Ethical Rights: HCP Refusing COVID-19 Vaccines

When deciding who should receive the vaccine first, healthcare personnel (HCP) were prioritized. This choice aimed to protect those who work with the sick and elderly. However, many workers were hesitant. It was found that nearly 20% of physicians and 33% of nurses had concerns about the vaccine's safety, long-term effects, and effectiveness. They felt the vaccine was new and needed more study. This was a serious issue. If HCP workers did not agree to be vaccinated, they would be putting themselves and others at risk. A normal economic and social life could not be fully restored without vaccinations. This argument can be supported by the four ethical principles outlined by Beauchamp and Childress: autonomy, beneficence, non-maleficence, and justice. Traditionally, medical ethics focused more on individuals rather than the community. However, these traditional frameworks do not always fit public health initiatives, where protecting society comes first. According to J.S. Mill, “The only purpose for which power can rightfully be exercised over any member of a civilized community, against his will, is to prevent harm to others.” When HCP workers refuse the vaccine, it harms the community.

On the other hand, HCP have the right to choose whether to get the vaccine or not. When making this decision, they should consider both the lives of their community and the vaccine’s risks and benefits. Respecting people’s choices doesn’t mean getting the vaccine just to support others. If enforcement is necessary, a clear explanation must be provided.

Eventually, after careful consideration and persuasion, vaccine mandates were implemented for the benefit of society as a whole. These mandates had to be carefully planned, as “unwarranted stringent public health measures degrade public trust.” The first approach was to encourage vaccination through incentives like cash payments or gift cards. Even though vaccines are crucial, some people had respected personal or religious reasons for not getting vaccinated. These mandates were used as a last resort and were implemented by local institutions and state policies.

References:

Mayo Clinic. Diseases and conditions - diseases and conditions - disease and condition information from mayo clinic experts [Internet]. Mayoclinic.org. 2023. Available from: https://www.mayoclinic.org/diseases-conditions 

Sween L, Ekeoduru R, Mann D. Ethics and Pitfalls of Vaccine Mandates. ASA Monitor [Internet]. 2022 Feb 1;86(2):24–5. Available from: https://pubs.asahq.org/monitor/article/86/2/24/118298/Ethics-and-Pitfalls-of-Vaccine-Mandates 

.Olick RS, Shaw J, Yang YT. Ethical Issues in Mandating COVID-19 Vaccination for Health Care Personnel. Mayo Clinic Proceedings [Internet]. 2021 Dec;96(12):2958–62. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8633920/ 

Canning AG, Watson KE, McCreedy KE, Olawepo JO. Ethics and Effectiveness of US COVID-19 Vaccine Mandates and Vaccination Passports: A Review. Journal of Research in Health Sciences. 2021 Oct 31;22(2):e00546–6. 

COVID-19 Vaccination Mandates for School and Work Are Sound Public Policy [Internet]. USC Schaeffer. 2021. Available from: https://healthpolicy.usc.edu/research/covid-19-vaccination-mandates-for-school-and-work-are-sound-public-policy/