persuasive essay about covid 19 vaccination

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Persuasive Essay Guide

Persuasive Essay About Covid19

How to Write a Persuasive Essay About Covid19 | Examples & Tips

11 min read

Steps to Write a Persuasive Essay About Covid-19

Here are the steps to help you write a persuasive essay on this topic, along with an example essay:

Step 1: Choose a Specific Thesis Statement

Your thesis statement should clearly state your position on a specific aspect of COVID-19. It should be debatable and clear. For example:

"COVID-19 vaccination mandates are necessary for public health and safety."

Step 2: Research and Gather Information

Collect reliable and up-to-date information from reputable sources to support your thesis statement. This may include statistics, expert opinions, and scientific studies. For instance:

COVID-19 vaccination effectiveness data
Information on vaccine mandates in different countries
Expert statements from health organizations like the WHO or CDC

Step 3: Outline Your Essay

Create a clear and organized outline to structure your essay. A persuasive essay typically follows this structure:

Introduction
Background Information
Body Paragraphs (with supporting evidence)
Counterarguments (addressing opposing views)

Step 4: Write the Introduction

In the introduction, grab your reader's attention and present your thesis statement. For example:

The COVID-19 pandemic has presented an unprecedented global challenge, and in the face of this crisis, many countries have debated the implementation of vaccination mandates. This essay argues that such mandates are essential for safeguarding public health and preventing further devastation caused by the virus.

Step 5: Provide Background Information

Offer context and background information to help your readers understand the issue better. For instance:

COVID-19, caused by the novel coronavirus SARS-CoV-2, emerged in late 2019 and quickly spread worldwide, leading to millions of infections and deaths. Vaccination has proven to be an effective tool in curbing the virus's spread and severity.

Step 6: Develop Body Paragraphs

Each body paragraph should present a single point or piece of evidence that supports your thesis statement. Use clear topic sentences, evidence, and analysis. Here's an example:

One compelling reason for implementing COVID-19 vaccination mandates is the overwhelming evidence of vaccine effectiveness. According to a study published in the New England Journal of Medicine, the Pfizer-BioNTech and Moderna vaccines demonstrated an efficacy of over 90% in preventing symptomatic COVID-19 cases. This level of protection not only reduces the risk of infection but also minimizes the virus's impact on healthcare systems.

Step 7: Address Counterarguments

Acknowledge opposing viewpoints and refute them with strong counterarguments. This demonstrates that you've considered different perspectives. For example:

Some argue that vaccination mandates infringe on personal freedoms and autonomy. While individual freedom is a crucial aspect of democratic societies, public health measures have long been implemented to protect the collective well-being. Seatbelt laws, for example, are in place to save lives, even though they restrict personal choice.

Step 8: Write the Conclusion

Summarize your main points and restate your thesis statement in the conclusion. End with a strong call to action or thought-provoking statement. For instance:

In conclusion, COVID-19 vaccination mandates are a crucial step toward controlling the pandemic, protecting public health, and preventing further loss of life. The evidence overwhelmingly supports their effectiveness, and while concerns about personal freedoms are valid, they must be weighed against the greater good of society. It is our responsibility to take collective action to combat this global crisis and move toward a safer, healthier future.

Step 9: Revise and Proofread

Edit your essay for clarity, coherence, grammar, and spelling errors. Ensure that your argument flows logically.

Step 10: Cite Your Sources

Include proper citations and a bibliography page to give credit to your sources.

Remember to adjust your approach and arguments based on your target audience and the specific angle you want to take in your persuasive essay about COVID-19.

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Examples of Persuasive Essay About Covid19

When writing a persuasive essay about the Covid-19 pandemic, it’s important to consider how you want to present your argument. To help you get started, here are some example essays for you to read:

Check out some more PDF examples below:

Persuasive Essay About Covid-19 Pandemic

Sample Of Persuasive Essay About Covid-19

Persuasive Essay About Covid-19 In The Philippines - Example

If you're in search of a compelling persuasive essay on business, don't miss out on our “ persuasive essay about business ” blog!

Examples of Persuasive Essay About Covid-19 Vaccine

Covid19 vaccines are one of the ways to prevent the spread of Covid-19, but they have been a source of controversy. Different sides argue about the benefits or dangers of the new vaccines. Whatever your point of view is, writing a persuasive essay about it is a good way of organizing your thoughts and persuading others.

A persuasive essay about the Covid-19 vaccine could consider the benefits of getting vaccinated as well as the potential side effects.

Below are some examples of persuasive essays on getting vaccinated for Covid-19.

Covid19 Vaccine Persuasive Essay

Persuasive Essay on Covid Vaccines

Interested in thought-provoking discussions on abortion? Read our persuasive essay about abortion blog to eplore arguments!

Examples of Persuasive Essay About Covid-19 Integration

Covid19 has drastically changed the way people interact in schools, markets, and workplaces. In short, it has affected all aspects of life. However, people have started to learn to live with Covid19.

Writing a persuasive essay about it shouldn't be stressful. Read the sample essay below to get idea for your own essay about Covid19 integration.

Persuasive Essay About Working From Home During Covid19

Searching for the topic of Online Education? Our persuasive essay about online education is a must-read.

Examples of Argumentative Essay About Covid 19

Covid-19 has been an ever-evolving issue, with new developments and discoveries being made on a daily basis.

Writing an argumentative essay about such an issue is both interesting and challenging. It allows you to evaluate different aspects of the pandemic, as well as consider potential solutions.

Here are some examples of argumentative essays on Covid19.

Argumentative Essay About Covid19 Sample

Argumentative Essay About Covid19 With Introduction Body and Conclusion

Looking for a persuasive take on the topic of smoking? You'll find it all related arguments in out Persuasive Essay About Smoking blog!

Examples of Persuasive Speeches About Covid-19

Do you need to prepare a speech about Covid19 and need examples? We have them for you!

Persuasive speeches about Covid-19 can provide the audience with valuable insights on how to best handle the pandemic. They can be used to advocate for specific changes in policies or simply raise awareness about the virus.

Check out some examples of persuasive speeches on Covid-19:

Persuasive Speech About Covid-19 Example

Persuasive Speech About Vaccine For Covid-19

You can also read persuasive essay examples on other topics to master your persuasive techniques!

Tips to Write a Persuasive Essay About Covid-19

Writing a persuasive essay about COVID-19 requires a thoughtful approach to present your arguments effectively.

Here are some tips to help you craft a compelling persuasive essay on this topic:

Choose a Specific Angle

Start by narrowing down your focus. COVID-19 is a broad topic, so selecting a specific aspect or issue related to it will make your essay more persuasive and manageable. For example, you could focus on vaccination, public health measures, the economic impact, or misinformation.

Provide Credible Sources

Support your arguments with credible sources such as scientific studies, government reports, and reputable news outlets. Reliable sources enhance the credibility of your essay.

Use Persuasive Language

Employ persuasive techniques, such as ethos (establishing credibility), pathos (appealing to emotions), and logos (using logic and evidence). Use vivid examples and anecdotes to make your points relatable.

Organize Your Essay

Structure your essay involves creating a persuasive essay outline and establishing a logical flow from one point to the next. Each paragraph should focus on a single point, and transitions between paragraphs should be smooth and logical.

Emphasize Benefits

Highlight the benefits of your proposed actions or viewpoints. Explain how your suggestions can improve public health, safety, or well-being. Make it clear why your audience should support your position.

Use Visuals -H3

Incorporate graphs, charts, and statistics when applicable. Visual aids can reinforce your arguments and make complex data more accessible to your readers.

Call to Action

End your essay with a strong call to action. Encourage your readers to take a specific step or consider your viewpoint. Make it clear what you want them to do or think after reading your essay.

Revise and Edit

Proofread your essay for grammar, spelling, and clarity. Make sure your arguments are well-structured and that your writing flows smoothly.

Seek Feedback

Have someone else read your essay to get feedback. They may offer valuable insights and help you identify areas where your persuasive techniques can be improved.

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Common Topics for a Persuasive Essay on COVID-19

Here are some persuasive essay topics on COVID-19:

The Importance of Vaccination Mandates for COVID-19 Control
Balancing Public Health and Personal Freedom During a Pandemic
The Economic Impact of Lockdowns vs. Public Health Benefits
The Role of Misinformation in Fueling Vaccine Hesitancy
Remote Learning vs. In-Person Education: What's Best for Students?
The Ethics of Vaccine Distribution: Prioritizing Vulnerable Populations
The Mental Health Crisis Amidst the COVID-19 Pandemic
The Long-Term Effects of COVID-19 on Healthcare Systems
Global Cooperation vs. Vaccine Nationalism in Fighting the Pandemic
The Future of Telemedicine: Expanding Healthcare Access Post-COVID-19

In search of more inspiring topics for your next persuasive essay? Our persuasive essay topics blog has plenty of ideas!

To sum it up,

You have read good sample essays and got some helpful tips. You now have the tools you needed to write a persuasive essay about Covid-19. So don't let the doubts stop you, start writing!

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Frequently Asked Questions

Are there any ethical considerations when writing a persuasive essay about covid-19.

