Minor Consent for Vaccination: Ethically Justified, Politically Fraught.

Policies allowing some minors to consent to receive recommended vaccines are ethically defensible. However, a policy change at the federal level expanding minor consent for vaccinations nationwide risks triggering a political backlash. Such a move may be perceived as infringing on the rights of parents to make decisions about their children's health care. In the current post-COVID environment of heightened anti-vaccination activism, changes to minor consent laws may be unadvisable, and policy makers should proceed with caution.

Lowering the Age of Consent for Vaccination to Promote Pediatric Vaccination: It's Worth a Shot.

This paper challenges historically preconceived notions surrounding a minor's ability to make medical decisions, arguing that federal health law should be reformed to allow minors with capacity as young as age 12 to consent to their own Centers for Diseases Control and Prevention (CDC)-approved COVID-19 vaccinations. This proposal aligns with and expands upon current exceptions to limitations on adolescent decision-making. This analysis reviews the historic and current anti-vaccination sentiment, examines legal precedence and rationale, outlines supporting ethical arguments regarding adolescent decision-making, and offers rebuttals to anticipated ethical counterarguments.

Moral persuasion for value-laden objections to human papillomavirus vaccination.

The martial art of jiu jitsu capitalizes on the strength of a sparring partner by redirecting their momentum. Jiu jitsu persuasion similarly redirects the concerns motivating an objection in a manner that undermines the objection. This method of persuasion effectively addresses criticisms that motivate vaccine hesitancy, including moral criticisms. Critics argue that human papillomavirus vaccination causes young women to become more promiscuous. Evidence undermines this objection, but such evidence fails to persuade many objectors because of countervailing moral concerns regarding promiscuity. Healthcare professionals, therefore, need to consider supplementing evidence with moral arguments against the objection, using a framework that appeals to the core values motivating vaccine objections. A jiu jitsu model of persuasion is one such framework. By employing a jiu jitsu model healthcare professionals can facilitate collaborative, normative discussion that persuades more objectors and fulfills healthcare professionals' obligations with respect to patient care vis-à-vis vaccination.

Jewish Ethics of Inmate Vaccines Against COVID-19.

PURPOSE: The COVID-19 pandemic broke out at the end of 2019, and throughout 2020 there were intensive international efforts to find a vaccine for the disease, which had already led to the deaths of some five million people. In December 2020, several pharmaceutical companies announced that they had succeeded in producing an effective vaccine, and after approval by the various regulatory bodies, countries started to vaccinate their citizens. With the start of the global campaign to vaccinate the world's population against COVID-19, debates over the prioritization of different sections of the population began around the world, but the prison population has generally been absent from these discussions. APPROACH AND FINDINGS: This article presents the approach of Jewish ethics regarding this issue, that is, that there is a religious and a moral obligation to heal the other and to take care of his or her medical well-being and that this holds true even for a prisoner who has committed a serious crime. Hence, prisoners should be vaccinated according to the same priorities that govern the administration of the vaccine among the general public. ORIGINALITY: The originality of the article is in a comprehensive and comparative reference between general ethics and Jewish ethics on a subject that has not yet received the proper attention.

Financial incentives for vaccination do not have negative unintended consequences.

Financial incentives to encourage healthy and prosocial behaviours often trigger initial behavioural change1-11, but a large academic literature warns against using them12-16. Critics warn that financial incentives can crowd out prosocial motivations and reduce perceived safety and trust, thereby reducing healthy behaviours when no payments are offered and eroding morals more generally17-24. Here we report findings from a large-scale, pre-registered study in Sweden that causally measures the unintended consequences of offering financial incentives for taking the first dose of a COVID-19 vaccine. We use a unique combination of random exposure to financial incentives, population-wide administrative vaccination records and rich survey data. We find no negative consequences of financial incentives; we can reject even small negative impacts of offering financial incentives on future vaccination uptake, morals, trust and perceived safety. In a complementary study, we find that informing US residents about the existence of state incentive programmes also has no negative consequences. Our findings inform not only the academic debate on financial incentives for behaviour change but also policy-makers who consider using financial incentives to change behaviour.

