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Why vaccines should be compulsory

Imagine we develop a vaccine against the coronavirus (COVID-19). Suppose the vaccine has some very small chance of some serious side effects, for instance seizures. However, this vaccine can save millions of lives globally, in the same way as other vaccines do. You are the prime minister and you have to decide whether to make the vaccine compulsory. You know that many people are opposed to vaccines and especially compulsory vaccination. They would not vaccinate even if failure to vaccinate enough people would result in a pandemic that would kill millions of people worldwide and devastate the world’s economy. They think that the state should have no business in telling us what should go into our bodies, that vaccines are harmful, that infectious diseases are no riskier than vaccines, and that the claims about the COVID-19 outbreak have been exaggerated or even made up to promote compulsory vaccination campaigns by Big Pharma.

The example at this point is no longer purely hypothetical, unfortunately. Even now, as the coronavirus pandemic is getting worse and worse and killing an increasing number of people every day, there are those who would not want to vaccinate against COVID-19 if this vaccine was available, for all these reasons. One of us wrote a short article three years ago defending mandatory vaccination policies. As the latest contagion started spreading in the US, people started commenting on that article again, suggesting that this virus is a scam and that various people have engineered it to boost pro-vaccine campaigns. For instance, someone wrote: “What a crock (…) this is from 2017 and three years later Italy is right up there with S Korea and China for Coronavirus cases. Yeah that crap doesn’t work”. Other comments are more explicit.

Now let’s jump back in time. Suppose you are the prime minister in the early 1990s. You are dealing with a different public health problem: the very high number of victims of car accidents. Cars are not as safe as they would be in 20 or 30 years (no airbags, no anti-lock brake systems, and so on). However, some other countries have started introducing seat belt requirements. You look at the figures and you see that seat belt requirements significantly reduce the number of injuries and deaths from car accidents. For example, it is estimated that risk of death is reduced by 45% and risk of serious injury by 50% in a country like the United States. However, you know that many people are opposed to seat belt mandates, because they think that the state has no business in telling us what risks we can take for ourselves and for our children, that it is not true that seat belts improve safety, and that seat belt requirements are the result of lobbying from the seat belt industry. You might be a bit more surprised than in the case of vaccination to learn that also this example is not purely hypothetical; this is precisely what happened when seat belt requirements were introduced between the ’80s and the ‘90s.

Vaccines are like a seat belt against infectious diseases, and that vaccination mandates are justified for the same reasons seat belt mandates are. Actually, the justification is stronger when it comes to vaccine mandates. If you fail to buckle up yourself or your child, you are putting yourself and your child at unnecessary risk, and perhaps other people at some small risk too (for instance, those who are not buckled up in the back seat are more likely to kill or injure those in the front seat in case of accident). But if you fail to vaccinate yourself or your children there is a much larger risk of harming other people who are not vaccinated (for example those who are immunosuppressed, young children or those whose immunity has waned over time), besides imposing an easily preventable risk on you and your children.

Now, here is the elephant in the room. Vaccines might entail some small risks. For instance, it seems that in very rare circumstances (one to two cases per million doses) the flu vaccine could cause Guillain-Barré Syndrome, although the evidence is not clear and the cases are so few that it is difficult to provide a statistical estimate.

And here is where the analogy with seat belt requirements becomes very effective. Seat belts, in rare circumstances, can cause injuries and even deaths that would not have occurred if people had not been buckled up. Sometimes the dynamics of car accidents are such that people would be better off without seat belts, e.g. when seat belts prevent them from getting out of the car fast enough to avoid drowning or fire. And there are injuries that form a specific injury profile labelled “seat belt syndrome,” which can be serious and require surgery.

And yet, the vast majority of people support seat belt mandates and eagerly buckle up these days. Wearing seat belts has become not only a legal requirement, but also a social norm in the vast majority of countries. And this is how it should be, because seat belts do save many lives. As vaccines do, in spite of very small risks, in both cases. Injuries from car accidents are way more common and way more likely to be lethal than injuries from seat belt use. And in the same way, many infectious diseases, such as measles, are way more likely to harm and to kill than vaccines.

If the very small risks of seat belts are not a good enough reason against seat belt requirements, then the very small risks of vaccines are not a good enough reason against mandatory vaccination.

Featured Image Credit: ‘Empty vehicle bench seat’ by Therese Mikkelsen Skaar. CCO public domain via Unsplash.

Recent Comments

  1. Lily

    I ain’t havin’ it, cuz. I would rather DIE.

  2. Iak

    No. Not when people like Bill Gates are determined to microchip and electrionically track the entire human population with his ID2020 manifesto.