Yes, there are ethical considerations when writing a persuasive essay about COVID-19. It's essential to ensure the information is accurate, not contribute to misinformation, and be sensitive to the pandemic's impact on individuals and communities. Additionally, respecting diverse viewpoints and emphasizing public health benefits can promote ethical communication.

What impact does COVID-19 have on society?

The impact of COVID-19 on society is far-reaching. It has led to job and economic losses, an increase in stress and mental health disorders, and changes in education systems. It has also had a negative effect on social interactions, as people have been asked to limit their contact with others.

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Persuasive Essay Writing

Persuasive Essay About Covid 19

Top Examples of Persuasive Essay about Covid-19

Published on: Jan 10, 2023

Last updated on: Jan 29, 2024

Examples of Persuasive Essay About Covid-19

The coronavirus pandemic has everyone on edge. You can expect your teachers to give you an essay about covid-19. You might be overwhelmed about what to write in an essay.

Worry no more!

Here are a few examples to help get you started.

The spread of covid-19 pandemic has greatly impacted how people work, with many companies and organizations adapting to remote working arrangements to stay afloat. While there may be certain benefits of remote working that have emerged due to the pandemic, it is undeniable that it also presents numerous challenges.

One of the main positive impacts of the pandemic on remote working is greater flexibility. Many companies have implemented flexible hours, which allow employees to work at times that best suit their schedule. This has proven beneficial for employers and employees, reducing stress levels and improving productivity. It also allows people with limited access to transportation or childcare solutions to still participate in the workforce.

On the other hand, the pandemic has also brought about several negative impacts for remote workers. Isolation is one of the biggest issues, as many people lack access to social contact daily, which can lead to feelings of loneliness and depression. Working from home can also be more difficult for those who do not have a quiet workspace.

Additionally, many workers may not have access to the same resources as their office-based counterparts, such as ergonomic chairs and computers with high-speed internet connections.

Overall, it can be said that while there are certain positives associated with remote working due to the pandemic, it also presents numerous negatives which cannot be ignored. Companies and organizations should strive to ensure that their remote workers are given the necessary tools, resources, and support to succeed in their roles from home.

Additionally, employers should prioritize employee well-being by ensuring all employees have access to social contact, even if it is only virtually. If these measures are taken, remote working due to the pandemic can be seen more positively.

In conclusion, while the COVID-19 pandemic has presented certain benefits of remote working, it is also important to recognize numerous challenges associated with this arrangement. Companies and organizations should take steps to ensure that their employees have all the necessary resources and support to be able to work from home effectively.

Persuasive Essay About Covid-19 Pandemic

Sample Of Persuasive Essay About Covid-19

Persuasive Essay About Covid-19 In The Philippines - Example

Check out some more persuasive essay examples to get more inspiration and guidance.

Examples of Persuasive Essay About the Covid-19 Vaccine

With so much uncertainty surrounding the Covid-19 vaccine, it can be challenging for students to write a persuasive essay about getting vaccinated.

Here are a few examples of persuasive essays about vaccination against covid-19.

Check these out to learn more.

Persuasive essay on the covid-19 vaccine

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Examples of Persuasive Essay About Covid-19 Integration

Writing a persuasive essay on Covid-19 integration doesn't have to be stressful or overwhelming.

With the right approach and preparation, you can write an essay that will get them top marks!

Here are a few samples of compelling persuasive essays. Give them a look and get inspiration for your next essay.

Integration of Covid-19 Persuasive essay

Integration of Covid-19 Persuasive essay sample

Examples of Argumentative Essay About Covid-19

Writing an argumentative essay can be a daunting task, especially when the topic is as broad as the novel coronavirus pandemic.

Read the following examples of how to make a compelling argument on covid-19.

Argumentative essay on Covid-19

Argumentative Essay On Covid-19

Examples of Persuasive Speeches About Covid-19

Writing a persuasive speech about anything can seem daunting. However, writing a persuasive speech about something as important as the Covid-19 pandemic doesnât have to be difficult.

So let's explore some examples of perfectly written persuasive essays.

Persuasive Speech About Covid-19 Example

Tips to Write a Persuasive Essay

Here are seven tips that can help you create a strong argument on the topic of covid-19.

Check out this informative video to learn more about effective tips and tricks for writing persuasive essays.

1. Start with an attention-grabbing hook:

Use a quote, statistic, or interesting fact related to your argument at the beginning of your essay to draw the reader in.

2. Make sure you have a clear thesis statement:

A thesis statement is one sentence that expresses the main idea of your essay. It should clearly state your stance on the topic and provide a strong foundation for the rest of your content.

3. Support each point with evidence:

To make an effective argument, you must back up each point with credible evidence from reputable sources. This will help build credibility and validate your claims throughout your paper.

4. Use emotional language and tone:

Emotional appeals are powerful tools to help make your argument more convincing. Use appropriate language for the audience and evokes emotion to draw them in and get them on board with your claims.

5. Anticipate counterarguments:

Use proper counterarguments to effectively address all point of views.

Acknowledge opposing viewpoints and address them directly by providing evidence or reasoning why they are wrong.

6. Stay focused:

Keep your main idea in mind throughout the essay, making sure all of your arguments support it. Donât stray off-topic or introduce unnecessary information that will distract from the purpose of your paper.

7. Conclude strongly:

Make sure you end on a strong note. Reemphasize your main points, restate your thesis statement, and challenge the reader to respond or take action in some way. This will leave a lasting impression in their minds and make them more likely to agree with you.

Writing an effective persuasive essay is a piece of cake with our guide and examples. Check them out to learn more!

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Frequently Asked Questions

How do you begin a persuasive essay.

To begin a persuasive essay, you must choose a topic you feel strongly about and formulate an argument or position. Start by researching your topic thoroughly and then formulating your thesis statement.

What are good topics for persuasive essays?

Good topics for persuasive essays include healthcare reform, gender issues, racial inequalities, animal rights, environmental protection, and political change. Other popular topics are social media addiction, internet censorship, gun control legislation, and education reform.

What impact does COVID-19 have on society?

The COVID-19 pandemic has had a major impact on society worldwide. It has changed the way we interact with one another. The pandemic has also caused economic disruption, forcing many businesses to close or downsize their operations.

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The Morning Newsletter

Vaccine Persuasion

Many vaccine skeptics have changed their minds.

persuasive essay about covid 19 vaccination

By David Leonhardt

When the Kaiser Family Foundation conducted a poll at the start of the year and asked American adults whether they planned to get vaccinated, 23 percent said no.

But a significant portion of that group — about one quarter of it — has since decided to receive a shot. The Kaiser pollsters recently followed up and asked these converts what led them to change their minds . The answers are important, because they offer insight into how the millions of still unvaccinated Americans might be persuaded to get shots, too.

First, a little background: A few weeks ago, it seemed plausible that Covid-19 might be in permanent retreat, at least in communities with high vaccination rates. But the Delta variant has changed the situation. The number of cases is rising in all 50 states .

Although vaccinated people remain almost guaranteed to avoid serious symptoms, Delta has put the unvaccinated at greater risk of contracting the virus — and, by extension, of hospitalization and death. The Covid death rate in recent days has been significantly higher in states with low vaccination rates than in those with higher rates:

(For more detailed state-level charts, see this piece by my colleagues Lauren Leatherby and Amy Schoenfeld Walker. The same pattern is evident at the county level, as the health policy expert Charles Gaba has been explaining on Twitter.)

Nationwide, more than 99 percent of recent deaths have occurred among unvaccinated people, and more than 97 percent of recent hospitalizations have occurred among the unvaccinated, according to the C.D.C. “Look,” President Biden said on Friday, “the only pandemic we have is among the unvaccinated.”

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Lessons learned: What makes vaccine messages persuasive

You’re reading Lessons Learned, which distills practical takeaways from standout campaigns and peer-reviewed research in health and science communication. Want more Lessons Learned? Subscribe to our Call to Action newsletter .

Vaccine hesitancy threatened public health’s response to the COVID-19 pandemic. Scientists at the University of Maryland recently reviewed 47 randomized controlled trials to determine how COVID-19 communications persuaded—or failed to persuade—people to take the vaccine. ( Health Communication , 2023 DOI: 10.1080/10410236.2023.2218145 ).

What they learned: Simply communicating about the vaccine’s safety or efficacy persuaded people to get vaccinated. Urging people to follow the lead of others, by highlighting how many millions were already vaccinated or even trying to induce embarrassment, was also persuasive.

Why it matters: Understanding which message strategies are likely to be persuasive is crucial.

➡️ Idea worth stealing: The authors found that a message’s source didn’t significantly influence its persuasiveness. But messages were more persuasive when source and receivers shared an identity, such as political affiliation.

What to watch: How other formats, such as interactive chatbots and videos, might influence persuasiveness. And whether message tailoring could persuade specific population subgroups.

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Getting the COVID-19 Vaccine

This article is part of a series of explainers on vaccine development and distribution. Learn more about vaccines – from how they work and how they’re made to ensuring safety and equitable access – in WHO’s Vaccines Explained series.

Vaccines are a critical tool in the battle against COVID-19, and getting vaccinated is one of the best ways to protect yourself and others from COVID-19.

