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APHA Scientific Session and Event Listing

Recorded presentation

Robert I. Field, JD, MPH, PhD, Health Policy Program, University of the Sciences in Philadelphia, 600 South 43rd Street, Philadelphia, PA 19104, 215-596-7618, r.field@usip.edu

When is it justifiable for government, employers, or schools to mandate vaccination? A growing number of people are resisting vaccination for themselves or their children based on religious, philosophical, and perceived safety concerns. Without a clearly and consistently articulated rationale, public health officials will face increasing difficulty in convincing the public, and perhaps courts, to accept vaccine mandates. This presentation proposes a framework for evaluating vaccine mandates based on competing ethical values. Recognition of a right to refuse vaccination is grounded in respect for individual autonomy. Mandating a vaccine reflects either beneficence in seeking to protect others or utilitarianism in enhancing the common good. As the threat of a disease increases, autonomy decreases in importance relative to the other values. This can be represented graphically as the intersection of lines with opposite slopes, as in the example below. The lines cross at the point where a mandated vaccine is ethically justified. This analysis can provide the ethical foundation for vaccine policy. It also frames legal analysis. Cases addressing the right to refuse vaccinations and other medical treatments have weighed rights to privacy and liberty against public health imperatives. The proposed framework structures this balancing based on underlying ethical values.

Learning Objectives: At the conclusion of the session, the participant will be able to

• Identify the key legal, policy, and ethical parameters governing mandated vaccination in various settings.
• Articulate the ethical values and conflicts that apply to vaccine mandates.
• Assess the ethical status of a mandate for a vaccine depending on the nature of disease threat involved.

Keywords: Ethics, Immunizations

Related Web page: www.bioethics.upenn.edu/vaccines/

Presenting author's disclosure statement:

Any relevant financial relationships? No

Recorded presentation