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This open access book discusses individual, collective, and institutional responsibilities with regard to vaccination from the perspective of philosophy and public health ethics. It addresses the issue of what it means for a collective to be morally responsible for the realisation of herd immunity and what the implications of collective responsibility are for individual and institutional responsibilities. The first chapter introduces some key concepts in the vaccination debate, such as ‘herd immunity’, ‘public goods’, and ‘vaccine refusal’; and explains why failure to vaccinate raises certain ethical issues. The second chapter analyses, from a philosophical perspective, the relationship between individual, collective, and institutional responsibilities with regard to the realisation of herd immunity. The third chapter is about the principle of least restrictive alternative in public health ethics and its implications for vaccination policies. Finally, the fourth chapter presents an ethical argument for unqualified compulsory vaccination, i.e. for compulsory vaccination that does not allow for any conscientious objection. The book will appeal to philosophers interested in public health ethics and the general public interested in the philosophical underpinning of different arguments about our moral obligations with regard to vaccination.
A comprehensive overview of important and contested issues in vaccination ethics and policy by experts from history, science, policy, law, and ethics. Vaccination has long been a familiar, highly effective form of medicine and a triumph of public health. Because vaccination is both an individual medical intervention and a central component of public health efforts, it raises a distinct set of legal and ethical issues—from debates over their risks and benefits to the use of government vaccination requirements—and makes vaccine policymaking uniquely challenging. This volume examines the full range of ethical and policy issues related to the development and use of vaccines in the United States and around the world. Forty essays, articles, and reports by experts in the field look at all aspects of the vaccine life cycle. After an overview of vaccine history, they consider research and development, regulation and safety, vaccination promotion and requirements, pandemics and bioterrorism, and the frontier of vaccination. The texts cover such topics as vaccine safety controversies; the ethics of vaccine trials; vaccine injury compensation; vaccine refusal and the risks of vaccine-preventable diseases; equitable access to vaccines in emergencies; lessons from the eradication of smallpox; and possible future vaccines against cancer, malaria, and Ebola. The volume intentionally includes texts that take opposing viewpoints, offering readers a range of arguments. The book will be an essential reference for professionals, scholars, and students. Contributors Jeffrey P. Baker, Seth Berkley, Luciana Borio, Arthur L. Caplan, R. Alta Charo, Dave A. Chokshi, James Colgrove, Katherine M. Cook, Louis Z. Cooper, Edward Cox, Douglas S. Diekema, Ezekiel J. Emanuel, Claudia I. Emerson, Geoffrey Evans, Ruth R. Faden, Chris Feudtner, David P. Fidler, Fiona Godlee, D. A. Henderson, Alan R. Hinman, Peter Hotez, Robert M. Jacobson, Aaron S. Kesselheim, Heidi J. Larson, Robert J. Levine, Donald W. Light, Adel Mahmoud, Edgar K. Marcuse, Howard Markel, Michelle M. Mello, Paul A. Offit, Saad B. Omer, Walter A. Orenstein, Gregory A. Poland, Lance E. Rodewald, Daniel A. Salmon, Anne Schuchat, Jason L. Schwartz, Peter A. Singer, Michael Specter, Alexandra Minna Stern, Jeremy Sugarman, Thomas R. Talbot, Robert Temple, Stephen P. Teret, Alan Wertheimer, Tadataka Yamada
Parents in the US and other societies are increasingly refusing to vaccinate their children, even though popular anti-vaccine myths – e.g. ‘vaccines cause autism’ – have been debunked. This book explains the epistemic and moral failures that lead some parents to refuse to vaccinate their children. First, some parents have good reasons not to defer to the expertise of physicians, and to rely instead upon their own judgments about how to care for their children. Unfortunately, epistemic self-reliance systematically distorts beliefs in areas of inquiry in which expertise is required (like vaccine immunology). Second, vaccine refusers and mainstream medical authorities are often committed to different values surrounding health and safety. For example, while vaccine advocates stress that vaccines have low rates of serious complications, vaccine refusers often resist vaccination because it is ‘unnatural’ and because they view vaccine-preventable diseases as a ‘natural’ part of childhood. Finally, parents who refuse vaccines rightly resist the utilitarian moral arguments – ‘for the greater good’ – that vaccine advocates sometimes make. Unfortunately, vaccine refusers also sometimes embrace a pernicious hyper-individualism that sanctions free-riding on herd immunity and that cultivates indifference to the interpersonal and social harms that unvaccinated persons may cause.