Getting vaccinated is safer than getting infected

Vaccines train our immune system to recognize the targeted virus and create antibodies to fight off the disease without getting the disease itself. After vaccination, the body is ready to fight the virus if it is later exposed to it, thereby preventing illness.

Most people who are infected with SARS-CoV-2, the virus that causes COVID-19, develop an immune response within the first few weeks, but we are still learning how strong and lasting that immune response is, and how it varies between different people.

People who have already been infected with SARS-CoV-2 should still get vaccinated unless told otherwise by their health care provider. Even if you’ve had a previous infection, the vaccine acts as a booster that strengthens the immune response. There have also been some instances of people infected with SARS-CoV-2 a second time, which makes getting vaccinated even more important.

What to expect during vaccination

Medical professionals can best advise individuals on whether or not, and when, they should receive a vaccine. A health worker will administer the vaccine, and the person receiving it will be asked to wait for 15–30 minutes before leaving the vaccination site. This is so that health workers can observe individuals for any unexpected reactions following vaccination.

Like any vaccine, COVID-19 vaccines can cause mild-to-moderate side effects, such as a low-grade fever or pain or redness at the injection site. These should go away on their own within a few days. See WHO’s Safety of COVID-19 Vaccines explainer and Vaccines Safety Q&A to learn more about common side effects and find out who should consult with a doctor before vaccination.

Vaccine doses

For some COVID-19 vaccines, two doses are required . It’s important to get the second dose if the vaccine requires two doses.

For vaccines that require two doses, the first dose presents antigens – proteins that stimulate the production of antibodies – to the immune system for the first time. Scientists call this priming the immune response. The second dose acts as a booster, ensuring the immune system develops a memory response to fight off the virus if it encounters it again.

Because of the urgent need for a COVID-19 vaccine, initial clinical trials of vaccine candidates were performed with the shortest possible duration between doses. Therefore an interval of 21–28 days (3–4 weeks) between doses is recommended by WHO. Depending on the vaccine, the interval may be extended for up to 42 days – or even up to 12 weeks for some vaccines – on the basis of current evidence.

There are many COVID-19 vaccines being developed and produced by different manufacturers around the world. WHO recommends that a vaccine from the same manufacturer be used for both doses if you require two doses. This recommendation may be updated as further information becomes available.

Safety against infection and transmission after vaccination

Available clinical trials have shown COVID-19 vaccines to be safe and highly effective at preventing severe disease. Given how new COVID-19 is, researchers are still looking into how long a vaccinated person is likely to be protected from infection, and whether vaccinated people can still transmit the virus to others. As the vaccine rollout expands, WHO will continue to monitor the data alongside regulatory authorities.

Safe and effective vaccines are making a significant contribution to preventing severe disease and death from COVID-19. As vaccines are rolling out and immunity is building, it is important to continue to follow all of the recommended measures that reduce the spread of SARS-CoV-2. This includes physically distancing yourself from others; wearing a mask, especially in crowded and poorly ventilated settings; cleaning your hands frequently; covering any cough or sneeze in your bent elbow; and opening windows when indoors.

COVID vaccine hesitancy: spell out the personal rather than collective benefits to persuade people — new research

Professor of Clinical Psychology, University of Oxford

Disclosure statement

Daniel Freeman receives funding from the National Institute for Health Research and the Medical Research Council. The current research was funded by the NIHR Oxford Biomedical Research Centre (BRC) and the NIHR Oxford Health BRC.

University of Oxford provides funding as a member of The Conversation UK.

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Approximately 10% of UK adults say they will never get vaccinated against COVID-19 or will avoid doing so for as long as possible. Scientists call this group the “vaccine hesitant”, though hesitancy may not seem the right term to describe views often held with clear conviction. People who are vaccine hesitant have often thought long and hard about whether to take a COVID-19 vaccine.

How can such views be shifted? Ideally, one would sit down with people, listen and discuss. In reality, public health campaigners have only mass messaging at their disposal: information disseminated through billboards, TV slots and social media. These are crude tools for tackling sometimes deeply ingrained personal beliefs. What messages delivered through them might really make a difference?

Over the past year, the Oxford Coronavirus Explanations, Attitudes and Narratives Surveys (OCEANS) team has tried to answer this question. We’ve worked to form a psychological explanation for vaccine hesitancy by canvassing the views of people for, against and undecided about vaccines.

We’ve found that hesitancy emerges from a nexus of beliefs , the most important being scepticism about the collective benefits of vaccination. The hesitant don’t accept that taking a vaccine means we’re all better off. They also tend to believe that COVID-19 isn’t a big danger to their health. And they worry that vaccines may be ineffective or downright harmful. The rapid development of COVID-19 vaccines reinforces these concerns.

Behind these specific ideas often lies mistrust. People who are hesitant tend to be suspicious of authority . But while it’s wise to make judgements based on evidence rather than blithely accepting what we’re told, in many cases we’ve found that the vaccine hesitant are susceptible to misinformation.

Fuelling this may be a sense of marginalisation. Vaccine-hesitant people are a little more likely to believe that they’re of lower social status . Feeling that society doesn’t care about them, they are unwilling to trust what they’re told by politicians and scientists.

Getting personal

Equipped with these insights, we decided to see whether we could craft messages that might shift negative attitudes. If people don’t appreciate the collective benefits of vaccination, let’s persuasively set out the case. Let’s explain that vaccines make it less likely we’ll pass on the virus, helping to protect others, particularly those especially vulnerable to the virus. And let’s make it clear that by reducing the risk of getting severely ill, we can help the country bounce back as quickly as possible. That should help shift attitudes, right?

To find out, in early February we surveyed nearly 19,000 UK adults, carefully selected to be representative for age, gender, ethnicity, income and region. Participants were then randomly asked to read one of ten texts about COVID-19 vaccines.

A woman with fatigue from long COVID lying on a bed

Some texts focused the collective benefits of vaccination, some on the personal benefits, some on safety and some a combination of messages. One text contained only basic information about the vaccine and didn’t provide any detail on benefits, and was used as a control. After reading their allocated text, participants completed a questionnaire on their willingness to be vaccinated for COVID-19.

The results were surprising. Previous surveys had suggested beliefs about the collective benefits of vaccination were pivotal to driving uptake. The extent to which people bought into this narrative seemed to determine their willingness to take a vaccine.

But the text that was most likely to change the minds of the vaccine hesitant (when compared to the control) emphasised not the collective but the personal benefits of vaccination. It pointed out that you can’t be sure that you won’t get seriously ill or struggle with long-term COVID-related problems, and that vaccination will minimise your chances of falling ill.

Months of media coverage in the UK has instead focused on collective responsibility – that we owe it to our fellow citizens to get vaccinated. But for the sceptical 10%, this hasn’t cut through, which is perhaps to be expected. If you think vaccines are unsafe, then you’ll be worried about what getting the jab will do to you. Your decision making then becomes dominated by personal risk.

The best way to counter these concerns, therefore, is to highlight the opposite: personal benefits – and our new research suggests this could well work. It’s also probable that for a group that’s more likely to feel socially excluded, messages that focus on the personal rather than collective ramifications of COVID-19 will be more compelling.

What about the view that the vaccines have been developed too quickly? It’s an understandable fear: these vaccines have been produced with unparalleled speed . In response to this, one text in our study explained that the speed of development reflects the exceptional commitment, investment and cooperation of scientists, governments, public health organisations and pharmaceutical companies – as well as of the tens of thousands of members of the public who volunteered to test the vaccines.

This text noted too that side-effects that affect a significant proportion of people don’t suddenly appear months and years after vaccination. Because of the way vaccines work – quickly training the body’s immune system to fight off a virus – any issues arise within a month and usually much sooner. Happily, this information did seem to reassure people and helped reduce hesitancy.

COVID-19 is unlikely to disappear in the foreseeable future, which means vaccination messaging will remain of critical importance. When it comes to persuading the vaccine hesitant, our research shows that we need to listen, understand concerns and address them seriously. No message will be truly effective if the messenger has not earned trust, nor if it doesn’t account for the desires and worries of those receiving it.

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The Persuasive Effects of Narrative PSAs on COVID-19 Vaccination Intention: The Mediating Role of Empathy and Psychological Reactance

Abstract: Successful COVID-19 vaccine promotion for the unvaccinated relies on increasing positive reactions but also reducing negative responses to persuasive messages. The current study examined the relative effects of narrative vs. non-narrative public service announcements (PSAs) promoting COVID-19 vaccination on both positive and negative reactions. We explored the role of empathy and psychological reactance as underlying mechanisms. Results of an experiment involving unvaccinated young adults indicate that the narrative (vs. non-narrative) PSAs led to greater empathy. While no direct effects of message type emerged on psychological reactance or vaccination intention, results of a serial multi-mediator model confirmed that empathy and psychological reactance mediated the effects of message type on vaccination intention, yielding theoretical and practical implications for research and practice in COVID-19 vaccination and health communication.

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Biased News Can Be More Dangerous Than Fake News on Social Media

June 25, 2024 • 5 min read.

Researchers from Wharton, Penn, and MIT found that misleading, but factual, Facebook posts about COVID-19 vaccines were more persuasive than fake news.

