AAt the age of 18 I packed my bags with great enthusiasm and left for what became two years working in a charity hospital boat on the coast of West Africa. Before I left, they gave me a list of the vaccines I needed, including yellow fever, hepatitis B, MMR, and tetanus / diphtheria.
At the time I didn’t think twice about organizing (and paying for) these. It was simply the “vaccine passport” that was needed to travel to these parts of the world. Because I would also work in a healthcare setting, I accepted the vaccines as necessary to protect myself and the patients I would care for.
Twenty-five years later, a new vaccine is added to the standard vaccine list: COVID-19. It is increasingly likely that everyone will have to show proof of our vaccination status against COVID-19 in order to travel, access public events, and perhaps even attend jobs.
Last year’s experiences offer many reasons to use this “vaccine passport” system some people they don’t seem to want to introduce any. Why can this new vaccine be seen differently from the well-accepted and somewhat routine requirement for other vaccines?
Perhaps the first thing to recognize is that hesitation is it is not a new phenomenon. Despite being one of the more effective ways to protect people’s health, the fact of injecting a foreign substance into the body certainly includes concerns.
For this reason, many vaccination programs they are volunteers, health systems prefer to use persuasion rather than the law to get people to take them. In adults, mandatory vaccinations are usually related to specific professions (mainly in the health field) and travel to certain parts of the world.
Given this story, a person who wants to avoid all vaccines would simply choose not to follow certain professions or travel to certain places. This lack of vaccination would not affect other aspects of your life, including access to events or public spaces and travel to many popular holiday destinations.
But with COVID-19, things will probably be different. It is likely that participation in these other activities will also be subject to vaccination status, but is it fair?
The most common understanding of “equity” is related to opportunity. If different people have the same opportunities for something (which could be almost anything), the situation is often considered fair. In relation to this with the passports of the COVID-19 vaccine, it could be considered that justice had the same opportunities to obtain a vaccine and therefore a passport.
In the UK, all adults over the age of 18 have the opportunity to receive a vaccine. When someone can’t (perhaps for a medical reason), a “fair” vaccine passport system should take that into account. A fair system should also allow any type of vaccine approved by the relevant regulator (the UK Medicines and Health Products Regulatory Agency) to count for passport purposes.
According to this idea of fairness, the obvious area of concern would be visitors from other countries with limited opportunities to receive a vaccine. It could legitimately be considered “unfair” if these people were denied entry into the United Kingdom without any mitigating arrangements, such as making vaccination available on arrival in the United Kingdom, followed perhaps by a period of mandatory quarantine.
But some may argue that justice is more than equality of opportunity. What about people who have moral or other objections to vaccination? Is it fair to exclude them too?
When this question is asked, a thought experiment proposed by the American philosopher John Rawls may be useful. The idea is to consider a problem such as vaccine passports, but try to forget about anything that applies to your personal position. From now on “Veil of ignorance”, try to make a decision about what a fair or just deal would be.
In the case of a moral objector to vaccination, this would require the individual to try to discount their own personal reasons for not getting vaccinated and instead think about what would be best for society at large.
Given the incredible damage caused by COVID-19 over the last year or so, it is increasing tests for the tremendous success of vaccines in preventing deaths and mitigating the most serious effects of the disease, the vaccine safety, and equal opportunities to receive a vaccine (certainly in the UK), it would be very difficult to argue against the concept of vaccine passport from a position of veil of ignorance.
Of course, the devil is almost always in the details. A poorly implemented vaccine passport system can still be very unfair and cause unforeseen and undesirable circumstances. There are currently a number of concerns related to the recognition of different types, and even different batches, of COVID-19 vaccines. But in general, it is important to distinguish between arguments about fair implementation and arguments concerning the justice of the concept in general.
Simon Kolstoe, Professor in evidence-based healthcare and university ethics, University of Portsmouth
This article is republished from The conversation under a Creative Commons license. Read the original article.
