لخّصلي

Introduction

Vaccines are one of the most effective tools for protecting people against COVID-19.Consequently, some governments and organizations have made COVID-19 vaccination 'mandatory' to increase vaccination rates, discharge what are perceived to be duties of care to at-risk populations and/or achieve public health goals.Although interfering with individual liberty or autonomy does not necessarily make a policy intervention unjustified, policies that constrain or eliminate individual choice can be controversial and raise a number of ethical considerations, and so they should he justified by advancing another valuable social goal, like protecting public health.This document identifies and articulates important ethical considerations that should be explicitly evaluated and discussed through ethical analysis by governments and/or institutional policy makers who may be considering mandates for COVID-19 vaccination.This document updates a policy brief initially published in April 2021 in response to changes in the COVID-19 vaccine landscape, including authorization of vaccines for children and additional information about, and experiences with, vaccination mandates for COVID-19.For instance, in many parts of the world, people are required to wear seatbelts, motorists with poor visual acuity are required to wear corrective lenses, restaurant owners are required to regularly submit to food service inspections and medical asssessments are required for certain jobs.Vaccination mandates can be ethically justified; however, their ethical justification is contingent upon a number of conditions and considerations, including the contexts within which they are implemented.Typically, mandatory vaccination policies permit limited number of exceptions, such as medical contraindications that are recognized by legitimate authorities (3).What does "mandatory vaccination" entail? Contemporary forms of "mandatory vaccination" make vaccination a condition of, for example, working in particular jobs or settings such as health care, attending school or participating in certain activities (2).Governments and institutions also have a history of requiring vaccination a condition for working in certain settings/roles or attending school..The aim of the document is to identify and articulate salient ethical considerations so that policy makers may engage with them; it does not aim to fully explain or address these ethical considerations and issues.Such policies can be ethically justified, as they may be crucial to protect the health and well-being of the public.This value, however, may come into tension with others, such as individual liberty and autonomy (i.c., allowing individuals to make their own decisions about their health) //).Governments and institutions mandate many actions or types of behaviour to protect the well-being of the public.Others may be considering whether they ought to do the same, and, if so, under what conditions, for whom, and in what contexts.

Introduction

Vaccines are one of the most effective tools for protecting people against COVID-19. Consequently, some governments and organizations have made COVID-19 vaccination 'mandatory' to increase vaccination rates, discharge what are perceived to be duties of care to at-risk populations and/or achieve public health goals. Others may be considering whether they ought to do the same, and, if so, under what conditions, for whom, and in what contexts.

Governments and institutions mandate many actions or types of behaviour to protect the well-being of the public. For instance, in many parts of the world, people are required to wear seatbelts, motorists with poor visual acuity are required to wear corrective lenses, restaurant owners are required to regularly submit to food service inspections and medical asssessments are required for certain jobs. Governments and institutions also have a history of requiring vaccination a condition for working in certain settings/roles or attending school.. Such policies can be ethically justified, as they may be crucial to protect the health and well-being of the public. This value, however, may come into tension with others, such as individual liberty and autonomy (i.c., allowing individuals to make their own decisions about their health) //). Although interfering with individual liberty or autonomy does not necessarily make a policy intervention unjustified, policies that constrain or eliminate individual choice can be controversial and raise a number of ethical considerations, and so they should he justified by advancing another valuable social goal, like protecting public health.

Vaccination mandates can be ethically justified; however, their ethical justification is contingent upon a number of conditions and considerations, including the contexts within which they are implemented. This document identifies and articulates important ethical considerations that should be explicitly evaluated and discussed through ethical analysis by governments and/or institutional policy makers who may be considering mandates for COVID-19 vaccination. The aim of the document is to identify and articulate salient ethical considerations so that policy makers may engage with them; it does not aim to fully explain or address these ethical considerations and issues. This document updates a policy brief initially published in April 2021 in response to changes in the COVID-19 vaccine landscape, including authorization of vaccines for children and additional information about, and experiences with, vaccination mandates for COVID-19.

What does "mandatory vaccination" entail?

Contemporary forms of "mandatory vaccination" make vaccination a condition of, for example, working in particular jobs or settings such as health care, attending school or participating in certain activities (2). Typically, mandatory vaccination policies permit limited number of exceptions, such as medical contraindications that are recognized by legitimate authorities (3). Despite its name, "mandatory vaccination" is rarely compulsory, i.c., people are not forced to be vaccinated. In other words, there is a difference between saying 'you must be vaccinated' and 'you must be vaccinated in order to.... Still, mandatory vaccination policies constrain individual choice in non-trivial ways, for example, by carrying consequences that make noncompliance challenging. Vaccination mandates are not uncommon (2), although it should be noted that the World Health Organization (WHO) docs not presently support the direction of mandates for COVID-19 vaccination, having argued that it is better to work on information campaigns and making vaccines accessible (4). In addition, WHO has issued a position statement that national authorities and conveyance operators should not require COVID-19 vaccination as a condition of international travel (5).

Laws and the legal justifications for mandatory vaccination differ by jurisdiction (6). Yet, what is ethical or ethically obligatory cannot and should not necessarily be reduced to what the law entails because not all that is ethical is legal, and vice versa.