Illustration of people staring at bright screens and being drawn in by misinformation on social media

The following article was originally published by Penn Engineering Today .

What threatens public health more, a deliberately false Facebook post about tracking microchips in the COVID-19 vaccine that is flagged as misinformation, or an unflagged, factual article about the rare case of a young, healthy person who died after receiving the vaccine?

According to Duncan J. Watts , Stevens University Professor in Computer and Information Science at Penn Engineering and Director of the Computational Social Science (CSS) Lab , along with David G. Rand , Erwin H. Schell Professor at MIT Sloan School of Management , and Jennifer Allen , 2024 MIT Sloan School of Management PhD graduate and incoming CSS postdoctoral fellow, the latter is much more damaging. “The misinformation flagged by fact-checkers was 46 times less impactful than the unflagged content that nonetheless encouraged vaccine skepticism,” they conclude in a new paper in Science .

Historically, research on “fake news” has focused almost exclusively on deliberately false or misleading content, on the theory that such content is much more likely to shape human behavior. But, as Allen points out, “When you actually look at the stories people encounter in their day-to-day information diets, fake news is a minuscule percentage. What people are seeing is either no news at all or mainstream media.”

“Since the 2016 U.S. presidential election, many thousands of papers have been published about the dangers of false information propagating on social media,” says Watts. “But what this literature has almost universally overlooked is the related danger of information that is merely biased. That’s what we look at here in the context of COVID vaccines.”

In the study, Watts, one of the paper’s senior authors, and Allen, the paper’s first author, used thousands of survey results and AI to estimate the impact of more than 13,000 individual Facebook posts. “Our methodology allows us to estimate the effect of each piece of content on Facebook,” says Allen. “What makes our paper really unique is that it allows us to break open Facebook and actually understand what types of content are driving misinformed-ness.”

One of the paper’s key findings is that “fake news,” or articles flagged as misinformation by professional fact-checkers, has a much smaller overall effect on vaccine hesitancy than unflagged stories that the researchers describe as “vaccine-skeptical,” many of which focus on statistical anomalies that suggest that COVID-19 vaccines are dangerous.

“What this literature has almost universally overlooked is the related danger of information that is merely biased.” —Duncan Watts

“Obviously, people are misinformed,” says Allen, pointing to the low vaccination rates among U.S. adults, in particular for the COVID-19 booster vaccine, “but it doesn’t seem like fake news is doing it.” One of the most viewed URLs on Facebook during the time period covered by the study, at the height of the pandemic, for instance, was a true story in a reputable newspaper about a doctor who happened to die shortly after receiving the COVID-19 vaccine.

That story racked up tens of millions of views on the platform, multiples of the combined number of views of all COVID-19-related URLs that Facebook flagged as misinformation during the time period covered by the study. “Vaccine-skeptical content that’s not being flagged by Facebook is potentially lowering users’ intentions to get vaccinated by 2.3 percentage points,” Allen says. “A back-of-the-envelope estimate suggests that translates to approximately 3 million people who might have gotten vaccinated had they not seen this content.”

Despite the fact that, in the survey results, fake news identified by fact-checkers proved more persuasive on an individual basis, so many more users were exposed to the factual, vaccine-skeptical articles with clickbait-style headlines that the overall impact of the latter outstripped that of the former.

“Even though misinformation, when people see it, can be more persuasive than factual content in the context of vaccine hesitancy,” says Allen, “it is seen so little that these accurate, ‘vaccine-skeptical’ stories dwarf the impact of outright false claims.”

As the researchers point out, being able to quantify the impact of misleading but factual stories points to a fundamental tension between free expression and combating misinformation, as Facebook would be unlikely to shut down mainstream publications. “Deciding how to weigh these competing values is an extremely challenging normative question with no straightforward solution,” the authors write in the paper.

Allen points to content moderation that involves the user community as one possible means to address this challenge. “Crowdsourcing fact-checking and moderation works surprisingly well,” she says. “That’s a potential, more democratic solution.”

With the 2024 U.S. Presidential election on the horizon, Allen emphasizes the need for Americans to seriously consider these tradeoffs. “The most popular story on Facebook in the lead-up to the 2020 election was about military ballots found in the trash that were mostly votes for Donald Trump,” she notes. “That was a real story, but the headline did not mention that there were nine votes total, seven of them for Trump.”

This study was conducted at the University of Pennsylvania’s School of Engineering and Applied Science, the Annenberg School for Communication, and the Wharton School, along with the Massachusetts Institute of Technology Sloan School of Management, and was supported by funding from Alain Rossmann.

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Motivating COVID-19 Vaccination through Persuasive Communication: A Systematic Review of Randomized Controlled Trials

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1 Department of Communication, University of Maryland.
PMID: 37254940
DOI: 10.1080/10410236.2023.2218145

Vaccination is a vital defense against COVID-19 infections and outbreaks, yet vaccine hesitancy poses a significant threat to pandemic response and recovery. We conducted a systematic review of published randomized controlled trials ( N = 47) assessing the persuasive effects of COVID-19 communication on COVID-19 vaccine acceptance. Individual vs. collective appeals and gain vs. loss frames are among the most frequently assessed message features, but they generally do not make a difference in persuasion. Normative messages that highlight higher (vs. lower) prevalence of vaccine acceptance are more persuasive. Message sources overall have limited impact on COVID-19 vaccine acceptance, but sources that have a shared identity with the message receivers tend to be persuasive. More engaging message channels such as interactive chatbots and videos are promising communication tools but are generally under-utilized and under-studied. Compared to no communication or irrelevant communication, COVID-19 vaccine messages generally have a small advantage in increasing COVID-19 vaccine acceptance. Messages that include 1) vaccine safety and/or efficacy information; 2) collective appeals combined with embarrassment appeals; and 3) political leaders' vaccine endorsement are among the most effective messaging strategies. There is no evidence of any backfire effects of COVID-19 vaccine messages. We discuss the implications of our findings for persuasive message design in pandemic vaccine communication.

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STUDENT ESSAY: Is Compulsory COVID-19 Vaccination a Violation of Human Rights?

In response to the COVID-19 pandemic, the UK Government passed the Coronavirus Act 2020 (CA), which implemented a number of emergency powers, allowing public officials to take action in specific situations in order to contain and slow down the spread of the virus as well as ease the burden on frontline staff. [1] Examples of these emergency powers include: the capability for public officials to test, isolate, and detain a person where they have reasonable grounds to think that the person is infected; restrict or prohibit gatherings or events; and require the temporary closure of a school or registered childcare provider. [2]

In its efforts to support the public health benefit, the CA has arguably led to interference with individuals’ right to liberty under Article 5(1) of the European Convention on Human Rights (ECHR). [3] Pugh’s 2020 article on the CA discusses how individuals may be deprived of their liberty to prevent the spread of infectious diseases, if that deprivation is “necessary and proportionate” and is in accordance with a procedure prescribed by law. [4] Pugh refers to this as “the public health exception”. [5] The importance of this approach directly relates to the consideration of a compulsory COVID-19 vaccine, specifically whether limitations on specific rights can be justified.

This essay analyzes whether a compulsory COVID-19 vaccine would be a violation of human rights law in the UK. For a comprehensive understanding of the implications of this topic, I provide background information and discuss perspectives regarding compulsory vaccinations in general. This discussion is followed by an outline of the specific rights under the ECHR that may be affected if a compulsory vaccination was to be implemented in the UK. I then discuss various interpretations of the elements required for state interference upon these rights and expand on them in regard to their application to compulsory vaccination. Through this analysis, it is concluded that a compulsory COVID-19 vaccination would not be a violation of human rights in the UK if the government sets out explicit parameters whereby a compulsory vaccination would be “necessary and proportionate” in the interests of health and safety, and if it was to ensure that the state is fulfilling its positive obligation to protect the right to life. [6]

Background on vaccinations and vaccine hesitancy

The topic of vaccination has been vastly studied across the world, affirming that high rates of vaccination coverage in childhood are important in preventing infectious diseases and contributing to a decline in mortality. [7] Despite the fact that vaccinations have proven to decrease rates of common childhood diseases and in some cases result in the complete termination of diseases, there is a rising trend of parents refusing to vaccinate their children. [8] This trend is commonly referred to as the anti-vaccination movement or Anti-Vaxx. The basis for these views revolves around arguments that vaccinations cause sickness, use unethical practices, and overall hold a lot of uncertainty, which causes hesitancy. [9] In addition, wide use of social media has allowed the Anti-Vaxx trend to become more widespread, and in a number of cases has led to vaccination rates dropping below the levels needed for herd immunity. Herd immunity occurs when a high enough percentage of the population is vaccinated that there are then too few people available to become hosts, so transmission of the disease or virus stops. [10] One of the most important characteristics of herd immunity is that it not only protects those who receive vaccination, but helps to protect individuals who are not vaccinated for whatever reason. [11]

