The Ethics of Vaccination Against Infectious Diseases: The Two Sides of the Coin

Abstract

Vaccination involves the use of killed or attenuated microorganism or its antigenic component such as the protein or toxin to stimulate the body to develop immunity against diseases caused by the organism. This process is believed to be one of the most successful means of infectious disease prevention and control. The public health is saddled with the responsibility of protecting the health of the population and assist with the identification and protection of at-risk individuals as mandated by the State. The success of vaccination is dependent on the attainment of herd immunity within the target population. To achieve and maintain herd immunity, it is expected that about 92-94% of the entire population needs to be immunised. However, there has been reported cases of vaccine failure where some individuals claim to have contracted the disease which, they were vaccinated against. Although vaccine failure does not imply that the vaccines are ineffective but such gaps in meeting the specific purpose of vaccination forms part of the reasons for voluntary vaccine dissension. Vaccination dissenters and critics of mandatory vaccination capitalize on these limitations and other views in their movement against mandatory vaccination policies. Hence, it becomes paramount to answer the question of whether vaccine refusal by some individuals is, a function of harming others or merely not benefitting from such vaccines. This poses an ethical dilemma of whether vaccination should be made compulsory by the State or remain a matter of choice. The concern then is to ethically justify the views of both the State and the individual voluntary vaccine dissenters. Despite the recent breakthroughs in the development of vaccines against certain cancer cells, much emphasis is placed on vaccination against infectious diseases caused by bacteria and viruses which, forms the epicentre of this debate. These ethical issues are examined from diverse perspectives ranging from the principle of beneficence, the autonomy of individuals, duty not to infect others, free riding, virtue ethics, and the exploration of liberalism and the harm principle based on available evidence.