1
|
Youssef A, Ulloa L. Ethical and Legal Debates on Vaccine Infodemics. Cureus 2024; 16:e52566. [PMID: 38371094 PMCID: PMC10874613 DOI: 10.7759/cureus.52566] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/19/2024] [Indexed: 02/20/2024] Open
Abstract
Over the course of three and a half years, the global toll of coronavirus disease 2019 (COVID-19) has claimed the lives of millions of individuals. Scientific breakthroughs, exemplified by mRNA vaccines, have emerged as crucial tools in saving numerous lives and fortifying our defenses against future pandemics. However, the battle against the virus has been complicated by the dissemination of misleading political and ethical information, resulting in avoidable fatalities. Recognizing this phenomenon, the term 'infodemics' has been coined to denote the proliferation of false or misleading information that hinders effective social responses. Given the historical prevalence of infodemics surrounding vaccinations, this discussion delves into the ongoing ethical and legal deliberations concerning vaccination mandates, an indispensable health intervention in the face of pandemics. Governments bear the responsibility of safeguarding their citizens, acknowledging the social requirements imposed by the collective well-being. The protection of both citizens and healthcare workers becomes paramount, considering the potential risks of infection and mortality associated with individuals refusing vaccination. Historically, governments have played a pivotal role in eradicating pandemics through the implementation of vaccine mandates. However, the contemporary landscape is marked by the infusion of political and misleading misinformation, presenting new challenges. Governments are now confronted with an ethical duty to ensure that citizens possess the necessary information to make informed decisions and safeguard their well-being. While grappling with the realization that extraordinary circumstances demand extraordinary responses, the lessons from past pandemics underscore the imperative of prioritizing public health, especially in the context of the high numbers of casualties worldwide. This discourse explores the ethical and legal dimensions surrounding vaccine mandates, with particular emphasis on their relevance to healthcare workers.
Collapse
Affiliation(s)
- Ayman Youssef
- Anesthesiology and Perioperative Medicine, Duke University Medical Center, Durham, USA
| | - Luis Ulloa
- Anesthesiology and Perioperative Medicine, Duke University Medical Center, Durham, USA
| |
Collapse
|
2
|
Matthews R, Menzel K. Vaccine Mandates and Cultural Safety. JOURNAL OF BIOETHICAL INQUIRY 2023; 20:719-730. [PMID: 38165556 DOI: 10.1007/s11673-023-10319-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Accepted: 10/20/2023] [Indexed: 01/04/2024]
Abstract
The issues and problems of mandatory vaccination policy and roll out in First Nations communities are unique and do not concern the safety and effectiveness of vaccines. These issues are also independent of more specific arguments of mandatory vaccination of healthcare workers as a condition of employment. As important as these issues are, they do not consider the complex politics of ongoing settler colonialism and First Nations community relations. In this paper, we also set aside the very real problems of disinformation, hesitancy, scientific and health illiteracy, and other concerns that drive vaccine hesitancy and refusal. These affect all communities, including First Nations communities. We, instead describe the dominant arguments in favour of mandatory vaccination and critique them in terms of the disputed legitimacy of Settler-Colonial decision-making as it impacts First Nations communities. We contend cultural responsiveness and safety-not state compulsion-must remain the first principles of any engagement-including vaccination-with First Nations Peoples, families, and communities.
Collapse
Affiliation(s)
- R Matthews
- Bond University, 14 University Drive, Robina, Queensland, 4226, Australia.
| | - K Menzel
- Southern Cross University, Military Road, Lismore, New South Wales, 2480, Australia
| |
Collapse
|
3
|
Shafik N, Akpo JE, Waterfield KC, Mase WA. COVID-19 Vaccination Hesitancy in Autoimmune Disease Patients: Policy Action and Ethical Considerations. Vaccines (Basel) 2023; 11:1283. [PMID: 37631851 PMCID: PMC10458844 DOI: 10.3390/vaccines11081283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Revised: 07/15/2023] [Accepted: 07/23/2023] [Indexed: 08/27/2023] Open
Abstract
As COVID-19 vaccination guidelines were issued by Advisory Committee on Immunization Practices (ACIP) and the Centers for Diseases Control and Prevention (CDC) across the US, each state and clinical provider instituted vaccine implementation and education policies and protocols for high-risk populations. However, current research has shown that while people with autoimmune diseases were listed by ACIP and CDC as a COVID-19 high-risk population, the rate of adherence to implementation and education protocols, as well as the prioritization of this sub-population as a high-risk group, varied among the clinicians and vaccinators thus impacting the hesitancy towards the COVID-19 vaccine and a correlation to low vaccination rates. The purpose of this review was to explore factors of COVID-19 vaccination hesitancy in people living with autoimmune diseases in relation to current implementation and education policies and protocols, as well as ethical and contextual factors, while providing possible implications. COVID-19 vaccine hesitancy in people living with autoimmune disease was greater than in the general population, as demonstrated by increased levels of overall mistrust and fear of potential risk and harmful side effects. Evidence has shown that COVID-19 vaccination is safe and effective for patients with autoimmune diseases. Additionally, the benefits of COVID-19 vaccination outweigh its potential risks and adverse effects in this population. However, the non-adherence to policy and protocols, especially community education protocols, by those providing the vaccination have a negative impact on the overall perception of the vaccine and needs to be addressed at local and state levels in order to protect this population. Future research should provide strategies to guide collaborative efforts between government and local agencies in providing tailored vaccination campaigns to this population. In parallel with policy, COVID-19 vaccination intervention implementation and educational protocols should be developed with evidence-based guidelines for public health and clinical professionals that are targeted at this vulnerable high-risk population.
