ANOTHER ARCHIVE: The Ethics of Vaccine Mandates
Just remembered another article that needs an archival copy since AllInOhio has been restructured
Originally published in Sept 2021… enjoy!
The Ethics of Vaccine Mandates
By Cathy Stein, Ph.D., and Michelle Cotterman, RN, CNHP
It seems every day a new employer, university, service provider, etc. decides to mandate the COVID-19 vaccine. Some of these places offer religious and/or medical exemptions, but make it nearly impossible to get them.
For people who choose to make their own medical decisions independently from proclamations from the CDC and Dr. Fauci, these are scary times.
Earlier this year, the Ohio Legislature passed HB244 with an amendment which makes it illegal for public schools/universities to mandate a vaccine product which has not received FDA approval. The law does not apply to private schools/universities. Governor DeWine signed it into law on June 23, 2021 and it takes effect on October 13, 2021. There remains confusion regarding the recent FDA approval of the Pfizer vaccine product and what implications this may have on HB244 and mandates. According to the FDA the Pfizer product COMIRNATY was approved on August 23, 2021 for those 16 years of age and older. The currently used Pfizer product Pfizer-BioNTech COVID vaccine remains under Emergency Use Authorization (EUA) for those 12 years of age and older. EUA products are experimental under U.S. law and both Pfizer products, despite one being FDA approved and being the same formula, remain legally separate and continue to be shielded from liability by the federal government under the 2005 Public Readiness and Preparedness Act. The question remains if HB 244 will protect public college bound students if the FDA approved COMIRNATY is not available for consumption, but rather the experimental EUA Pfizer BioNTech vaccine.
But we need to back up and ask ourselves, despite the question of legality, are these mandates ethical? Are they consistent with basic principles of medical ethics?
To answer that question, we interviewed Dr. Alvin Moss, M.D., FACP, FAAHPM, the Director of the West Virginia University Center (WVU) for Health Ethics and Law at the West Virginia University Health Sciences Center in Morgantown, West Virginia.*
According to Dr. Moss, mandated vaccines violate basic principles of biomedical ethics. These include respect for patient autonomy, bodily integrity, and patient privacy. Interested readers can read more in the Principles of Bioethical Ethics by Beauchamp and Childress, currently in its 8th edition. When an employer is requesting information on your medical history (which includes vaccination status), and is requiring vaccination as a condition of employment, patient privacy and bodily integrity, respectively, are clearly violated.
Informed consent is a “basic paradigm of the exercise of autonomy” according to Beauchamp and Childress, and one of the key components of informed consent is voluntariness. Coercion occurs when an overt or implicit threat of harm is intentionally presented by one person to another in order to obtain compliance. Undue influence, by contrast, often occurs through an offer of an excessive or inappropriate reward or other overture in order to obtain compliance. Both coercion and undue influence violate voluntariness. Both are being used by employers when they mandate vaccines and threaten termination if the employee does not yield to the mandate. The other component of informed consent that is being violated, according to Dr. Moss, is a discussion of risk and benefits of the medical procedure (vaccine). While the media certainly elaborates on the benefits, there is not enough information on the risks. There are not enough data to make an appropriate decision, and it is very possible that the benefits are being overstated and risks understated, according to Dr. Moss. A recent evaluation of the informed consent forms from the COVID-19 vaccine trials does not clearly outline the risks of the experimental vaccine
“Good ethics starts with good facts” Dr. Moss said. VAERS collects information on adverse reactions to the COVID-19 vaccine, and contrary to what popular media says, between two-third and three-fourths of these reports come from reputable sources. It is also known to be underreported. A good example of this are two papers published in JAMA showing the rate of anaphylaxis post vaccination. The first paper from the CDC showed that anaphylaxis was rare, but in a second paper by authors from a Harvard-affiliated hospital only a few months later, the reported rate was 50 times higher.
This raises a very simple question: If vaccine mandates violate basic medical ethics, then how are these vaccine mandates being allowed and even promoted by hospital systems? Dr. Moss proposed two paradigms that seem to be prevailing in our culture. First, he posed the idea that “public health ethics supersedes all other ethics”. This follows the idea that “our lives are at stake” according to health authorities like the CDC, so that extreme measures are necessary. However, this paradigm falls apart when one understands that the vaccine is not preventing transmission and is waning in efficacy. First, the vaccine trials were not designed to determine if the vaccines prevented transmission. Second, there are several recent studies showing that vaccine efficacy is quickly and markedly waning. For example in Israel, a study in June and early July cited an effectiveness rate of 64%, which is already quite a bit lower than the ~94% originally cited by Pfizer, and then a follow-up study just 2 weeks later cited an effectiveness rate of only 39%. A study of healthcare workers in California showed this same waning of effectiveness over time, starting at 90% in March and falling to 65% in July. This Public Health England report showed that the death rate was actually higher in vaccinated individuals. A CDC study of a COVID-19 outbreak in Massachusetts showed that 74% of the cases were fully vaccinated. A surveillance study in Wisconsin during July also showed comparable viral loads in vaccinated and unvaccinated individuals, and detection of “infectious virus” in the sample from an asymptomatic, fully vaccinated individual. There are many similar examples in the literature and public health data. For these reasons, according to Dr. Moss, the justification for mandates at this time based on the supremacy of public health ethics over the basic principles of medical ethics with the current outcomes of SARS-CoV-2 vaccines fails.
The second paradigm, according to Dr. Moss, is the argument for “community ethics.” This is the mantra that “we are all in this together” and seems to disregard personal responsibility when it comes to protecting one’s health. However, this paradigm falls apart for the same reasons that the argument for public health ethics overriding respect for patient autonomy and bodily integrity falls apart, as described above. And given that the infection fatality rate is far below 1%, it isn’t clear that this qualifies as an “emergency”. Again, as stated by Dr. Moss, “we need good facts” to drive these policies.
In closing, Dr. Moss remarked how we “need to go back to first principles” when it comes to ethics. Also, he harkened back to how “personal liberty is why we formed this country.” Those seeking to violate personal rights with mandates in the name of “public health” are violating the central tenets of the founding of this nation, and their arguments are not supported by the evidence.
*Dr. Moss’s opinions are his own and not those of his employer.
Dr. Cathy Stein is a Professor of Epidemiology and has studied infectious diseases for 20 years. Michelle Cotterman is an RN who has cared for chronically ill patients for 14 years and is also a Certified Natural Health Professional. Their views are their own and not those of their employers.