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Tuesday, December 5, 2023

COVID-19 vaccination mandate needs “strong justification” and fairness, experts argue

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Mandatory vaccination proposals must be backed by “strong justification”, and less restrictive avenues to increase uptake must be “meaningfully attempted” first, according to authors of an article published by the Medical Journal of Australia.

Professor Julie Leask and colleagues from the Collaboration on Social Science in Immunisation, wrote that a range of issues must be considered before COVID-19 vaccine mandates were introduced.

“Because they are more coercive than other interventions to increase vaccination coverage, mandates demand stronger ethical justification,” Leask and colleagues wrote.

“Policy makers should balance rights of individuals and the promotion of public good whilst carefully considering the epidemiological, programmatic, and legal issues.”

The authors outlined the following prerequisites for a successful and fair mandate:

  • The mandate should be legal – in most settings it must have legislative support. Fair Work Australia provides general guidance in workplace settings;
  • The burden of disease should be high enough to justify a mandate;
  • The mandated vaccines must be safe – “Governments need to operate a no-fault vaccine injury compensation scheme to compensate those required to vaccinate in the rare occurrence of a serious adverse event”;
  • The vaccines should reduce transmission – “more justifiable when vaccinating one person helps protect others around them”;
  • Vaccine supply should be sufficient and access easy – “A penalty for not vaccinating when the government has failed to meet its service delivery obligations is unjust”;
  • Less restrictive and trust-promoting measures should come first;
  • The type of mandate should not penalise the poor unfairly – “Mandates should not compound disadvantage”;
  • Those mandating need to plan and support implementation – “systems for documenting and retrieving evidence of vaccination are essential”; and,
  • Affected populations should be considered in planning – “All mandates must include exemptions for those with a valid medical reason”.

“Addressing these considerations in ways that are procedurally just can ensure that outcomes are fairer and more trusted,” Leask and colleagues concluded.

“Mandate decisions that are careful and responsive to context are more likely to avoid social harms while, ideally, helping to achieve a public good.”

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