Imposing a vaccination mandate could trigger mistrust in government and increase polarisation and anti-vaccination sentiment, a Department of Health report has found.
A paper examining ethical and human rights issues relating to mandatory Covid-19 vaccinations was compiled by the department and found that many countries that have introduced such mandates have experienced civil unrest.
It also found, however, that mandatory vaccination of healthcare workers could represent a “justifiable limitation” of the person’s autonomy “as it ensures the fulfilment of certain professional and ethical responsibilities”.
“In the case of healthcare workers, a legal duty to be vaccinated could be grounded in their moral duties of beneficence and non-maleficence,” the report finds.
However, in a conclusion briefing given to members of the National Public Health Emergency Team (Nphet), the paper says that, in relation to healthcare workers, “less intrusive measures must first be shown to be ineffective before more intrusive measures should be considered”.
“Thus, continued exploration of why some healthcare workers have not taken up the offer of a Covid-19 vaccine as well as an evaluation of the effectiveness of the current measures in place should be undertaken prior to any change in policy.”
Social inequality
The document, dated February 17th, looked at a range of ethical and legal considerations. It was compiled by the department’s chief bioethics officer, Siobhán O’Sullivan.
It found that a vaccine mandate would be likely to disproportionately penalise the most disadvantaged in society and “serve to exacerbate existing social inequalities”.
“While concerns regarding the free-rider aspect are understandable, attaching blame to those who remain unvaccinated for not protecting themselves or indeed others against Covid-19 is not productive, and fails to recognise that decisions regarding vaccine uptake are shaped by social and cultural factors.”
The paper defines free-riders as “those who choose not to be vaccinated but instead rely on population immunity” and therefore eschew the burden while receiving the benefit.
The paper states that mandatory vaccination may potentially interfere with a number of human rights including the right to liberty, to work, to education, bodily integrity, privacy, freedom of movement, freedom of assembly, freedom of religion and the right to equal treatment.
Officials were told that Australia, Belgium, Canada, Croatia, the Czech Republic, Finland, France, Germany, Greece, Hungary, Italy, Latvia, New Zealand, Poland and the US have introduced vaccine mandate for health and social care workers.
Austria became the first European country to introduce mandatory vaccination for all adults, with some exceptions, with fines of €600-€3,600. Austria has one of the lowest vaccination rates in western Europe. Ireland, on the other hand, has one of the highest rates of vaccination in the EU.
