Washington D.C., Aug 28, 2020 / 13:01 pm
With more than 1,000 deaths a day still being registered in the United States, coronavirus vaccines are being developed, and tested at speed. Ahead of an effective vaccine being found, some government officials have broached the possibility of mandatory vaccinations-prompting ethical and legal questions.
Governments, as a general principle, have the authority to mandate vaccinations when the public health requires it, one ethicist said.
"In principle, when there's a public health emergency, and there's reason to believe that a vaccine is crucial to overcoming that emergency, the government does have the authority to mandate vaccination," said Dr. Melissa Moschella, a philosophy and ethics professor at The Catholic University of America.
"That's been done in the past, and at times that can be a reasonable and legitimate thing to do," she told CNA.
Last Friday, Virginia's health commissioner Dr. Norman Oliver told News 8 that he would require all citizens in the state to receive a COVID vaccine if one is reliably produced.
"We would not launch a campaign around mass vaccination with anything that hasn't proven to be safe," Oliver told News 8 last week.
However, a spokesperson for the state's governor Ralph Northam told News 8 on Monday that the administration has not yet decided to mandate a vaccine, instead relying on citizens of the state to receive one voluntarily.
A state vaccine mandate during a public health emergency would actually be constitutional, provided that it is applied evenly and that the situation is grave enough to require it, said Richard Garnett, a constitutional law professor at the University of Notre Dame.
"State governments have much broader powers over their states than the federal government does under the federal constitution," Garnett said of state "police" power.
"It's difficult to say much that's true across-the-board, except to say that, as a general matter, state governments have the power to regulate in the interest of the public health, and that does include requiring vaccines," he said.
However, a government mandate should be avoided if a less-coercive means of ensuring public health are available, Moschella said.
"If coercion would be the only way to enable society to kind of move forward, rather than being severely limited by concerns about the spread of COVID-19 as we have been," she said, "then there could be a justification for that."
However, she said, "the non-coercive route is clearly the preferable one."
Furthermore, exemptions should be granted that "respect other fundamental rights of individuals," she said, such as exemptions for people with high medical risks, and religious or conscientious objections to receiving a vaccine.
However, religious exemptions to a vaccine mandate would not be automatic under the U.S. constitution.
"There is not a federal constitutional right to opt out of a vaccine requirement," Garnett said.
Rather, the possibility of receiving a religious exemption to a vaccine mandate might depend on where one lives. States vary as to the extent of their religious freedom protections, and many states have more narrow religious free exercise protections in their constitutions than those granted in the first amendment of the federal constitution, Garnett said.
In Virginia, for instance, only a medical exemption is granted by law to a vaccine mandate during a public health emergency. Two bills to allow for religious exemptions were defeated in the state legislature this week.
Catholics may have "reasonable concerns" against receiving a COVID vaccine once one is produced and distributed, Moschella said, such as concerns about rushed production or lack of testing.
President Trump said in his acceptance speech at the Republican National Convention this week that a coronavirus vaccine would be ready by the end of the year or sooner, while public health officials have cautioned that one may not be ready until several months into 2021.
In July, the president of the National Catholic Bioethics Center, Joseph Meaney, warned against rushing the development of a coronavirus vaccine. Potential recipients must be well-informed about the risks of the vaccine, and these risks or potential side effects might not be fully known if a vaccine is rushed to market.
"One can also think hypothetically about how coercive measures requiring persons to take a vaccine that has not had the time to be tested thoroughly would be ethically unacceptable," Meaney said.
Legitimate concerns about receiving a rushed vaccine should be weighed against the possibility that the vaccine could help stop the transmission of the virus, Moschella said.
Another question raised about vaccine production is who would get one first, once a coronavirus vaccine is developed.
Pope Francis said Aug. 19 that developed countries should not hoard a coronavirus vaccine at the expense of the developing world, emphasizing that poor people must have access to one if it is distributed.
Moschella stated that "The vaccine is an extremely-important public good. In a way, it's kind of analogous to things like water, clean air, or basic goods to meet peoples' basic needs."
"Without the vaccine, countries can be completely crippled economically, can face devastating death rates, particularly in places where they don't have advanced medical systems or the kinds of resources that we have here, or in Europe," she said, noting that it would be a "terrible injustice" if poorer countries did not have access to a vaccine.
In May, Bishop James Wainaina of Muranga warned against the exploitation of the poor in coronavirus vaccine trials.