Collapse
Affiliation(s)
| | | | - Kristie C. Waterfield
- Department of Health Policy and Community Health, Jiann-Ping Hsu College of Public Health, Georgia Southern University, P.O. Box 8015, Statesboro, GA 30458, USA; (N.S.); (J.E.A.); (W.A.M.)
| | | |
Collapse
|
4
|
Kraaijeveld SR. The Ethical Significance of Post-Vaccination COVID-19 Transmission Dynamics. JOURNAL OF BIOETHICAL INQUIRY 2023; 20:21-29. [PMID: 36542290 PMCID: PMC9768787 DOI: 10.1007/s11673-022-10223-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Accepted: 10/27/2022] [Indexed: 05/04/2023]
Abstract
The potential for vaccines to prevent the spread of infectious diseases is crucial for vaccination policy and ethics. In this paper, I discuss recent evidence that the current COVID-19 vaccines have only a modest and short-lived effect on reducing SARS-CoV-2 transmission and argue that this has at least four important ethical implications. First, getting vaccinated against COVID-19 should be seen primarily as a self-protective choice for individuals. Second, moral condemnation of unvaccinated people for causing direct harm to others is unjustified. Third, the case for a harm-based moral obligation to get vaccinated against COVID-19 is weak. Finally, and perhaps most significantly, coercive COVID-19 vaccination policies (e.g., measures that exclude unvaccinated people from society) cannot be directly justified by the harm principle.
Collapse
|
5
|
Elbarazi I, Yacoub M, Reyad OA, Abdou MS, Elhadi YAM, Kheirallah KA, Ababneh BF, Hamada BA, El Saeh HM, Ali N, Rahma AT, Tahoun MM, Ghazy RM. Exploring enablers and barriers toward COVID-19 vaccine acceptance among Arabs: A qualitative study. INTERNATIONAL JOURNAL OF DISASTER RISK REDUCTION : IJDRR 2022; 82:103304. [PMID: 36193257 PMCID: PMC9519527 DOI: 10.1016/j.ijdrr.2022.103304] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Revised: 07/02/2022] [Accepted: 09/13/2022] [Indexed: 05/26/2023]
Abstract
BACKGROUND With the emergence of the coronavirus disease 2019 (COVID-19) and rapid vaccine development, research interest in vaccine hesitancy (VH) has increased. Research usually focuses on quantitative estimates which largely neglected the qualitative underpinnings of this phenomenon. This study aimed to explore the beliefs and views towards COVID-19 vaccination among Arabs in different countries. Furthermore, we explored the effect of confidence in the healthcare system, misinformation, and scientific approaches adopted to mitigate COVID-19 on how individuals are following the recommended preventative actions including vaccination. METHODS This study was based on the Strategic Advisory Group of Experts (SAGE)-VH Model: A qualitative design that utilized in-depth, online interviews. The study was conducted in seven Arab countries (Egypt, Qatar, Kingdom of Saudi Arabia, Libya, Sudan, United Arab Emirates and Jordan) from June 2020 to December 2021. Transcripts were analyzed using NVivo 12 Software. RESULTS A total of 100 participants, 44 males and 56 females, of different age groups (37.1 ± 11.56 years) were interviewed. Findings revealed six themes as enablers and barriers to COVID-19 vaccination. Many participants indicated trusting the vaccines, the healthcare systems, and the vaccination policies were the main driver to get the vaccine. Participants showed concerns towards potential long-term vaccine effects. A consistent inclination towards collective responsibility, which is the willingness to protect others by own vaccination, was also reported. CONCLUSION Enablers and barriers of COVID-19 vaccination acceptance in the Arab region, from sociocultural and political perspectives, are critical to guide policymakers in designing target-oriented interventions that can improve vaccine acceptance.
Collapse
Key Words
- Arab Countries
- COVID-19
- COVID-19, Coronavirus disease 2019
- ECDC, European Centre for Disease Prevention and Control
- GDP, Gross Domestic Product
- HCWs, Health care workers
- KSA, Kingdom of Saudia Arabia
- LMIC, Low- and middle-income countries
- PI, Principal investigator
- Qualitative
- SAGE
- SAGE, Strategic Advisory Group of Experts on immunization
- SARS-CoV-2
- UAE, United Arab Emirates
- US, United States
- VH, Vaccine hesitancy
- Vaccine acceptance
- Vaccine hesitancy
- WHO, World Health Organization
Collapse
Affiliation(s)
- Iffat Elbarazi
- Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, AlAin, United Arab Emirates
| | - Mohamed Yacoub
- English Department, Florida International University, Miami, FL, USA
| | - Omar Ahmed Reyad
- Internal Medicine and Cardiology Clinical Pharmacy Department, Alexandria Main University Hospital, Alexandria, Egypt
| | - Marwa Shawky Abdou
- Department of Epidemiology, High Institute of Public Health, Alexandria University, Egypt
| | - Yasir Ahmed Mohammed Elhadi
- Department of Public Health, Medical Research Office, Sudanese Medical Research Association, Khartoum, Sudan
| | - Khalid A Kheirallah
- Department of Public Health, Medical School of Jordan University of Science and Technology, Irbid, Jordan
| | - Bayan F Ababneh
- Department of Public Health, Medical School of Jordan University of Science and Technology, Irbid, Jordan
| | - Bayan Abu Hamada
- Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, AlAin, United Arab Emirates
| | - Haider M El Saeh
- Community Medicine Department, Faculty of Medicine, University of Tripoli, Tripoli, Libya
| | - Nancy Ali
- Department of Communication and Media, Indiana University of Pennsylvania, Pennsylvania, USA
| | - Azhar T Rahma
- Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, AlAin, United Arab Emirates
| | - Mohamed Mostafa Tahoun
- Department of Epidemiology, High Institute of Public Health, Alexandria University, Egypt
| | - Ramy Mohamed Ghazy
- Tropical Health Department, High Institute of Public Health, Alexandria University, Egypt
| |
Collapse
|
6
|
Nguyen KH, Irvine S, Epstein R, Allen JD, Corlin L. Prior COVID-19 Infection, Mental Health, Food and Financial Insecurity, and Association With COVID-19 Vaccination Coverage and Intent Among College-Aged Young Adults, US, 2021. Prev Chronic Dis 2021; 18:E101. [PMID: 34914579 PMCID: PMC8718122 DOI: 10.5888/pcd18.210260] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
INTRODUCTION More than 700,000 COVID-19 cases have been linked to American colleges and universities since the beginning of the pandemic. However, studies are limited on the effects of the pandemic on college-aged young adults and its association with their COVID-19 vaccination status and intent. METHODS Using the Census Bureau's Household Pulse Survey (HPS), a large, nationally representative survey fielded from April 14 through May 24, 2021, we assessed the effects of the pandemic (COVID-19 infection, mental health, food and financial security) on COVID-19 vaccination coverage (≥1 dose) and intentions toward vaccination among college-aged young adults in the United States (N = 6,758). We examined factors associated with vaccination coverage and intent, and reasons for not getting vaccinated. RESULTS Approximately one-fifth (19.6%) of college-aged young adults had a previous diagnosis of COVID-19, 43.5% and 39.1% reported having anxiety or depression, respectively, 10.9% reported that they sometimes or often did not have enough food to eat, and 22.6% and 12.3% found it somewhat or very difficult, respectively, to pay for household expenses. Of college-aged young adults, 63.1% had received at least 1 dose of the COVID-19 vaccine, 15.4% probably would be vaccinated or were unsure about getting the vaccine, and 14.0% probably will not or definitely will not get vaccinated. Adults who were non-Hispanic Black (vs non-Hispanic White) or had food or financial insecurities (vs did not) were less likely to be vaccinated or intend to be vaccinated. Among adults who probably will not or definitely will not be vaccinated, more than one-third said that they did not believe a vaccine was needed. CONCLUSION Ensuring high and equitable vaccination coverage among college-aged young adults is critical for safely reopening in-person learning and resuming prepandemic activities.
Collapse
Affiliation(s)
- Kimberly H Nguyen
- Department of Public Health & Community Medicine, Tufts University School of Medicine, 136 Harrison Ave, Boston, MA 02111.
| | - Shannon Irvine
- Department of Public Health & Community Medicine, Tufts University School of Medicine, Boston, Massachusetts
| | - Rebecca Epstein
- Department of Public Health & Community Medicine, Tufts University School of Medicine, Boston, Massachusetts
| | - Jennifer D Allen
- Department of Community Health, Tufts University, Medford, Massachusetts
| | - Laura Corlin
- Department of Public Health & Community Medicine, Tufts University School of Medicine, Boston, Massachusetts.,Department of Civil and Environmental Engineering, Tufts University School of Engineering, Medford, Massachusetts
| |
Collapse
|
7
|
Yu KH, Kohane IS. Framing the challenges of artificial intelligence in medicine. BMJ Qual Saf 2018; 28:238-241. [DOI: 10.1136/bmjqs-2018-008551] [Citation(s) in RCA: 101] [Impact Index Per Article: 16.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2018] [Revised: 08/20/2018] [Accepted: 08/26/2018] [Indexed: 12/18/2022]
|