Looking further into vaccine hesitancy, Kestenbaum and Feester identified some of the common factors contributing to this trend, including knowledge and information sources, experience or lack of experience with vaccine-preventable diseases, the role of recommendations by health professionals, social norms, and parental responsibility, trust, and religious beliefs. [12] They found many factors contribute to this trend, with uncertainty and the rapid transfer of information leading to the refusal of vaccination by families and individuals. The rise in the Anti-Vaxx movement has been shown to significantly impair health protection. A number of studies found that from 2006-2011, decreases in MMR (measles, mumps, and rubella) vaccination rates in the UK, Ireland, France, Italy, and the United States, had a direct correlation with measles outbreaks in those areas. [13] In response to these changes, both Italy and France passed legislation that made specific vaccinations, including MMR, compulsory for children. [14]

Religious beliefs and conscientious objection, which would fall under Article 9 of the ECHR, also contribute to decisions not to vaccinate. [15] There are a number of governments that have implemented compulsory vaccination for children in public and private schools, as well as childcare centres. In conjunction with these policies, governments allow for exemption from vaccination on medical and non-medical grounds. In this context, the non-medical grounds often relate to religion and conscientious objection. But religion has not been found to contribute much to decisions not to vaccinate. A North American study published in the Journal of the American Academy of Pediatricians found that over 70% of 512 doctors who had patients who had refused vaccines, claimed that parents had denied vaccination for their children because they felt the vaccine was unnecessary. [16] In addition, the Vanderbilt University Medical Centre states that “most religions have no prohibition against vaccinations” but the two common objecting religions are ‘Christian Scientists’ and ‘Dutch Reformed Congregations’. [17] These studies suggest that in the United States most non-medical exemptions fall under the category of conscientious objection rather than religion and that this trend is one of the primary reasons why some US jurisdictions have chosen to ban non-medical exemptions for compulsory vaccinations. [18]

State obligations under ECHR and compulsory vaccination

Regarding the potential implementation of a compulsory vaccination, the primary source of law to be considered is the ECHR, which was incorporated into UK law through the Human Rights Act 1998. [19] Article 2 of the ECHR concerning the right to life is of upmost importance in this context as it places positive and negative obligations on the state. Interpretation of this Article is summarized by the ECtHR in L.C.B. v The United Kingdom (1998), stating that “the state must not only refrain from the intentional and unlawful taking of life, but also take appropriate steps to safeguard the lives of those within its jurisdiction.” [20] Specifically regarding the positive obligation, states have a “primary duty to put in place a legislative and administrative framework designed to provide effective deterrence against threats to the right to life.” [21] As suggested by Camilleri, the positive obligation deriving from Article 2 may lead to claims that, in the context of a public health emergency, a vaccine should be made mandatory for those who are able to receive it, in order to protect those who rely on herd immunity for protection against such diseases. [22] However, when considering a narrower compulsory vaccination claim, the case of Calvelli and Ciglio (2002) is highly relevant as the court applied the positive obligation principle of Article 2 specifically to “the public health sphere”, stating that the obligation “requires states to make regulations compelling hospitals, whether public or private, to adopt appropriate measures for the protection of their patients’ lives.” [23]

This concept is demonstrated through a number of examples where the MMR vaccine, among others, has been made a legal requirement for healthcare professionals. Countries such as Canada, Australia, and several Caribbean countries, as well as some countries in Europe, have polices whereby certain vaccinations are a requirement by law for those directly in the healthcare sector, one of them being the UK. [24] In addition, there are a number of governments that have adopted similar policies with specific focus on the education sector. For example, in Italy, France, three provinces of Canada, as well as the United States, there is a requirement for children to be vaccinated in order to attend public or private schools. [25] An important element of this requirement is that they allow for medical, religious, and philosophical exemptions, aside from Mississippi, West Virginia, and California, which now only allow for medical exemptions. [26] In countries such as Australia, although vaccinations for children are not mandatory, the government offers financial incentives to have their children vaccinated. This is through non-taxable payments for each child who meets the requirements for immunization. [27]

One of the key outcomes of the implementation of these mandatory vaccination policies is that the government has not only taken positive action to protect the right to life of individuals within their jurisdiction, but they have ensured that individuals who rely on herd immunity are able to fully enjoy their human rights and fundamental freedoms the same way every other individual is able to, without putting their own lives at risk.

State interference and limitations on rights

From a public health perspective, a compulsory vaccination would be beneficial and it is clear that states have an obligation to protect the life of those within its jurisdiction. However, consideration should be given as to whether forcing individuals to receive a vaccination would interfere with any of their rights, and if so, would such an interference be lawful in the circumstances. Camilleri brings forward two specific ECHR articles with which compulsory vaccination would likely interfere: (i) Article 8-right to respect for private and family life, and (ii) Article 9-freedom of thought, conscience and religion. [28] The primary argument behind a violation of these rights relates to the idea that individuals should have reasonable control over the actions in which they partake, particularly when it considers an individual’s human body. As we can see in the case of Herczegfalvy (1992), the forceful administration of food was considered under Article 8, but was held to be compatible with respect for the claimant’s private life, as medical treatment was a necessity under the principles of psychiatry at that time. [29] Although the claimant was unsuccessful in this element, the violation would have been deemed unlawful if the court found that it was either not necessary, proportionate, or for a legitimate aim.

Regarding Article 8 specifically, the state holds a primary negative obligation to ensure that public authorities do not interfere with individuals’ right to private and family life. [30] As confirmed in the case of Kroon and others (1994), private life includes both the physical and psychological integrity of the individual. [31] Therefore, the physical aspect of the individual is an important element which may be conflicted with if that individual is required to be vaccinated by law. That said, Article 8(2) sets out that a state may interfere with the enjoyment of this right in certain circumstances. Similarly, Article 9 follows an analogous provision where states have an obligation to not interfere unless specific criteria can be satisfied. The “Guide on Article 8 of the ECHR”, which is again similar to that of Article 9, says that for interference to be lawful, it must be: (1) in accordance with the law; (2) in the interests of national security, public safety, or the economic well-being of the country, for the prevention of the disorder of crime, for the protection of health or morals, or for the protection of the rights and freedoms of others; and (3) that such interference is necessary in a democratic society. [32]

Regarding the first element, the court has been consistent in ensuring that any interference with these rights by a public authority must be in accordance with the law. This requirement revolves around the rule of law, as an interference must not only comply with domestic law but should be equally enforced among all individuals and entities that fall under its jurisdiction. [33] An interpretation of this element is found in Silver and Others (1983), stating that the national law must be clear, foreseeable, and adequately accessible. [34] As mentioned in Piechowicz (2012) the clarity requirement relates to “the scope of discretion exercised by public authorities” which is to ensure that individuals are provided with a “minimum degree of protection” from the relevant authorities and the authorities are therefore working within the rule of law. [35]

The second element relates to the question of whether the interference is in line with a legitimate aim set out in paragraph 2 of the relevant Article. [36] The court has often shown that as long as the aim of the interference falls within one of the objects set out in the provision, they will not hesitate to confirm satisfaction of this requirement. This can be observed in S.A.S. v France (2014) , where the sensitive action of banning full face veils in public places did in fact serve a legitimate aim to ensure individuals can enjoy their right to live in spaces of socialization without having any barrier to social interaction. [37] That said, it would be fairly clear that a compulsory vaccination would work directly in line with an aim to protect the interests of public health and safety, as well as for the protection of the rights and freedoms of others through the effective implementation of herd immunity.

The third element is perhaps the most critical, as “necessary” is a requirement that relies heavily on the specific circumstances. In the case of Olssen v Sweden (1988), “necessary” was said to imply the existence of a pressing social need and that it must be proportionate to the legitimate aim pursued. [38] This is a direct understanding that was incorporated into the ECtHR’s “Guide on Article 8”. [39] An important interpretation of this element is again found in Piechowicz , where it is stated that although the respondent state in the case must “demonstrate the existence of a pressing social need behind the interference”, it is the court who must consider the margin of appreciation left to the state authorities. [40] This margin of appreciation varies depending on the circumstances in question, and therefore, allows the court to resolve practical differences in the implementation of provisions within the convention. [41] Upon the elements of necessity and proportionality, it would be very difficult to justify that a compulsory vaccination applying to all individuals within the UK jurisdiction would be justified.

In the case of Biblical Centre of the Chuvash Republic v Russia (2014), the relevant authorities had to show that no other measures were available to achieve the same end that would interfere less seriously with the fundamental right concerned. [42] This was a burden that existed in order to prove that the interference was in fact necessary and proportionate. Specifically in relation to a compulsory COVID-19 vaccination, it is important to consider that there are alternatives that could be applied that would follow the same legitimate aim, yet would likely be less intrusive on individual rights. One of the more feasible options would be to continue, or even further the restrictions that have been implemented by the Coronavirus Act 2020, and that would apply to the UK population as a whole. In addition, while considering the elements of interference above, due to the variety of individual characteristics, activities, and needs across the population of the UK, it would be fair to say that certain population groups would find a compulsory vaccine significantly less necessary and proportionate than others.