Natural disasters and cholera outbreaks. Ebola, SARS, and concerns over pandemic flu. HIV and AIDS. E. coli outbreaks from contaminated produce and fast foods. Threats of bioterrorism. Contamination of compounded drugs. Vaccination refusals and outbreaks of preventable diseases. These are just some of the headlines from the last 30-plus years highlighting the essential roles and responsibilities of public health, all of which come with ethical issues and the responsibilities they create. Public health has achieved extraordinary successes. And yet these successes also bring with them ethical tension. Not all public health successes are equally distributed in the population; extraordinary health disparities between rich and poor still exist. The most successful public health programs sometimes rely on policies that, while improving public health conditions, also limit individual rights. Public health practitioners and policymakers face these and other questions of ethics routinely in their work, and they must navigate their sometimes competing responsibilities to the health of the public with other important societal values such as privacy, autonomy, and prevailing cultural norms. This Oxford Handbook provides a sweeping and comprehensive review of the current state of public health ethics, addressing these and numerous other questions. Taking account of the wide range of topics under the umbrella of public health and the ethical issues raised by them, this volume is organized into fifteen sections. It begins with two sections that discuss the conceptual foundations, ethical tensions, and ethical frameworks of and for public health and how public health does its work. The thirteen sections that follow examine the application of public health ethics considerations and approaches across a broad range of public health topics. While chapters are organized into topical sections, each chapter is designed to serve as a standalone contribution. The book includes 73 chapters covering many topics from varying perspectives, a recognition of the diversity of the issues that define public health ethics in the U.S. and globally. This Handbook is an authoritative and indispensable guide to the state of public health ethics today.
At the World Health Assembly in May 1980, the World Health Organization declared the world free of smallpox. Smallpox vaccination of civilians is now indicated only for laboratory workers directly involved with smallpox or closely related orthopox viruses. However recent questions raised by the terrorist attacks in fall 2001 have renewed concerns about possible outbreaks of smallpox resulting from its use as a biological weapon. In June 2002, the Institute of Medicine convened a public conference to discuss the scientific, clinical, procedural, and administrative aspects of various immunization strategies. Scientific and Policy Considerations in Developing Smallpox Vaccination Options summarizes the presentations and discussions from this workshop.
Vaccines are among the most safe and effective public health interventions to prevent serious disease and death. Because of the success of vaccines, most Americans today have no firsthand experience with such devastating illnesses as polio or diphtheria. Health care providers who vaccinate young children follow a schedule prepared by the U.S. Advisory Committee on Immunization Practices. Under the current schedule, children younger than six may receive as many as 24 immunizations by their second birthday. New vaccines undergo rigorous testing prior to receiving FDA approval; however, like all medicines and medical interventions, vaccines carry some risk. Driven largely by concerns about potential side effects, there has been a shift in some parents' attitudes toward the child immunization schedule. The Childhood Immunization Schedule and Safety identifies research approaches, methodologies, and study designs that could address questions about the safety of the current schedule. This report is the most comprehensive examination of the immunization schedule to date. The IOM authoring committee uncovered no evidence of major safety concerns associated with adherence to the childhood immunization schedule. Should signals arise that there may be need for investigation, however, the report offers a framework for conducting safety research using existing or new data collection systems.
Public health ethics is a discipline concerned with the health of the public or a population as a whole, rather than focusing on the individual. This book introduces a number of this new field's central concepts and explores the key and controversial issues arising. Topics covered include the nature of public health ethics, the concepts of disease and prevention, risk and precaution, health inequalities and justice, screening, vaccination and disease control, smoking and issues relating to the environment and public health. With insightful contributions from leading experts, Public Health Ethics presents thought-provoking reviews of these topics, at the same time as encouraging and identifying areas for future discussion in this emerging discipline. This is a valuable addition to the library of anyone working in the fields of public health, health policy, ethics, philosophy and social science.
The Vaccine Book, Second Edition provides comprehensive information on the current and future state of vaccines. It reveals the scientific opportunities and potential impact of vaccines, including economic and ethical challenges, problems encountered when producing vaccines, how clinical vaccine trials are designed, and how to introduce vaccines into widespread use. Although vaccines are now available for many diseases, there are still challenges ahead for major diseases, such as AIDS, tuberculosis, and malaria. This book is designed for students, researchers, public health officials, and all others interested in increasing their understanding of vaccines. It answers common questions regarding the use of vaccines in the context of a rapidly expanding anti-vaccine environment. This new edition is completely updated and revised with new and unique topics, including new vaccines, problems of declining immunization rates, trust in vaccines, the vaccine hesitancy, and the social value of vaccines for the community vs. the individual child's risk. - Provides insights into diseases that could be prevented, along with the challenges facing research scientists in the world of vaccines - Gives new ideas about future vaccines and concepts - Introduces new vaccines and concepts - Gives ideas about challenges facing public and private industrial investors in the vaccine area - Discusses the problem of declining immunization rates and vaccine hesitancy
This first comprehensive history of the social and political aspects of vaccination in the United States tells the story of how vaccination became a widely accepted public health measure over the course of the twentieth century. One hundred years ago, just a handful of vaccines existed, and only one, for smallpox, was widely used. Today more than two dozen vaccines are in use, fourteen of which are universally recommended for children. State of Immunity examines the strategies that health officials have used—ranging from advertising and public relations campaigns to laws requiring children to be immunized before they can attend school—to gain public acceptance of vaccines. Like any medical intervention, vaccination carries a small risk of adverse reactions. But unlike other procedures, it is performed on healthy people, most commonly children, and has been mandated by law. Vaccination thus poses unique ethical, political, and legal questions. James Colgrove considers how individual liberty should be balanced against the need to protect the common welfare, how experts should act in the face of incomplete or inconsistent scientific information, and how the public should be involved in these decisions. A well-researched, intelligent, and balanced look at a timely topic, this book explores these issues through a vivid historical narrative that offers new insights into the past, present, and future of vaccination.