theme in public health ethics, namely, how far it is ethically defensible to use different forms of ‘social influence’ to ensure that individuals comply with immunisation policies that are designed to serve the good of the population. This rests on two main concerns: first, some kind of assessment of the health benefits of vaccination, and second, a consideration of the balance of individual autonomy and the good of the population.

Introduction

Eradicating communicable diseases has been a primary public health goal for centuries, and vaccination programmes comprise a significant part of that population health effort. To achieve community health, public health authorities are bestowed with policing powers whereby individual rights may be sacrificed for the greater good of the population (Mann et al, 1999; Gostin, 2004). However, healthcare providers and scholars are encouraging public health programmes to attain their community health goals through the least coercive and intrusive means possible (Gostin, 2004). The coercive strategies implemented by public health authorities in the past are discouraged today (Mann et al, 1999). Public health strategies that aim to balance individual and community rights and recognise that protecting human rights positively affects individual and population health are preferred (Mann et al, 1999). Despite a history of coercive strategies adopted by public health vaccination programmes, particularly in the US, vaccines have been deemed among the most successful public health interventions (Salmon and Siegel, 2001). However their success has been accompanied by controversy. Anti-vaccination movements have challenged state infringement of bodily integrity and individual rights since the nineteenth century and have been particularly vocal in countries mandating vaccination (Arnup, 1992; Colgrove, 2005; Blume, 2006; Salmon et al, 2006).

As population health threats emerge and as new vaccines are developed to address them, the ethical implications of vaccination programmes (particularly of mandatory vaccines) will be of increasing concern to individuals of all ages, cultures and ethnicities. As public health departments prepare their vaccination programmes for the future, an approach that recognises the importance of protecting individual human rights, as delineated in both the Universal Declaration of Human Rights (UDHR) (United Nations, 1948) and the ‘Siracusa Principles’ (ECOSOC, 1984), is a necessary first step towards ensuring the health of the community.

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Publisher: Bristol University Press
Print publication year: 2009

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