In considering each of the three essential elements relating to the lawful interference of Article 8, the recent decision in Vavřička and Others v. the Czech Republic is highly significant as the ECtHR provided a ruling specifically in respect of compulsory vaccinations for MMR, as well as other diseases such as poliomyelitis, hepatitis B, and tetanus. [43] The applicants in Vavřička challenged the lawfulness of the sanctions imposed as a result of failing to fully vaccinate their children under Czech law, specifically the Public Health Protection Act. [44] The sanctions imposed consisted of a fine equivalent to €110 for Mr. Vavřička, and denial of admission to nursery schools for the children of the other applicants. [45] In determining whether the interfering sanctions entailed a violation of Article 8, the court was required to assess whether it was justified under Article 8(2), by applying the three prong test: (1) whether it was in accordance with the law, (2) whether it pursued one or more legitimate aims, and (3) whether it was necessary in a democratic society. [46] Without going into extensive detail, the court was satisfied that the state met each of these three requirements as the law existed to protect against diseases posing a serious health risk, to prevent decline in vaccination rates among children, and to support the state’s positive obligation to protect the lives and health of those within its jurisdiction. [47] Furthermore, the ECtHR decided that the interference was proportionate in light of the aim pursued, therefore it concluded that there was no violation of Article 8. [48]

Vavřička is a case that very clearly considers all of the elements required in determining the lawfulness of compulsory vaccination under Article 8. That being said, although the ECtHR determined that compulsory vaccination in this case was lawful, it does not necessarily mean that this decision is the sole precedent for a challenge to a compulsory COVID-19 vaccination. Firstly, this is due to the fact that the court in Vavřička explicitly states that “the present case relates to the standard and routine vaccination of children against diseases that are well known to medical science.” [49] It would be extremely difficult to claim that medical professionals have reached the same level of understanding of COVID-19 as the diseases concerned in the case of Vavřička . Furthermore, the court made it clear that while vaccination was a legal duty in the Czech Republic, there were no provisions that allowed forceable vaccination. Therefore, this decision is one that was made based on the specific facts involved and cannot be assumed to dictate the ruling in a case of compulsory COVID-19 vaccination. Given this decision, the lawfulness of efforts to enforce a compulsory COVID-19 vaccination may depend on the degree of the consequence for noncompliance, while also considering what might be deemed an exception for noncompliance, specifically medical or religious reasons.

The history of compulsory vaccination across the globe shows a trend of specific areas where compulsory vaccinations are lawfully implemented and therefore considered legitimate, necessary, and proportionate. There is a compelling argument supporting the implementation of such a vaccine to those in the public and private education sectors, as well as those who work in the healthcare system. These are typically environments where large numbers of people occupy relatively small areas. This leads to conditions where viruses can easily be transferred and therefore health matters within these areas are of high concern. Supporting the argument for the need for increased protection in these areas, a study from the Usher Institute showed that the reopening of schools (without any regard to vaccination) increases transmission of the virus by 24%. [50] Furthermore, a study conducted by the University College London Hospitals (UCLH) NHS Foundation Trust found that about 45% of the healthcare workers at the UCLH showed evidence of being infected with COVID-19 between the months of April and May 2020. [51] When applying the criteria for interference under Article 8(2) and Article 9(2), specifically to the education and healthcare sectors, the argument supporting necessity and proportionality appears to be considerably stronger than that of a compulsory vaccine directed at the general public.

The purpose of this essay is simply to state whether a compulsory COVID-19 vaccination would be a violation of human rights law. From the above analysis, primarily regarding the elements of the relevant articles of the ECHR and the interpretation of those elements by the court, it is evident that a compulsory vaccination would be lawful if the government were to implement such a policy within explicit parameters whereby a compulsory vaccination would be necessary and proportionate in the interest of public health and safety and for the protection of the rights and freedoms of others. The Joint Committee on Vaccination and Immunisation (JCVI) is the independent expert advisory committee that advises the UK health departments on immunisation, making recommendations concerning vaccination schedules and vaccine safety. In December 2020, JCVI provided a document to the UK Government with advice to facilitate the development of policy on COVID-19 vaccination. [52] This document set out the recommendations regarding prioritization of the administration of COVID-19 vaccines in the UK population based on a comprehensive review of COVID-19, demographic data, clinical risk factors for mortality and hospitalisation, as well as the mathematical modelling on the potential impact of different vaccination programs. [53] If at some point there is a decision to make a COVID-19 vaccination compulsory in the UK, who would be subject to this compulsory vaccination would likely be a decision made in line with further advice from JCVI through enforcement by the UK Government. However, imposing such a requirement upon specific groups of people raises a number of significant concerns, considering the potential challenges that can be brought forward by ethicists and/or representatives of various religions. These questions and concerns are highly complicated matters which are essentially outside the scope of this specific discussion.

As COVID-19 continues to develop, the questions about vaccination become more significant. When considering the case law on the legality of interference with specific provisions of the ECHR, it seems possible that a compulsory COVID-19 vaccination can be enforced while still complying with human rights law. Only time will tell if compulsory vaccination will be adopted, but when it comes to the state’s protection of the greater good under such unprecedented circumstances, enforcement of a compulsory vaccination appears to be one of the most effective and beneficial protective measures.

Aaron Chia is a law graduate from the School of Law, University of Stirling, Scotland and currently a student associate at Yeghoyan & Jacula Law Firm, Ontario, Canada.

[1] UK Public General Acts, Coronavirus Act 2020 , c.7 (March 25, 2020).

[2] Ibid, s.51; s.52; s.38-39.

[3] European Convention on Human Rights, European Treaty Series No. 5 (1950), art. 5. Available at http://www.conventions.coe.int/Treaty/en/Treaties/Word/005.doc .

[4] J. Pugh, “The United Kingdom’s Coronavirus Act, deprivations of liberty, and the right to liberty and security of the person,” Journal of the Law and the Biosciences 7/1 (2020), pp. 1-14.

[6] Enhorn v. Sweden App no. 56529/00 (ECtHR, January 25, 2005); European Convention on Human Rights (see note 2), art. 2.

[7] Centers for Disease Control and Prevention, “Impact of vaccines universally recommended for children–United States, 1990-1998,” Morbidity and Mortality Weekly Report 48/12 (1999), pp. 243-248.

[8] Hussain et al., “The Anti-vaccination Movement: A Regression in Modern Medicine,” Cureus Journal of Medical Science 10/7 (2018), e2919.

[9] R. Pierik, “Mandatory Vaccination: An Unqualified Defence” Journal of Applied Philosophy 35/2 (2016), pp. 381-398.

[10] M. Mallory, L.Lindesmith, and R. Baric, “Vaccination-induced herd immunity: Success and challenges,” Journal of Allergy and Clinical Immunology 142/1 (2018), pp. 64-66.

[11] M. Sadarangani, Oxford Vaccine Group, Herd Immunity: How does it work? (2016). Available at https://www.ovg.ox.ac.uk/news/herd-immunity-how-does-it-work .

[12] L. Kestenbaum, and K. Feemster, “Identifying and Addressing Vaccine Hesitancy” Pedatric annals 44/4 (2015), pp. e71-e75.

[13] D. Antona et al., “Measles Elimination Efforts and 2008-2011 Outbreak, France,” Emerging Infectious Diseases 19/3 (2013), pp. 357-364; M. Pepys, “Science and serendipity,” Clinical Medicine 7/6 (2007), pp. 562-578.

[14] G. Rezza, “Mandatory vaccination for infants and children: the Italian experience,” Pathogens and Global Health 113/7 (2019), pp. 291-296; D. Lévy-Bruhl et al. “Extension of French vaccination mandates: from the recommendation of the Steering Committee of the Citizen Consultation on Vaccination to the law,” Eurosurveillance 23/17 (2018), 18-00048.

[15] European Convention on Human Rights (see note 2), art. 9.

[16] C. Hough-Telford et al. “Vaccine Delays, Refusals, and Patient Dismissals: A Survey of Pediatricians,” Journal of the American Academy of Pediatrics 138/3 (2016), e20162127.

[17] Vanderbilt Occupational Health Clinic, Immunizations and Religion (2013). Available at https://www.vumc.org/health-wellness/news-resource-articles/immunizations-and-religion ; J. Grabenstein, “What the world’s religions teach, applied to vaccines and immune globulins,” Vaccine 31/16 (2013), pp. 2011-2023.

[18] E. Walkinshaw, “Mandatory vaccinations: The international landscape,” Canadian Medical Association Journal 183/16 (2011), pp. e1167-e1168.

[19] UK Public General Acts, Human Rights Act 1998 , c.42 (November 9, 1998).

[20] L.C.B. v The United Kingdom App no. 14/1997/798/1001 (ECtHR, June 9, 1998), para. 36.

[21] O¨neryildiz v Turkey App no. 48939/99 (ECtHR, November 30, 2004), para. 89.

[22] F. Camilleri, “Compulsory vaccinations for children: Balancing the competing human rights at stake,” Netherlands Quarterly of Human Rights 37/3 (2019), pp. 245-267.

[23] Calvelli and Ciglio v Italy App no. 32967/96 (ECtHR, January 17, 2002), para. 49.

[24] A. Fiebelkorn, J. Seward, and W. Orenstein, “A Global Perspective of Vaccination of Healthcare Personnel against Measles: Systematic Review,” Vaccine 32/38 (2015), 4823.