    I’d rather get COVID19 than be forced to put my body and trust into the Big Pharma industry.

    The vast mjaority of people who get COVID19 recover. There is absoutely no need for a vaccination against this.

  3. John Stone

    Vaccines are not like seat belts. If a seat belt has a faulty design this may become mechanically evident all too soon. By comparison with vaccines it is very easy to deny harm from victims or their families. Every time we see a column like this from bio-ethicists they are manifestly simply supporting the reputation of the industry, and ignoring human concerns, and it is in itself merely a demonstration of technocratic prejudice, and self assertion. But vaccines are inadequately tested and there is much ambiguity over their safety – even many professionals are sceptical.

    https://www.bmj.com/content/365/bmj.l4291/rr-37

    The extraordinary technical difficult of producing a safe/effective COVID-19 vaccine has already been acknowledged

    https://www.pnas.org/content/early/2020/03/27/2005456117

    but even one comes to fruition in time to make any difference it will with certainty not have been tested for very long and in the main on relatively young healthy people who would likely handle the disease well anyway. It is hard for example to imagine cancer patients volunteering.

    All I see here are simplistic and one-sided ethical arguments about the best of all vaccines in the best of all possible worlds.

  4. Marc

    This article is disgusting propaganda. Vaccines destroy more lives than they save.

    The idea that injecting (among many other poisons) mercury, aluminum and cells from aborted fetuses could in any way help the immune system is absolutely bonkers. Nature doesn’t need the help.

    And perhaps even more importantly, we should all, ALL, have the right to reject having something injected into our bloodstream. That surely should not even be up for debate.

    I will not consent to any vaccination, even if it means losing my job, and like the other posters above, I would rather get Covid or even death.

    We have to take a united stand.

  5. John Stone

    Dr Giubilini, Prof Savulescu

    It is problematic that this blog does not accept any reasoned debate (that is unless my previous submission ended up accidentally in the spam). It is obviously reckless to be already endorsing products to the point of them being made compulsory (with huge commercial and governmental interests behind them) which have not yet even been developed, as well airily sweeping aside all criticism of extant vaccine products.It is also evident that many professional conflicts might exist within the Oxford Martin School in promoting the commercial success of vaccination and vaccine products.

    If you can only assert that vaccines are safe as a class then we are not dealing with the reality of human fallibility. Moreover, the failure to entertain such discussion will only increase the danger. If people cannot raise the issue of harm without coming under ad hominem attack it poses the gravest questions, which cannot be settled by simply suggesting the existence of good intentions.

    So far you have posted three negative comments but what they do not do is require sensible response. I request this.

  6. vinu Arumugham

    Vaccines are contaminated with numerous viral proteins (including coronavirus proteins) because they use excipients derived from infected animals.
    COVID-19 severity is most likely the result of IgE mediated sensitization to such coronavirus proteins.
    Please see details in my comment posted in the Annals of Internal Medicine:

    Please see comments section:

    https://annals.org/aim/fullarticle/2764199/use-hydroxychloroquine-chloroquine-during-covid-19-pandemic-what-every-clinician

    Remember the Dengvaxia disaster?
    https://www.sciencemag.org/news/2019/04/dengue-vaccine-fiasco-leads-criminal-charges-researcher-philippines

    Remember the Pandemrix induced narcolepsy disaster?
    https://www.bmj.com/content/363/bmj.k4152

    If vaccines were safe, there would be no need for mandates.

  7. Linda Margaret Cameron

    I will never consent to any vaccine. Far healthier – biologically and economically – to let nature do her work and provide real, robust, herd immunity immunity with zero cost burden on economies “forced” to pay billions thinking they are dependent on vaccine manufacturers. Natural immunity circulated throughout the population protects the elderly and sick. Those immunocompromised due to drug treatments or HIV are more at risk from vaccine shedding than a population with natural immunity. Our body is built for defence but not everyone can live forever vaccine or no vaccine. This seems to be difficult for many people to accept.

    The article cites the usual debunked seat belt clap trap. To my knowledge using a seat belt does not cause permanent changes to bodily chemistry or release aluminium and other toxins into our bloodstream and brain, nor do seat belt manufacturers use aborted human tissue in manufacturing process. Seat belts are inert, vaccines the opposite.

    Additionally only ONE seat belt is required to hold us into a seat – we are not faced with a plethora of risk mixing seat belts as we are from vaccine drug interactions. No vaccine has been tested for reactivity when added to all the other “recommended” vaccines on the burgeoning schedule or tested on the immunosuppressed or sick.

  8. w p

    A seat-belt is a non-invasive intervention that can be cast aside at any moment.

