Compulsory vaccination: yes or no?

If we were to ask the seasoned reader who Edward Jenner was, he would surely not be able to identify this 18th-century English doctor, who may have been one of the men who has saved the most lives. He discovered the vaccine against smallpox and managed not only to eradicate it, but also to put a stop to numerous diseases.

This is what is happening today in the midst of this destructive covid-19 pandemic: one of the most accurate ways to stop it, and even defeat it, are vaccines. But can it be forced to vaccinate the population?

Compulsory vaccination under debate

In December 2021, the president of the european commission, Ursula von der Leyen, asked to open the debate on compulsory vaccination, since only 66% of the total population of Europe was vaccinated, but warned that health competencies fall on the Member States.

In this sense, the disparity in Europe is clear. Compulsory vaccination is being imposed in Austria, in Italy for all people over 50 years of age and Greece for those over 60 years of age.

In Germany, sanctions on the unvaccinated could make them pay more to social security or that the vaccinated have greater tax relief. In France it is mandatory for all its health personnel and the controversy has increased when its president Emmanuel Macron has announced that he is going to piss off to the unvaccinated, limiting their social activity.

The Spain’s vaccination strategy was oriented, from the beginning, along the path of recommendation, the willfulness and the co-responsibility. Especially since there is more than 80% of the total population with the complete guideline and the anti-vaccine groups have very little strength. In addition, some sectors considered that the implementation of such compulsory vaccination could provoke an even more anti-vaccine reaction.

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Indirect obligation

What is clear is that, even if compulsory vaccination is not imposed, a legal status of non-vaccinated can be created that implies the reduction of rights, which is called the conditioning vaccination. This approach makes the vaccination certificate mandatory to function on a day-to-day basis, and therefore means an indirect obligation.

From a legal point of view, the art. 28 of the General Health Law appeals to the principle of voluntary collaboration with the authorities, distinguishing between what is legally possible and what is necessary, as the principle of proportionality reminds us.

And it is that there is a general interest behind the desirable generalization of vaccines. The more citizens are vaccinated, the better the health of the population understood as the sum of individuals. In addition, there will be fewer illnesses and, therefore, the pressure on hospitals and health professionals will improve, and it will have less impact on the workplace and production, on the economy in general.

From an ethical point of view, is it possible to require this vaccination? Why is there so much resistance to vaccination in some countries? The answers can be diverse.

an individualistic society

Our society is characterized by a deep individualism, a pre-eminence of the principle of autonomy and personal freedom, in opposition to another very important principle that is that of “solidarity” and “fraternity”.

Individual autonomy has its limits:

  • The first of these, damage to third parties: any action that harms third parties or the interests of third parties must be prohibited by the State;

  • The second, that autonomy is always relational. We are linked, social beings, we do not live in isolation, and it is precisely those links and relationships that make true autonomy possible. And individual rights have to be confronted with the rights of others, there are no absolute rights.

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Getting vaccinated, in the current circumstances of massive contagion, should be considered a “moral obligation”, in addition to a display of civility and responsibility.

This is not a unique case: there are many areas of Medicine in which we are forced to accept treatments, especially when there is a risk to public health, as stated by the Law 41/2002, on patient autonomy, in its art. 9.2.a); or when we are forced to get vaccinated if we want to travel to certain countries.

In fact, rather than focusing on compulsory nature, the debate that should prevail today is that of the equitable access to covid-19 vaccination around the planet, which is crucial to mitigate the disproportionate morbidity and mortality of this disease and the production of new variants.

Let’s finish with one quote by E. Jenner:

“I will do my best to continue this research, research that I trust will not be merely speculative, but of sufficient thrust to inspire the pleasant hope that it will turn out to be something essentially beneficial to humanity.”

That appealing to freedom does not make the efforts of so many in vain.

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