[25] F. D’Ancona, “The law on compulsory vaccination in Italy: an update 2 years after the introduction,” Eurosurveillance 24/26 (2019), 1900371; Lévy-Bruhl et al. (see note 13); E. Walkinshaw, “Mandatory vaccination: The Canadian picture,” Canadian Medical Association Journal 183/16 (2011), pp. e1165-e1166; Walkinshaw (see note 17), pp. e1167.

[27] K. Ward, B. Hull, and J. Leask, “Financial incentives for childhood immunisation – a unique but changing Australian initiative,” Medical Journal of Australia 198/11 (2013), pp. 590-592.

[28] Camilleri (see note 21), pp. 251-252.

[29] Herczegfalvy v Austria App no. 10533/83 (ECtHR, September 24, 1992).

[30] European Convention on Human Rights (see note 2), art. 8.

[31] Kroon and Others v. the Netherlands App no. 18535/91 (ECtHR, October 27, 1994), para. 31.

[32] European Court of Human Rights, “Guide on Article 8 of the European Convention on Human Rights – Right to respect for private and family life,” (December 31, 2016). Available at https://www.echr.coe.int/documents/guide_art_8_eng.pdf.

[33] Halford v The United Kingdom App no. 20605/92 (ECtHR, June 25, 1997).

[34] Silver and others v The United Kingdom App no. 5947/72; 6205/73; 7052/75; 7061/75; 7107/75; 7113/75; 7136/75 (ECtHR, March 25 1983).

[35] Piechowicz v Poland App no, 20071/07 (ECtHR, April 17, 2012).

[36] European Court of Human Rights, “Freedom of thought, conscience and religion: A guide to the implementation of Article 9 of the European Convention on Human Rights,” (June, 2007). Available at https://www.echr.coe.int/Documents/Guide_Art_9_ENG.pdf .

[37] S.A.S. v France App no. 43835/11 (ECtHR, July 1, 2014).

[38] Olsson v Sweden App no. 10465/83 (ECtHR), March 24, 1988), para. 67; Dudgeon v. The United Kingdom App no. 7525/76 (ECtHR, October 22, 1981).

[39] Also see Z v Finland App no. 22009/93 (ECtHR, February 25, 1997).

[40] Piechowicz (see note 34).

[41] Paradiso and Campanelli v Italy App no. 25358 (ECtHR, January 24, 2017), para. 182.

[42] Biblical Centre of the Chuvash Republic v Russia App no. 33203/08 (ECtHR, June 12, 2014).

[43] Vavřička and Others v. the Czech Republic App no. 47621/13 and 5 others (ECtHR, April 8, 2021).

[44] Act No. 258/2000 on protection of public health as consolidated to Act No. 471/2005.

[45] Vavřička (see note 42), para. 293.

[46] Vavřička (see note 42), para. 265.

[47] Vavřička (see note 42), para. 272; para. 284; para. 282.

[48] Vavřička (see note 42), paras. 290-309; para. 311.

[49] Vavřička (see note 42), para. 158.

[50] Y. Li et al. “The temporal association of introducing and lifting non-pharmaceutical interventions with the time-varying reproduction number (R) of SARS-CoV-2: a modelling study across 131 countries,” The Lanclet Infectious Diseases 22/2 (2021), pp.139-202.

[51] University College London Hospitals NHS Foundation Trust, “Pandemic peak SARS-CoV-2 infection and seroconversion rates in London frontline health-care workers,” Elsevier Public Health Emergency Collection 396 (2020) pp. e6-e7.

[52] Department of Health and Social Care, “Joint Committee on Vaccination and Immunisation: advice on priority groups for COVID-19 vaccination,” (December 30, 2020). Available at https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/950113/jcvi-advice-on-priority-groups-for-covid-19-vaccination-30-dec-2020-revised.pdf .

[53] Ibid, pp. 1.

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An Ethical Anaylsis of the Arguments Both For and Against COVID-19 Vaccine Mandates for Healthcare Workers

Since the development of the first U.S. Food and Drug Administration–approved vaccine for the prevention of serious disease and death associated with the SARS-CoV-2 virus, health care workers have been expected to comply with mandatory immunization requirements or face potential termination of employment and censure by their state medical boards. Although most accepted this mandate, there have been several who have felt this was an unnecessary intrusion and violation of their right to choose their own health care mitigation strategies, or an infringement on their autonomy and other civil liberties. Others have argued that being a health care professional places your duties above your own self-interests, so-called fiduciary duties. As a result of these duties, there is an expected obligation to do the best action to achieve the “most good” for society. A so-called “utilitarian argument.”

We explore arguments both for and against these mandatory vaccine requirements and conclude using duty- and consequence-based moral reasoning to weigh the merits of each.

Conclusions

Although arguments for and against vaccine mandates are compelling, it is the opinion of the Ethics Committee of the American Academy of Emergency Medicine that vaccine mandates for health care workers are ethically just and appropriate, and the benefit to society far outweighs the minor inconvenience to an individual's personal liberties.

Introduction

The introduction of COVID-19 vaccine mandates for health care workers has caused debate and disruption in hospitals across the world, as well as within the United States. Several arguments have been made for and against the mandates, although mostly in political and social media. As the Ethics Committee of the American Academy of Emergency Medicine (AAEM), we are entrusted to guide the Academy and its members, and hopefully the entire emergency medicine (EM) community, regarding ethical matters affecting all facets of emergency care. COVID-19 quickly became a polarizing public health crisis, affecting people of all educational, socioeconomic, political, religious, and demographic backgrounds. COVID-19 greatly impacted emergency departments (EDs), which are often front and center to issues related to not only disease and its manifestations, but to the effects of vaccine mandates on health care professionals. As an ethics committee, we focus our arguments solely on ethics and do not debate the safety or efficacy of vaccines. The Ethics Committee accepts that these vaccines were recommended by the Centers for Disease Control and Prevention and are U.S. Food and Drug Administration (FDA)–approved, and proceed with the assumption that these vaccines meet safety requirements ( 1 ). We will also not debate the role of immunity from prior COVID-19 infection as being equivalent to the vaccine, as study on the equivalency is still ongoing at the time of writing this article. We will also avoid religious and legal arguments (except to mention one precedent case on public health law and vaccine mandates, which was based on a utilitarian ethical principle). Similarly, we will avoid discussion of religious or medical exemptions that may legitimately prevent receiving the vaccine. We present the arguments both for and against vaccine mandates and weigh the substantive arguments made by two panels of members, representing arguments “for” (M.M., B.W., A.U., E.S.) and “against” (L.D., R.B., D.F., A.G.) mandates. A.G. examined each of the arguments for their ethical soundness and, using principles of moral reasoning invoking deontology and consequentialism, concluded with the recommended moral position.

Of note, we use the term health care workers to include a physician-led team that may consist of any combination of residents, fellows, medical students, nurses, advanced practice providers, and health care assistants and technologists. It is not enough to focus on one out of this diverse group. As a physician-led group, it is the position of AAEM and most physician societies that medical care is best led by a board-certified physician, who also ensures the professional ethics guiding their practice are exhibited in each team member.

Arguments in Favor of Vaccine Mandates

Historically, vaccine mandates have been part of the protections under public health laws of many nations of the world. As far back as 1807, the German state of Bavaria introduced a mandate for vaccination of the public after development of the smallpox vaccine ( 2 ). In the 1905 Jacobson vs. Massachusetts decision, the U.S. Supreme Court ruled that state vaccine mandates were legal and enforceable to protect public health ( 3 ). Although in recent years there have been controversies regarding mandatory vaccination for schoolchildren, in large part these vaccination mandates have continued yearly without public debate. Generally speaking, and using the principle of acceptability, most members of the public have long accepted the role vaccines play in protecting their health and the health of those around them. There are many definitions of acceptability in ethics, however, we find most illustrative the following: “Acceptability is a multi-faceted construct that reflects the extent to which people delivering or receiving a healthcare intervention consider it to be appropriate, based on anticipated or experienced cognitive and emotional responses to the intervention” ( 4 ).

The initial argument in support of the COVID-19 vaccine mandates for health care workers must start with the principle of justice and consistency and their related ethical concepts that support fair and equitable treatment of individuals. Although justice is typically viewed through a patient-centric lens, it is reasonable to expect that health care workers not only treat their patients justly, but be treated and act justly and consistent with their professional ethics. Justice is defined as “fair, equitable, and appropriate treatment of persons” ( 5 ). There is a further implied principle within justice, that is, consistency. It is impossible to be just yet inconsistent. Just policies, even with caveats and exceptions, must be reproducible and consistent, otherwise they will not withstand scrutiny by society and, as a result, will not be ethical. A policy is just if it is fair, and the policy to mandate that health care workers receive the COVID-19 vaccine is fair, equitable, and appropriate, as it seeks to provide a means to distribute a necessary treatment without discrimination or bias and its benefits far outweigh any risks.

