Global Ethical Considerations Regarding Mandatory Vaccination in Children

Reference

Savulescu, J., Giubilini, A. and Danchin, M., (2021), 'Global Ethical Considerations Regarding Mandatory Vaccination in Children', The Journal of Pediatrics, Vol: 231(April): 10-16 [PMC7817402]

Abstract

Whether children should be vaccinated against coronavirus disease-2019 (COVID-19) (or other infectious diseases such as influenza) and whether some degree of coercion should be exercised by the state to ensure high uptake depends, among other things, on the safety and efficacy of the vaccine. For COVID-19, these factors are currently unknown for children, with unanswered questions also on children's role in the transmission of the virus, the extent to which the vaccine will decrease transmission, and the expected benefit (if any) to the child. Ultimately, deciding whether to recommend that children receive a novel vaccine for a disease that is not a major threat to them, or to mandate the vaccine, requires precise information on the risks, including disease severity and vaccine safety and effectiveness, a comparative evaluation of the alternatives, and the levels of coercion associated with each. However, the decision also requires balancing self-interest with duty to others, and liberty with usefulness. Separate to ensuring vaccine supply and access, we outline 3 requirements for mandatory vaccination from an ethical perspective: (1) whether the disease is a grave threat to the health of children and to public health, (2) positive comparative expected usefulness of mandatory vaccination, and (3) proportionate coercion. We also suggest that the case for mandatory vaccine in children may be strong in the case of influenza vaccination during the COVID-19 pandemic.

Links

Publisher website: https://www.sciencedirect.com/science/article/pii/S0022347621000287

Europe PMC: https://europepmc.org/article/MED/33484698

All OUCs Open Access papers are available on our Open Access webpage

Funders

Wellcome Trust WT203132 [Wellcome Centre for Ethics and Humanities]

Wellcome Trust WT104848 [Responsibility and Healthcare]

UKRI AHRC AH/V013947/1 [Ethics Accelerator]

UKRI AHRC AH/V006819/1 [Ethical Exit Strategy (COVID-19)]