    A vaccine is an invasive intervention that can not be undone once it has been done.

  9. Celia

    Comparing a seatbelt to a vaccine makes this whole article unworthy of anyone’s time no matter if someone is pro vaccine or against. People are not fools and writing an article like this is taking people for fools. So no thanks.

  10. Emily

    No! It should not be complulsory!
    I ended up in Hospital after my Flu shot at work back in 2010!
    It weakened my immune system so much that I picked up 2 other viruses literally by that night I could barley Breath & was on Hospital the next day!
    The Nurses told me that directly after your Flu shot or vaccine your immune system is bbq instantly weakened while busy creating antibodies the inactive virus they jabbed in me. That flu I got after flu shot was one of the worst I had ever gotton. My Arm also bruised & was tender for about a week. I got the Flu alot that Year too! Im 33 never had another flu shot since 2010 & Iv had 2 colds in 20 Years! I eat very healthy & focus on building my immunity, Ginger Tumeric, Sage, Greens, Ocean, Meditation. No no no I AM NOT TAKING IT!!! No way. So many people will get bad reactions like swine flu VAX it will be rushed plus they dont bloody work (on me anyway). What would you do if YOU had a fatal reaction to COVID 19 Vax???? What if your body shuts down? What will you do then? Research everything to the Bone & Stay Smart.

  11. adrian boliston

    You cannot compare a vaccine to a seatbelt as driving a car is something people choose to do, so if you don’t drive you don’t need a seatbelt – it’s like saying you need a gun licence to own a gun yet you can choose to not own a gun

  12. Chris

    There was obviously going to be someone profiting from that Covid 19 crisis. This is very well staged and set up. There are medicines readily available to people who have developed symptoms of this virus so they get back on their feet but governments refuse to make it public as they cost very little. (see professor Raoult) The media and government cannot be trusted. There are certainly too big financial interests at stake. Governments will buy the vaccine when it’s ready and the taxpayer once again will pay for it.

  13. […] the only “reasonable” endgame for living anything like a free life is either or both enforced vaccination and constant registered surveillance, or who for partisan political reasons want to make 2020 so […]

  14. […] in which the only "reasonable" endgame for living anything like a free life is either or both enforced vaccination and constant registered surveillance, or who for partisan political reasons want to make 2020 so […]

  15. […] the only “reasonable” endgame for living anything like a free life is either or both enforced vaccination and constant registered surveillance, or who for partisan political reasons want to make 2020 so […]

  16. […] the only “reasonable” endgame for living anything like a free life is either or both enforced vaccination and constant registered surveillance, or who for partisan political reasons want to make 2020 so […]

  17. […] the only “reasonable” endgame for living anything like a free life is either or both enforced vaccination and constant registered surveillance, or who for partisan political reasons want to make 2020 so […]

  18. Rzenx

    Hello everyone. I have few questions. Why is it ok to protests against no right to abortion saying my body is my choice but its insanity to do the same about vaccines?
    Second question concerns the idea of mandatory vaccines. People are told that those who would object to be vaccinated would impose a threat to the rest of the society. My question is why and how if those who choose to be vaccinated will be protected? If the vaccine works like its said to work then those who choose to be protected will be safe with no threat and rest who would choose not to be would only threat themselves. Therefore why isnt it freedom of the same kind as “my body my choice”?
    Thanks in advance

  19. john do

    false equivilance, A seatbelt has no risks. A seatbelt isnt a viral cocktail with cultured human and fetus cells. Seatbelts dont need to be studied for decades to observe consequences. Its nit even close to being a seatbelt. We are losing sovereignty over our own bodies and medical treatment. If this was the best argument you coukd make for vaccines then you shouldnt be writing articlrs

  20. Joe

    You said that maybe 2 in 1 million could have bad effects, I would say probably more but even with that low number if everyone in the world took the vaccine then it would still cause more harm than this virus has.

  21. Elias

    Vaccine logic doesnt work , if you take it and you are safe (apparently) why are scared from someone who doesnt have it?the one who doesnt have it should be scared not the other way round.

  22. Most stupid comparison I have ever seen, comparing vaccines to seat bealts, ridiculous

  23. Jt Kong

    Adverse events following immunisation (AEFIs), including death, are not rare and can occur despite the best care. It is possible for people to suffer AEFIs even if full attention is paid to the guidelines for the manufacture, storage and distribution of vaccines, and even if the selection of recipients and the technique of vaccination are appropriate.

    Indian Journal of Medical Ethics, [S.l.], v. , n. , p. 93, apr. 2017. ISSN 0975-5691.

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