Moral Foundations Predict COVID-19 Vaccine Hesitancy: Evidence from a National Survey of Black Americans.

In this study we examine the role of moral values in predicting COVID-19 vaccine hesitancy among Black Americans. Guided by moral foundations theory, we assess the associations between six moral foundations (care, fairness, loyalty, authority, purity, liberty) and attitudes and intentions toward COVID-19 vaccination. Results of a national survey of Black Americans (N = 1,497) indicate that the care and loyalty moral foundations consistently predicted less vaccine hesitancy with overall more favorable attitudes and intentions toward COVID-19 vaccination, whereas the purity and liberty moral foundations were consistently associated with greater vaccine hesitancy. Relationships between the foundations and vaccine hesitancy were mediated by perceived vaccine effectiveness and safety. Implications of the findings for COVID-19 vaccine communication are discussed.

Correspondencia vacunación-inmunización como necesidad social y reto para la ciencia y la educación médica / Vaccination-immunization correspondence as a social need and challenge for science and medical education

Introducción: La vacunación constituye el arma preventiva más efectiva para las enfermedades trasmisibles que conoce la humanidad. Hacer que las vacunas aplicadas sean realmente inmunizantes resulta la responsabilidad de los profesionales de la atención primaria. Del mismo modo, es importante que se acepte, sin recelo, la vacunación, sobre todo en la situación epidemiológica actual. Objetivo: Describir las implicaciones sociales, económicas y éticas relacionadas con la existencia de vacunas teóricamente no inmunizantes. Métodos: Se emplearon los resultados de un programa de intervención educativa en edades pediátricas en el Policlínico 13 de marzo. Se utilizó la prueba de rangos con signo de Wilcoxon, con índice de confianza del 95 por ciento. Resultados: Inicialmente, predominó el nivel inadecuado de conocimiento, que luego mejoró significativamente. Se recuperaron 48 niños no vacunados y 29 vacunaciones no inmunizados. Conclusiones: No existe correspondencia entre las coberturas vacunales y la inmunización. Están instauradas, como correctas, falsas contraindicaciones para la vacunación. La intervención educativa fue efectiva, y se hizo patente la pertinencia de programas de pregrado y posgrado que perfeccionen la formación de los profesionales y la calidad en el desempeño profesional(AU)

Introduction: Vaccination is the most effective preventive weapon for communicable diseases known to humanity. It is the responsibility of primary health care professionals to ensure that the administered vaccines are truly immunizing. Likewise, it is important that vaccination be accepted without hesitations, especially in the current epidemiological situation. Objective: To describe the social, economic and ethical implications related to the existence of theoretically nonimmunizing vaccines. Methods: The results of an educational intervention program in pediatric ages at 13 de Marzo Policlinic were used. The Wilcoxon signed-rank test was used, with a confidence index of 95 percent. Results: Initially, an inadequate level of knowledge predominated, which later improved significantly. Forty-eight unvaccinated children and 29 unimmunized children recovered. Conclusions: There is no correspondence between vaccination coverage and immunization. False contraindications for vaccination are established as correct. The educational intervention was effective, while the relevance became evident for undergraduate and postgraduate programs to improve the training of professionals and the quality of professional performance(AU)

¿Es posible obligar a las personas a vacunarse? Nudge contra el coronavirus / Is it possible to force people to be vaccinated? Nudge against coronavirus / É possível obrigar as pessoas a vacinar-se? Cutucar contra o coronavírus

Resumen: Sabemos que el mundo enfrenta una terrible pandemia. La ciencia, con esfuerzo y prontitud, ha podido desarrollar diversas vacunas contra el covid-19, generando ello grandes expectativas. Sin embargo, por diversos factores, los procesos masivos de vacunación no han avanzado a la velocidad requerida; uno de los principales es la resistencia de muchas personas a vacunarse, aduciendo diferentes razones. Frente a esta situación se ha oscilado entre la realización de campañas de publicidad hasta propuestas de imposición forzada. Una alternativa para ir más allá de lo meramente lírico y lo coercitivo es generar formas de motivación para que aquellas personas decidan voluntariamente vacunarse a través de diversas medidas, directas e indirectas, apelando a "Nudge" -o "teoría del pequeño empujón"-, con el fin de propiciar la mejor protección de la salud individual y colectiva, tema del que trata el presente artículo, a partir de la revisión bibliográfica sobre la materia y diversas experiencias en la lucha contra el coronavirus.

