This dissertation explores the idea and ethics of vaccination for the sake of others. It conceptually distinguishes four different kinds of vaccination—self-protective, paternalistic, altruistic, and indirect—based on who receives the primary benefits of vaccination and who ultimately makes the vaccination decision. It describes the results of focus group studies that were conducted to investigate what people who might get vaccinated altruistically think of this idea. It also applies the different kinds of vaccination to ethical issues surrounding COVID-19, such as lockdown (...) measures, routine or mandatory vaccination of healthy children, and the ethical justification of restrictive measures for unvaccinated people. A more general philosophical account of vaccination ethics is ultimately developed, which is based not on moral duties, but on the moral reasons that people may have to get vaccinated for the sake of others. It is argued that such reasons may be stronger or weaker, depending on various factors related to the vaccines in question and the specific epidemiological circumstances. (shrink)

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In several countries, governments have implemented so-called ‘COVID passport’ schemes, which restrict access to venues such as bars or sports events to those who are vaccinated against COVID-19 and/or exempt vaccinated individuals from public health measures such as curfews or quarantine requirements. These schemes have been the subject of a heated debate. Concerns about inequality have played an important role in the opposition to such schemes. This article highlights that determining how COVID passports affect equality requires a much more nuanced (...) analysis than is typically assumed. I identify a range of broadly egalitarian considerations that could be affected by the introduction of COVID passport schemes. While these schemes could undermine certain aspects of equality, I argue that they could also be used to promote equality. The magnitude and severity of these different effects, both promoting and undermining equality, depend on how precisely these schemes are framed and the local context in which they are implemented. (shrink)

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Effective public health responses to many infectious diseases require sustained collective action. Communicable disease control in populations can only be achieved by high levels of public compliance with health directives. However, governing authorities have limited options if public compliance is insufficient and collective action is failing. Mechanisms to promote public compliance occur on a spectrum from providing public health advice, offering incentives so people cooperate more, to enacting coercive public health orders and mandates. Because the burdens and benefits of these (...) interventions have patterned distributions across society and raise questions of fairness and legitimacy, they have ethical dimensions. Against the background of government responses to COVID-19, we draw on Amatai Etzioni’s compliance mechanisms to analyse the ethics and politics of using state power to drive collective action during public health emergencies. We show how different compliance mechanisms have been applied simultaneously and strategically and that the political and ethical impacts of their interaction warrant particular attention. When considering the adoption of compliance strategies, at the level of individuals and groups, it is important to recognise that intervention uptake will vary based on the threat faced, the characteristics of the population and communities, and local capacity to implement strategies. The use of compliance mechanisms during COVID-19 is also instructive. Significant preparatory work to enculture more restrictive social norms and high levels of public compliance must be undertaken immediately if efforts to sustain collective action against pressing global health problems such as global heating and antimicrobial resistance are to be successful. (shrink)

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