Vaccinations are an important part of global healthcare, with the NHS and World health Organization (WHO) reporting that they prevent millions of deaths worldwide every year. The NHS further claims that they’re ‘the most effective way to prevent infectious diseases’ and the ‘most important thing we can do to protect ourselves and our children against ill health’.
Across the world we have ‘vaccines to prevent more than 20 life-threatening diseases’ and since their introduction in the UK, ‘diseases like smallpox, polio and tetanus that used to kill or disable millions of people are either gone or seen very rarely’, while ‘other diseases like measles and diphtheria have been reduced by up to 99.9%’.
You can find more information about vaccination and immunisation from the following:
The WHO are clear that vaccines are ‘critical to the prevention and control of infectious-disease outbreaks’. With the ongoing COVID-19 pandemic and the widespread interest in the development and delivery of vaccines to protect against coronavirus, this topic is even more at the forefront. Having an understanding of vaccines and immunisation will support you if you’re asked to discuss them more generally, or you’ll be able to draw upon your understanding of them, if you’re asked specifically about COVID-19.
The following are some wider issues concerning vaccinations and the related ethical considerations:
The NHS provides a wide ranging vaccination programme and recommends what vaccines individuals should have, and at what stage of life, to protect them against infections; you can find this information here. However, vaccinations are not compulsory within the UK and individuals can exercise their right to autonomy, making a decision for themselves (and their children) whether or not to get vaccinated.
The topic of compulsory vaccination is particularly relevant now, as there has been speculation and questions asked about whether vaccines to protect against COVID-19 would be mandatory, and although the British government have specified that this will not be the case, it has raised the debate of whether vaccinations should be. An article in the BMJ provides one take on the debate of compulsory vaccination, with ‘Good reasons to vaccinate: mandatory or payment for risk?’.
However, as we mentioned previously, an individual’s right to make their own decision should be respected, and ‘consent is a fundamental legal and ethical principle’ within the UK. Under the standards set by the General Medical Council (GMC), doctors have a duty to ‘work in partnerships with patients’ and support them to make decisions by ‘sharing with them the information they will need’, but ultimately patients have a right to make their own decision, if they’re able to.
No doubt you’ll be aware of ‘anti-vaccination’ arguments, particularly in relation to the development of coronavirus vaccines, and, in turn, the response of the medical community. There has been some speculation about how this will affect the uptake of coronavirus vaccines and the impact this will have.
In its general information about why vaccinations are safe and important, the NHS warns about ‘anti-vaccine stories [which] are spread online through social media’ and ‘may not be based on scientific evidence’. You may find it useful to explore the dangers of misinformation and how this impacts things like vaccine uptake, to enrich your knowledge and support your discussions, should the question arise at your medical school interview.
Vaccination has a wider impact than simply benefitting an individual who chooses to receive it; it can ‘protect other people in [the] community’ and ‘reduce or even get rid of some diseases – if enough people are vaccinated’.
No doubt you’ve heard references to ‘herd immunity’ in relation to vaccinations. Herd immunity, or community immunity, is when a ‘high percentage of the population is vaccinated’ making it ‘difficult for infectious diseases to spread, because there are not many people who can be infected’. This helps to protect people who cannot have a vaccine, for example those ‘who are ill or have a weakened immune system’.
However, ‘herd immunity only works if most people in the population are vaccinated’. Consider how this relates to the COVID-19 pandemic and the development of coronavirus vaccines: why is recommended that most people have a vaccine when available? How does this contribute to protecting others and preventing the spread of the virus?
As part of the standards set by the GMC, ‘good medical practice’ states that doctors ‘should be immunised against common serious communicable diseases (unless otherwise contraindicated)’; an example of contraindication would if a doctor has underlying health conditions which means a particular vaccine/s would not be suitable.
What are the ethical considerations of this standard? Consider the duties of doctors, for example to protect the health of patients and to put their care first, and implications in terms of their autonomy.
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Ensure that you have a clear understanding of vaccination, including how vaccines work (in general terms) and the importance of them for global healthcare; the following links, which were provided earlier in this section, will support you to achieve this:
An awareness of the most common vaccines provided by the NHS may also support you in your discussion of the topic. The NHS provide information about what vaccines are given in the UK, as well as further advice relating to each, including who are advised to have them and possible side effects.
You may also find it interesting to explore Public Health England’s vaccination timeline, which shows the ‘development and introduction of routine vaccine programmes in the UK’.
If you’re interested in exploring herd immunity further, the ‘Vaccine Knowledge Project’ by the University of Oxford provides more information on this. Likewise the WHO also discusses the topic of herd immunity and discusses it specifically in relation to COVID-19.
Although the coronavirus vaccines have been, and will continue to be, widely discussed in the media, meaning you’ll be well aware of them, ensure that you have a sound, factual understanding. You should refer to the following, to allow you to keep up-to-date with the information, especially as this will continue to change in the coming months:
