Centre for Biomedical Ethics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
Faculty of Health Sciences, University of Western Ontario, London, Ontario, Canada.
East Mediterr Health J. 2022 Jun 29;28(6):454-458. doi: 10.26719/emhj.22.023.
To reopen society, various countries are planning or have implemented differential public health and social measures (PHSMs) for COVID-19-vaccinated individuals, by exempting these individuals from some of the measures.
To examine the ethical considerations raised by differential PHSMs by differrnt countries based on individual vaccination status verified by vaccination certificates.
Decisions on whether and when measures should be lifted specifically for vaccinated individuals should be guided by scientific and ethical considerations. These considerations include the public health risks of differential lifting, particularly in a context where a substantial portion of society is not vaccinated; mitigation of inequities and unfair disadvantages for unvaccinated individuals; and whether to permit other health certificates or credentials besides proof of vaccination as alternative options to access specific activities or services, as a way to balance public health and freedom of movement.
Vaccination certificates may undermine a population-based approach to COVID-19 vaccination to achieve and accelerate universal lifting of PHSMs, result in unfair and inequitable health and social outcomes, and generate social divisions at a time when solidarity within (and between) countries is necessary to navigate the pandemic and its burdens. Further research on the ethical acceptability and impact of COVID-19 vaccine certificates in countries that have implemented them should be carried out to inform future ethical considerations on this issue.
为了重新开放社会，各国正在计划或已经实施针对 COVID-19 疫苗接种者的差异化公共卫生和社会措施（PHSMs），豁免这些人遵守部分措施。
根据疫苗接种证书验证的个人疫苗接种状况，考察各国实施差异化 PHSMs 所引发的伦理问题。
是否以及何时应专门为接种疫苗的人解除措施，应基于科学和伦理考虑做出决定。这些考虑因素包括差异化解除措施的公共卫生风险，特别是在社会上很大一部分人未接种疫苗的情况下；减轻未接种疫苗者的不公平和不利处境；以及是否允许除疫苗接种证明以外的其他健康证明或证书作为进入特定活动或服务的替代选择，以平衡公共卫生和行动自由。
疫苗接种证书可能会破坏基于人群的 COVID-19 疫苗接种方法，以实现和加速 PHSMs 的普遍解除，导致不公平和不平等的健康和社会结果，并在各国之间需要团结以应对大流行及其负担的时期产生社会分裂。应在实施疫苗接种证书的国家进一步开展有关 COVID-19 疫苗接种证书的伦理可接受性和影响的研究，以为解决这一问题提供未来的伦理考虑。
