Covid-19 has quickly become the most urgent health crisis faced worldwide since the 1918 Spanish flu pandemic. The Covid-19 pandemic has, to date, infected 51.2 million people and killed 1.27 million people worldwide.[1] In the United States alone, 1.3 million people have been infected and 240 thousand people have died.[2] An end to Covid-19 can only be possible with the arrival of a vaccine.[3] As Dr. McMillan stated in her presentation, pharmaceutical companies have stopped previous research trials to put all of their resources into formulating a vaccine. However, there is the issue as to whether or not a Covid-19 vaccine can be mandated while upholding the principles of bioethics. Logistically, mandating a vaccine might prove unrealistic, as evidenced by the reluctance of a large part of our population that refuse to wear state mandated masks. There is also another part of the population that is concerned about the legitimacy of a Covid-19 vaccine that has been pushed through trials so quickly. While my opinion can only be hypothetical for these reasons, I believe that a mandated Covid-19 vaccine upholds the three principles of bioethics: autonomy, beneficence, and justice.

 

Autonomy is commonly known as the respect for persons principle, or more clearly defined as self-rule that is free from both limitation and control. One may argue that mandating a vaccine is a direct violation of bodily autonomy. However, in all 50 states, there are varying laws mandating that children cannot attend schools without receiving specific vaccines.[4] There are medical, religious, and even personal exemptions to vaccines, but these exemptions are rare. Per the CDC, in the 2018-2019 school year, 94.7% of all kindergarten-age children received the immunizations required to attend school in their state.[5] Mass immunizations required by schools have eradicated numerous childhood diseases. Autonomy should not only concern protecting one’s body, but rather about protecting all bodies. Mandating vaccines in schools protects the bodily autonomy of the student body as whole. If schools mandate the Covid-19 vaccine, this would be a start to ensuring the bodily autonomy of the whole population in the future.

 

Beneficence is defined as bringing the most benefit to the population and preserving welfare to the most reasonable extent. A mandated Covid-19 vaccine will bring the most benefit to not only the high-risk population, but the population as a whole. According to the CDC, 45.4% of the US adult population is considered high risk for Covid-19 due to chronic conditions.[6] This is almost half of the adult population in the United States. Health care workers face high exposure to the virus every day. Between the months of March and May, up to 6% of all Covid-19 hospitalizations across 13 states were health care workers.[7] A mandated vaccine will provide the benefit of relief to the health care workers who put their lives in danger to care for their patients.

 

Justice is the focus on the fair distribution of social goods in a society. Here, the good which requires distribution is the Covid-19 vaccine. Mandating a vaccine means that all members of a society must have access to it. Covid-19 disproportionately affects minorities and those of lower socioeconomic status.[8] This demographic has less access to health care, creating the possibility of members of this demographic being forced to pay for the vaccine out of pocket. Besides mandating the vaccine, I believe that justice includes providing the vaccine to this disproportionately affected demographic at little to no cost.

 

Although logistically unrealistic, the best way to uphold the principles of bioethics and bring a complete end to the Covid-19 pandemic is through a mandated vaccine. A mandated vaccine will uphold bodily autonomy, bring the most benefit to the population, and provide justice through its distribution to all.

[1] The New York Times, “Covid World Map: Tracking the Global Outbreak,” The New York Times, 11 November 2020, https://www.nytimes.com/interactive/2020/world/coronavirus-maps.html

[2] The New York Times, “Covid in the U.S.: Latest Maps and Case Count,” The New York Times, 11 November 2020, https://www.nytimes.com/interactive/2020/us/coronavirus-us-cases.html.

[3] Anita Heywood, “Elimination of Covid-19: what would it look like and is it possible?” The Lancet, 6 August 2020, https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(20)30633-2/fulltext.

[4] CDC, “Vaccination Laws,” CDC, U.S. Department of Health & Human Services, 28 February 2018, https://www.cdc.gov/phlp/publications/topic/vaccinationlaws.html.

[5]  Ranee Seither et al., “Vaccination Coverage with Selected Vaccines and Exemption Rates Among Children in Kindergarten – United States, 2018-19 School Year,” CDC, U.S. Department of Health & Human Services, 17 October 2019, https://www.cdc.gov/mmwr/volumes/68/wr/mm6841e1.htm#suggestedcitation.

[6]  Mary Adams et al., “Population-Based Estimates of Chronic Conditions Affecting Risk for Complications from Coronavirus Disease, United States,” CDC, U.S. Department of Health & Human Services, 19 July 2020, https://dx.doi.org/10.3201/eid2608.200679.

[7] Reed Abelson, “Nurses are at High Risk for Covid Among Health Care Workers, C.D.C. Says,” The New York Times, 26 October 2020, https://www.nytimes.com/2020/10/26/health/covid-nurses-.html.

[8] Carlos Del Rio, “Covid-19 and its Disproportionate Impact on Racial and Ethnic Minorities in the United States,” Contagion Live, 14 August 2020, https://www.contagionlive.com/view/covid19-and-its-disproportionate-impact-on-racial-and-ethnic-minorities-in-the-united-states.

Upholding the Principles of Bioethics with a Mandated Covid-19 Vaccine 

This article was written by Bioethics Minor student Katherine Hansen

Katherine Hansen is a second year undergraduate student at Loyola Marymount University, pursuing her Bachelors in Psychology with a Minor in a Bioethics.

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