For the last half century, health care workers had generally accepted, as part of the requirements for obtaining hospital privileges, the role of mandatory vaccines for their and society's good. It is reasonable and expected then to mandate additional vaccines, as diseases become prevalent and vaccines are discovered, with the same intent to provide protection to health care workers and their patients. Prior to March 2020, proof of certain mandatory vaccinations, such as hepatitis B, tetanus, measles, mumps and rubella, and other childhood vaccinations (or proof of immunity) was an accepted norm in the process of starting clinical work in most clinical settings in the United States ( 6 ). When the COVID-19 vaccination became available, given the similar public health protection that the vaccination provided for this disease, it is reasonable and not an unusual or unfair burden on health care workers to add one more vaccine to the multitude they are required to get in order to provide clinical care. As stated in the first principle of AAEM's Principles of Ethics, there is a fiduciary duty by physicians to place the patient's interests above their own ( 7 ). In keeping with this principle, it is hard to conceive that refusing to protect oneself from severe disease from COVID-19, as well as the reported decreased rate of viral transmission and hence disease in vaccinated persons compared with the unvaccinated, is consistent with placing the interests of patients above health care workers ( 8 ).

One of the core tenets of medical ethics is the principle of nonmaleficence. This is best described as our unique duty to “do no harm,” as described in the Hippocratic Oath, which states physicians must “act in a way which does no harm” ( 9 ). Given the data that suggest even with the most recent highly virulent and contagious mutations of the SARS-CoV-2 virus, there is a decreased risk of transmission from vaccinated individuals, hence vaccinated health care workers uphold their duty of nonmaleficence to their patients. In contrast, remaining unvaccinated potentially exposes highly vulnerable patients and coworkers to the virus and potentially COVID-19. In addition, a health care worker who is unavailable due to COVID-19 and who is unvaccinated unfairly shifts more work burden on to their vaccinated coworkers and reduces the pool of health care workers available to society, which is worse during a pandemic.

Given the trust that society has in the medical profession, and the resultant duty that health care workers owe to society, ensuring wellness both physically and emotionally is integral in providing ethically based care. Health care workers aim not just to avoid causing harm to patients, but to ensure good. Beneficence , another throwback to the Hippocratic Oath, is defined as “an act of charity, mercy, and kindness with a strong connotation of doing good to others including moral obligation. All professionals have the foundational moral imperative of doing right. In the context of the professional–client relationship, the professional is obligated to, always and without exception, favor the well-being and interest of the client” ( 10 ). This definition is especially helpful in reiterating the fiduciary responsibility health care workers have to their patients and the need to ensure they are willing and able to provide ethical care, which implies having not only the technical and experiential knowledge, but the appropriate state of mind and physical well-being. A sick health care worker diminishes the potency of the physician–patient relationship.

As alluded to earlier, public health ethics, policy, and law have generally been structured around the utilitarian principle of doing the best for the most ( 11 ). Its underlying theme is to maximize the good in society to the benefit of the most members of that society. It acknowledges that there are certain segments of the society in which individual liberties may be affected to protect the welfare of other members, but it is felt to be just and appropriate ethically for the greater good of society. Like all other vaccines mandated to attend school or for employment in a health care facility in the United States, once the Pfizer-BioNTech COVID-19 vaccine was approved by the FDA, its role in risk-mitigating the serious sequela of COVID-19 was sufficient justification to mandate that all health care workers add this vaccine to the list of mandatory vaccines, thereby ensuring protection for the vulnerable who seek medical care ( 12 ). Serving as a mini-cosmos of society, vaccine mandates for health care workers ensure that the greatest utility (i.e., protection from COVID-19) is achieved.

Argument against Vaccine Mandates

Utilitarianism appeals to us during times of crisis. It offers an enticing solution: do the greatest good, to the greatest number of people. However, the pursuit of utilitarian ideals often challenges the rights of the individual. In the COVID-19 pandemic, the utilitarian argument has been applied to vaccine mandates.

Why is vaccination a moral issue? The decision to become vaccinated and the prevention of harm fulfills the first categorical imperative and it also has the appeal of prudence. Vaccine mandates risk treating individuals as a means to an end and risk running afoul of the second categorical imperative. Utilitarian advocates would argue for a vaccine mandate as it provides the greatest well-being for the most people possible. The utilitarian argument that vaccine mandates are doing the best for the most falls flat when taking into consideration that a vaccine for the seasonal influenza virus (flu), for example, is available and, although required by many health care facilities, it is not mandated, as there is a workaround for those who refuse it. Using the principle of consistency to ensure like circumstances are treated similarly: if utilitarianism was to be the underpinning of the COVID-19 vaccine mandate, one would expect that the flu vaccine would also be mandated, as its impact on the health care field is just as large as SARS-CoV-2, yet only four states require it ( 13 ). Furthermore, individuals who choose not to receive an influenza vaccine are not harassed, stigmatized, or threatened with termination of their job, but are allowed to seek exemptions or are required to mask for the entirety of the flu season. Consistency is key in ethical principles and consistency in this utilitarian argument seems to be lacking.

To the “pro” argument on acceptability, we must disagree. It requires very little formal research to establish that many things deemed absolutely correct 100 years ago may not be acceptable today. Society only questions the “status quo” when enough individuals refuse to follow it, or when advances in science or other studies elevate our collective knowledge. There are, and have been, many “accepted” practices that are not fair, equitable, just, or ethical, and hence acceptability as a criterion lacks merits. Likewise, we must question the “fiduciary” argument that blindly mandates physician wellness and interests below that of their patients. Moral injury, burnout, post-traumatic stress disorder, anxiety, for example, are all concepts permeating the medical (especially EM) literature, and are directly related to the work environment of medicine. Although it is important in general terms to hold the patient's medical interests over one's own, does this require self-sacrifice in order to uphold the Hippocratic Oath? Are we, as health care workers, now enslaved to the profession without any rights of our own? We are entrusted with great responsibility and trust by society and have access to the greatest bodies of knowledge, yet as subject matter experts we are not afforded the same “right to refuse” as any other autonomous agent in the free world. For that, we call foul.

It is our position that Kantian ethics provide a solution to this dilemma and address both the concerns of individual rights and society at large. Kant's moral theory describes individuals as having intrinsic worth as autonomous, rational agents. He describes a concept of “good will” in which people have the capacity to recognize a moral act and the duty to act on it. This is an ongoing, conscious process ( 14 ). In contrast, utilitarianism would view the intrinsic value of individual choice in its effects. In Jeremy Bentham's interpretation, this was hedonism: the degree of how much pleasure could be caused or pain avoided ( 15 , 16 ). Other philosophers view the ideal outcomes of personal decisions as well-being. For the utilitarian John Stuart Mill, decisions or rules were also viewed as moral to the degree in which they benefited the majority ( 17 ).

Central to Kant's work were his categorical imperatives, that is, moral laws applicable to all individuals ( 14 ). These are laws freely accessible to individuals using reason and intellect and apply to all equally. The first principle described the concept of universalizability; a moral actor considers the principle underlying their personal decisions and the effect if all other individuals acted in a similar manner. The second principle emphasizes that humanity should be an end in itself, and never a means to an end. As human beings are rational and autonomous, we can set our own goals; humans exist for themselves and are morally self-governed.

It is important to note that Kant thought that decisions could be divided into those that were prudent and those that were ethical ( 14 ). Often, these categories coincide. During the COVID-19 pandemic, there was a wide range of public health decisions made with the intent of limiting morbidity and mortality. Masking, travel restrictions, and quarantining after exposure fall into both categories. A prudent individual, concerned about their own health and considering their duty to preserve both their own health and that of their peers would reasonably adopt these measures to preserve their own health and longevity as well as that of their peers.

Kantian philosophers must argue against these mandates, as it is the individual's duty to identify the moral good offered by these vaccines and take the appropriate action. Compelling action and violating personal autonomy to reach the so-called, “herd immunity” would be a moral evil.

To this dilemma, we offer a solution. We have seen the public's trust in clinicians and the medical establishment erode throughout this pandemic, as people chafe against changing mandates and norms. The evidence we have of the benefit of the vaccines for our patients is clear; it is both a prudent and moral decision. But it is a personal decision based on moral duty. Physicians must continue to educate and guide to moral clarity. To do anything else is to treat our patients as a means to an end.

We have presented ethical arguments both for and against a mandate for health care workers to receive vaccination against COVID-19. A key argument for vaccine mandates rests on the ethical requirements for health care workers to place the well-being of the community as a whole above their own individual interests. Whereas, the key arguments against mandates state that an individual's autonomy must be primary, and that autonomy should not be overridden or ignored in the name of a “higher” good.

Both arguments being compelling, it is the opinion of the Ethics Committee of AAEM that vaccine mandates for health care workers are ethically just and appropriate, and the benefit to society far outweighs the minor inconvenience to an individual's personal liberties. This opinion rests on the following key conditions: the risks of the disease are significant to society as a whole, the vaccine has been FDA-approved (which implies thoroughly tested and deemed “safe”), and there are exceptions for those with legitimate medical or religious reasons. Vaccine mandates are consistent with professional ethics and fiduciary duties to patients. Society's interest should be held as primary over individual interests, especially as it concerns an action that is consistent and congruent with actions in our well established and accepted practice of medicine. That said, as we see a shift from pandemic to endemic status, and the research grows on natural vs. obtained immunity, there may be a shift in this opinion over time on mandatory COVID-19 vaccination.

Acknowledgments

The authors would like to thank the AAEM Ethics Committee for their assistance in providing critical feedback on this manuscript.

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