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The unnaturalistic fallacy: COVID-19 vaccine mandates should not discriminate against natural immunity

COVID-19 vaccine requirements have generated significant debate. Here, we argue that, on the evidence available, such policies should have recognised proof of natural immunity as a sufficient basis for exemption to vaccination requirements. We begin by distinguishing our argument from two implausibl...

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Autores principales: Pugh, Jonathan, Savulescu, Julian, Brown, Rebecca C H, Wilkinson, Dominic
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9132858/
https://www.ncbi.nlm.nih.gov/pubmed/35256487
http://dx.doi.org/10.1136/medethics-2021-107956
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author Pugh, Jonathan
Savulescu, Julian
Brown, Rebecca C H
Wilkinson, Dominic
author_facet Pugh, Jonathan
Savulescu, Julian
Brown, Rebecca C H
Wilkinson, Dominic
author_sort Pugh, Jonathan
collection PubMed
description COVID-19 vaccine requirements have generated significant debate. Here, we argue that, on the evidence available, such policies should have recognised proof of natural immunity as a sufficient basis for exemption to vaccination requirements. We begin by distinguishing our argument from two implausible claims about natural immunity: (1) natural immunity is superior to ‘artificial’ vaccine-induced immunity simply because it is ‘natural’ and (2) it is better to acquire immunity through natural infection than via vaccination. We then briefly survey the evidence base for the comparison between naturally acquired immunity and vaccine-induced immunity. While we clearly cannot settle the scientific debates on this point, we suggest that we lack clear and convincing scientific evidence that vaccine-induced immunity has a significantly higher protective effect than natural immunity. Since vaccine requirements represent a substantial infringement of individual liberty, as well as imposing other significant costs, they can only be justified if they are necessary for achieving a proportionate public health benefit. Without compelling evidence for the superiority of vaccine-induced immunity, it cannot be deemed necessary to require vaccination for those with natural immunity. Subjecting them to vaccine mandates is therefore not justified. We conclude by defending the standard of proof that this argument from necessity invokes, and address other pragmatic and practical considerations that may speak against natural immunity exemptions.
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spelling pubmed-91328582022-06-10 The unnaturalistic fallacy: COVID-19 vaccine mandates should not discriminate against natural immunity Pugh, Jonathan Savulescu, Julian Brown, Rebecca C H Wilkinson, Dominic J Med Ethics Feature Article COVID-19 vaccine requirements have generated significant debate. Here, we argue that, on the evidence available, such policies should have recognised proof of natural immunity as a sufficient basis for exemption to vaccination requirements. We begin by distinguishing our argument from two implausible claims about natural immunity: (1) natural immunity is superior to ‘artificial’ vaccine-induced immunity simply because it is ‘natural’ and (2) it is better to acquire immunity through natural infection than via vaccination. We then briefly survey the evidence base for the comparison between naturally acquired immunity and vaccine-induced immunity. While we clearly cannot settle the scientific debates on this point, we suggest that we lack clear and convincing scientific evidence that vaccine-induced immunity has a significantly higher protective effect than natural immunity. Since vaccine requirements represent a substantial infringement of individual liberty, as well as imposing other significant costs, they can only be justified if they are necessary for achieving a proportionate public health benefit. Without compelling evidence for the superiority of vaccine-induced immunity, it cannot be deemed necessary to require vaccination for those with natural immunity. Subjecting them to vaccine mandates is therefore not justified. We conclude by defending the standard of proof that this argument from necessity invokes, and address other pragmatic and practical considerations that may speak against natural immunity exemptions. BMJ Publishing Group 2022-06 2022-03-07 /pmc/articles/PMC9132858/ /pubmed/35256487 http://dx.doi.org/10.1136/medethics-2021-107956 Text en © Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY. Published by BMJ. https://creativecommons.org/licenses/by/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license, which permits others to copy, redistribute, remix, transform and build upon this work for any purpose, provided the original work is properly cited, a link to the licence is given, and indication of whether changes were made. See: https://creativecommons.org/licenses/by/4.0/.
spellingShingle Feature Article
Pugh, Jonathan
Savulescu, Julian
Brown, Rebecca C H
Wilkinson, Dominic
The unnaturalistic fallacy: COVID-19 vaccine mandates should not discriminate against natural immunity
title The unnaturalistic fallacy: COVID-19 vaccine mandates should not discriminate against natural immunity
title_full The unnaturalistic fallacy: COVID-19 vaccine mandates should not discriminate against natural immunity
title_fullStr The unnaturalistic fallacy: COVID-19 vaccine mandates should not discriminate against natural immunity
title_full_unstemmed The unnaturalistic fallacy: COVID-19 vaccine mandates should not discriminate against natural immunity
title_short The unnaturalistic fallacy: COVID-19 vaccine mandates should not discriminate against natural immunity
title_sort unnaturalistic fallacy: covid-19 vaccine mandates should not discriminate against natural immunity
topic Feature Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9132858/
https://www.ncbi.nlm.nih.gov/pubmed/35256487
http://dx.doi.org/10.1136/medethics-2021-107956
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