Verweij Marcel
Wageningen University, The Netherlands.
Public Health Ethics. 2022 Nov 14;15(3):233-239. doi: 10.1093/phe/phac028. eCollection 2022 Nov.
For contagious diseases like measles a successful immunization program can result in herd protection. Small outbreaks may still occur but fade out soon, because the possibilities for the pathogen to spread in the 'herd' are very small. This implies that people who refuse to participate in such a program will still benefit from the protection it offers, but they don't do their part in maintaining protection. Isn't that a case of freeriding-and isn't that unfair towards all the people who do collaborate? If so, that might be considered an additional ground for making vaccination mandatory or compulsory. In this paper I argue that vaccination refusal can be considered as freeriding, but that this might not be unfair. The public good of herd protection is a peculiar public good because it supervenes on private benefits that are enjoyed by all who do opt for vaccination. For vaccinated individuals, the additional benefit of herd protection comes about, as it were, for free, and hence they can't complain that others benefit without sharing in the burdens. There are however still other grounds for making vaccination compulsory or at least for seeing refusal as a morally wrong choice.
对于像麻疹这样的传染病，一个成功的免疫计划可以带来群体保护。小规模的疫情可能仍会发生，但很快就会消退，因为病原体在“群体”中传播的可能性非常小。这意味着拒绝参与此类计划的人仍将受益于该计划提供的保护，但他们没有尽自己的一份力量来维持这种保护。这难道不是一种搭便车的行为吗？而且这对所有参与合作的人来说难道不公平吗？如果是这样，那么这可能被视为强制接种疫苗的另一个理由。在本文中，我认为拒绝接种疫苗可以被视为搭便车行为，但这可能并不不公平。群体保护这一公共利益是一种特殊的公共利益，因为它基于所有选择接种疫苗的人所享有的私人利益之上。对于接种疫苗的个体来说，群体保护的额外好处可以说是免费获得的，因此他们不能抱怨其他人不承担负担却从中受益。然而，仍然有其他理由支持强制接种疫苗，或者至少认为拒绝接种是一种道德上错误的选择。
