To impose vaccination or not?

Last April, House Bill No. 9252 or the COVID-19 Vaccination Program Act of 2021 was proposed to make vaccination mandatory in order to address the majority of Filipinos’ reluctance (about 60 percent) to receive it. Can a person be forced to take the anti-COVID-19 vaccine against her will for the common good?

The main issue here is respect for personal autonomy, the right of every human being to chart her course, including the right to decide what can and cannot be done to one’s body. From here springs the right to informed consent due to each competent patient in a medical situation. Although the doctor professionally prescribes to the patient the medical options to manage the illness, it is the latter who ultimately deserves to make the final decision. The patient, not the doctor. She must factor in her personal beliefs, values, and circumstances in order to make her crucial decision. Only the patient can decide what happens to her body because she alone will bear whatever the consequences of her decision, beneficial or harmful.

However, the respect for her and her decision is not absolute. It must be balanced with another value, the common good or the greater good. For example, what if she has the deadly Ebola virus infection, requiring her isolation, but she rejects self-isolation and continues her usual daily routine meeting many people despite her infective condition?

It is the same with refusing vaccination with the anti-COVID-19 vaccine. The vaccine offers the opportunity for herd immunity, which will never be reached if many individuals reject the vaccine due to their personal reason or another. Although the individual’s reason may be personally important, it may still be less valuable than the common good that can be attained by enforcing the vaccination program.

However, the end can never justify the means. We have already witnessed how coercion and violence, supposedly undertaken in the name of the common good—managing our national “shabu” problem, for instance—have resulted in disaster, in human rights abuses. Indeed, history has repeatedly seen lives sacrificed on the altar of the common good.

All this, therefore, boils down to a conflict of values: personal autonomy versus public safety. And a problematic dilemma results from insisting on choosing one value over the other. But, why not compromise and settle for striving to have both values duly promoted? Trusting in God and our God-giftedness, we can still find rational and creative ways to solve our problems without resorting to coercion and violence. We can protect public health and still respect, and thus protect, human rights, which include the respect for personal autonomy. We can aim for herd immunity and still protect the right to decidedly accept or reject vaccination.

How do we do this? First, by focusing on vaccinating the 40 percent who are willing to be vaccinated. Realistically, the vaccines entering the country are arriving slowly and, thus, at present, are limited in availability. Such precious and promising antidotes should, therefore, be given first to those who welcome them. Filipinos deemed more prioritized for vaccination, but who refuse it, can be skipped from their prioritized position in the vaccination list.

The only way we can convince the remaining reluctant 60 percent is to persuade them through education and, especially, by showing them the worthwhile benefits of the vaccine to be manifested by the 40 percent who would have already gone ahead of them. Even if those vaccinated earlier will not be perfectly free from undesired vaccination side effects, they will prove that the risks or unwanted harm are minimal and worth the greater benefit that the vaccines have provided. By the time the still needed but later-

coming vaccines arrive, the remaining vaccination-reluctant population may have been convinced by then to receive their shots as well, even if this has to happen gradually, but at least steadily. Thus, coercion and manipulation are never considered or utilized, since persuasion is the only moral means to promote vaccination.

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Fr. Robbie Sian, SJ, is a medical doctor. He has a Masteral Degree in Bioethics from Loyola Marymount University, USA, and now teaches in Cagayan de Oro City.