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The unintended consequences of COVID-19 vaccine policy: why mandates, passports and restrictions may cause more harm than good

Vaccination policies have shifted dramatically during COVID-19 with the rapid emergence of population-wide vaccine mandates, domestic vaccine passports and differential restrictions based on vaccination status. While these policies have prompted ethical, scientific, practical, legal and political de...

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Autores principales: Bardosh, Kevin, de Figueiredo, Alex, Gur-Arie, Rachel, Jamrozik, Euzebiusz, Doidge, James, Lemmens, Trudo, Keshavjee, Salmaan, Graham, Janice E, Baral, Stefan
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9136690/
https://www.ncbi.nlm.nih.gov/pubmed/35618306
http://dx.doi.org/10.1136/bmjgh-2022-008684
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author Bardosh, Kevin
de Figueiredo, Alex
Gur-Arie, Rachel
Jamrozik, Euzebiusz
Doidge, James
Lemmens, Trudo
Keshavjee, Salmaan
Graham, Janice E
Baral, Stefan
author_facet Bardosh, Kevin
de Figueiredo, Alex
Gur-Arie, Rachel
Jamrozik, Euzebiusz
Doidge, James
Lemmens, Trudo
Keshavjee, Salmaan
Graham, Janice E
Baral, Stefan
author_sort Bardosh, Kevin
collection PubMed
description Vaccination policies have shifted dramatically during COVID-19 with the rapid emergence of population-wide vaccine mandates, domestic vaccine passports and differential restrictions based on vaccination status. While these policies have prompted ethical, scientific, practical, legal and political debate, there has been limited evaluation of their potential unintended consequences. Here, we outline a comprehensive set of hypotheses for why these policies may ultimately be counterproductive and harmful. Our framework considers four domains: (1) behavioural psychology, (2) politics and law, (3) socioeconomics, and (4) the integrity of science and public health. While current vaccines appear to have had a significant impact on decreasing COVID-19-related morbidity and mortality burdens, we argue that current mandatory vaccine policies are scientifically questionable and are likely to cause more societal harm than good. Restricting people’s access to work, education, public transport and social life based on COVID-19 vaccination status impinges on human rights, promotes stigma and social polarisation, and adversely affects health and well-being. Current policies may lead to a widening of health and economic inequalities, detrimental long-term impacts on trust in government and scientific institutions, and reduce the uptake of future public health measures, including COVID-19 vaccines as well as routine immunisations. Mandating vaccination is one of the most powerful interventions in public health and should be used sparingly and carefully to uphold ethical norms and trust in institutions. We argue that current COVID-19 vaccine policies should be re-evaluated in light of the negative consequences that we outline. Leveraging empowering strategies based on trust and public consultation, and improving healthcare services and infrastructure, represent a more sustainable approach to optimising COVID-19 vaccination programmes and, more broadly, the health and well-being of the public.
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spelling pubmed-91366902022-05-27 The unintended consequences of COVID-19 vaccine policy: why mandates, passports and restrictions may cause more harm than good Bardosh, Kevin de Figueiredo, Alex Gur-Arie, Rachel Jamrozik, Euzebiusz Doidge, James Lemmens, Trudo Keshavjee, Salmaan Graham, Janice E Baral, Stefan BMJ Glob Health Analysis Vaccination policies have shifted dramatically during COVID-19 with the rapid emergence of population-wide vaccine mandates, domestic vaccine passports and differential restrictions based on vaccination status. While these policies have prompted ethical, scientific, practical, legal and political debate, there has been limited evaluation of their potential unintended consequences. Here, we outline a comprehensive set of hypotheses for why these policies may ultimately be counterproductive and harmful. Our framework considers four domains: (1) behavioural psychology, (2) politics and law, (3) socioeconomics, and (4) the integrity of science and public health. While current vaccines appear to have had a significant impact on decreasing COVID-19-related morbidity and mortality burdens, we argue that current mandatory vaccine policies are scientifically questionable and are likely to cause more societal harm than good. Restricting people’s access to work, education, public transport and social life based on COVID-19 vaccination status impinges on human rights, promotes stigma and social polarisation, and adversely affects health and well-being. Current policies may lead to a widening of health and economic inequalities, detrimental long-term impacts on trust in government and scientific institutions, and reduce the uptake of future public health measures, including COVID-19 vaccines as well as routine immunisations. Mandating vaccination is one of the most powerful interventions in public health and should be used sparingly and carefully to uphold ethical norms and trust in institutions. We argue that current COVID-19 vaccine policies should be re-evaluated in light of the negative consequences that we outline. Leveraging empowering strategies based on trust and public consultation, and improving healthcare services and infrastructure, represent a more sustainable approach to optimising COVID-19 vaccination programmes and, more broadly, the health and well-being of the public. BMJ Publishing Group 2022-05-25 /pmc/articles/PMC9136690/ /pubmed/35618306 http://dx.doi.org/10.1136/bmjgh-2022-008684 Text en © Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. https://creativecommons.org/licenses/by-nc/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) .
spellingShingle Analysis
Bardosh, Kevin
de Figueiredo, Alex
Gur-Arie, Rachel
Jamrozik, Euzebiusz
Doidge, James
Lemmens, Trudo
Keshavjee, Salmaan
Graham, Janice E
Baral, Stefan
The unintended consequences of COVID-19 vaccine policy: why mandates, passports and restrictions may cause more harm than good
title The unintended consequences of COVID-19 vaccine policy: why mandates, passports and restrictions may cause more harm than good
title_full The unintended consequences of COVID-19 vaccine policy: why mandates, passports and restrictions may cause more harm than good
title_fullStr The unintended consequences of COVID-19 vaccine policy: why mandates, passports and restrictions may cause more harm than good
title_full_unstemmed The unintended consequences of COVID-19 vaccine policy: why mandates, passports and restrictions may cause more harm than good
title_short The unintended consequences of COVID-19 vaccine policy: why mandates, passports and restrictions may cause more harm than good
title_sort unintended consequences of covid-19 vaccine policy: why mandates, passports and restrictions may cause more harm than good
topic Analysis
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9136690/
https://www.ncbi.nlm.nih.gov/pubmed/35618306
http://dx.doi.org/10.1136/bmjgh-2022-008684
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