There is a great deal of confusion at the moment regarding the question of whether vaccines should be mandatory. Where there is confusion there is opportunity for mischief, or to be biblical about these things, “where there is confusion there is every evil thing” (James 3:16).
The source of this confusion is that term “mandatory” is assumed wrongly to be synonymous with “compulsory”. Although both terms imply restrictions deriving from a rule or order, there is a subtle but crucial distinction between mandatory and compulsory practices.
A rule is compulsory when it justifies the use of force against an individual, whereas it is mandatory when it merely adds a cost to a certain decision, nudging a person towards a certain action.
For example, taxation is compulsory to the extent that someone who does not pay taxes will be forced or compelled to do so. Alternatively, wearing seat belts is mandatory in the sense that there will be a fine imposed on drivers breaking the rule.
This distinction between compulsory and mandatory rules also applies to vaccine policies. Compulsory vaccination is the criminalisation of vaccine refusal. It works on the assumption that a person can be forced to be vaccinated.
Mandatory vaccination is the withholding of valuable social goods or services from those who choose not to be vaccinated. The fact that in certain countries a child’s access to education hinges on compliance with immunisation regulations makes it mandatory, not compulsory.
In Ireland, and across Europe, the debate regarding coronavirus vaccines is strictly about mandatory vaccinations, not compulsory vaccinations. Unfortunately, this distinction is often neglected.
Under mandatory vaccination there is no forceful inserting of a needle in the body of someone without their voluntary informed consent; this would be a violation of someone’s right to their bodily integrity, not to mention the fact that it is against the Nuremberg Code (1947) and the HSE’s National Consent Policy (2017).
Mandatory vaccinations are about the consequences of exercising one’s right not to be vaccinated. Vaccinations are mandatory in the sense that there will be an added cost to not being vaccinated: when someone exercises their right not to be vaccinated, they are also consenting to these consequences.
Contrary to what the anti-vax movement is declaring, mandatory vaccinations are not an infringement of our basic rights. One’s right to choose not to be vaccinated is being respected, although this right does not give anyone the licence to put others at risk.
Under mandatory vaccination a person maintains the right not to be vaccinated, but does not enjoy the right that puts others under a duty to allow unvaccinated people into their restaurants, pubs, or work environments. In certain circumstances this may extend to losing one’s job.
There are hypothetical scenarios where vaccinations could be compulsory, given the gravity of the situation or threat being faced, as in the case of the science-fiction film Contagion (2011). But that is not the case with Covid-19, so there is no need to indulge in whimsical speculation.
However, in the case of Covid-19, there is a strong case for vaccination to be mandatory, at least in theory. That is because the principle of fairness requires that the burden to reach herd immunity be fairly shared among the individual members of the morally responsible collective.
To refuse a vaccine may be a right, but it is also a very selfish act, since a person aims to benefit from the actions of others without contributing towards the common good.
Some people have argued that there are pragmatic reasons why mandatory Covid-19 vaccination may not be advisable, at least in Ireland where more than 90 per cent of adults are already vaccinated.
Those who hold out against coronavirus vaccination are not motivated by science or reason, but by ideological beliefs often grounded on prejudice or imagined conspiracies, which is why trying to influence their rational choice by adding costs to their actions will probably not work.
In fact, it is likely to have the opposite effect by reinforcing their unreasonable stance. These are people who will take any opportunity to entrench their position, and the perceived authoritarian actions of the State presents them with a perfect excuse to dig in their heels.
But mandatory vaccines are not only about convincing anti-vaxxers to reconsider, they are also a signal of gratitude to those who have been vaccinated, and have thus contributed to the common good.
Making vaccinations mandatory is a reminder that as individuals we don’t only have rights, but also duties towards others in society.
Exactly what mandatory measures should be introduced is of course a matter of contention, the devil is always in the detail. Mandatory vaccinations could be as minimal as stipulating a longer isolation period for the non-vaxxed, or at the other end of the spectrum legislation could be introduced so that those whose elective surgery has been postponed can take a civil case against those who refused vaccination but ended up in hospital due to Covid-19.
Somewhere in the middle there is the option of making pubs and stadiums out of bounds to anti-vaxxers – that’s probably what would hurt them the most.
Dr Vittorio Bufacchi is senior lecturer in Philosophy at University College Cork