Abstract: We all know that the world is facing a terrible pandemic. Science, with effort and promptness, has been able to develop various vaccines against Covid-19, generating great expectations. However, mass vaccination processes have not advanced at the required speed due to various factors; one of the main ones is the resistance of many people to get vaccinated, for different reasons. Faced with this situation, it has oscillated between carrying out advertising campaigns to proposals for forced imposition. An alternative to go beyond the merely lyrical and coercive is to generate forms of motivation for those people to voluntarily decide to be vaccinated through various measures, direct and indirect, appealing to "Nudge" -or the "little push theory" - in order to promote the best protection of individual and collective health, the subject of this article, based on the bibliographic review on the matter and various experiences in the fight against coronavirus.

Resumo: Sabemos que o mundo enfrenta uma terrível pandemia. A ciência, com esforço e prontidão, pode desenvolver diversas vacinas contra a Covid-19, gerando grandes expectativas. Sem dúvida, os processos massivos de vacinação não avançaram à velocidade requerida por diversos fatores; um dos principais é a resistência de muitas pessoas a vacinar-se, alegando diferentes razões. Frente a esta situação, observou-se uma oscilação entre a realização de campanhas de publicidade a propostas de imposição forçada. Uma alternativa para ir além do meramente lírico e do coercitivo é gerar formas de motivação para que as pessoas decidam voluntariamente vacinar-se através de diversas medidas, diretas e indiretas, apelando a "Nudge" -ou a "teoria do pequeno empurrão"- a fim de propiciar a melhor proteção da saúde individual e coletiva, tema do que trata o presente artigo, a partir da revisão bibliográfica sobre a matéria e diversas experiências na luta contra o coronavírus.

Considering a COVID-19 vaccine mandate for pediatric kidney transplant candidates.

The world continues to face the effects of the SARS-CoV-2 pandemic. COVID-19 vaccines are safe and effective in protecting recipients, decreasing the risk of COVID-19 acquisition, transmission, hospitalization, and death. Transplant recipients may be at greater risk for severe SARS-CoV-2 infection. As a result, transplant programs have begun instituting mandates for COVID-19 vaccine for transplant candidacy. While the question of mandating COVID-19 vaccine for adult transplant candidates has garnered attention in the lay and academic press, these discussions have not explicitly addressed children who may be otherwise eligible for kidney transplants. In this paper we seek to examine the potential ethical justifications of a COVID-19 vaccine mandate for pediatric kidney transplant candidacy through an examination of relevant ethical principles, analogous cases of the use of mandates, differences between adult and pediatric kidney transplant candidates, and the role of gatekeeping in transplant vaccine mandates. At present, it does not appear that pediatric kidney transplant centers are justified to institute a COVID-19 vaccine mandate for candidates. Finally, we will offer suggestions to be considered prior to the implementation of a COVID-19 vaccine mandate.

Solidarity in Pandemics, Mandatory Vaccination, and Public Health Ethics.

Mandatory vaccination has been a highly disputed policy for tackling infectious diseases. Here I argue that a universal mandatory vaccination policy for the general public against the COVID-19 pandemic is ethically preferable when grounded in the concept of solidarity, which is defined by Barbara Prainsack and Alena Buyx as an enacted commitment to a relevant respect recognized by a group of individuals with equal moral status. This approach is complementary to utilitarian accounts and could better address other reasonable oppositions to mandatory vaccination. From a solidaristic account, the recognized relevant respect is to end the COVID-19 pandemic as soon as possible. This group of individuals would be willing to carry costs to assist each other in this respect, and a mandatory vaccination policy could be their institutionalized mutual assistance. The costs to be carried include both the financial costs of vaccination and the health costs stemming from potential adverse events and scientific uncertainties. The proposed social health insurance similarity test suggests the degree of coercion the mandatory vaccination policy could undertake within each state's specific legal and judicial context. (Am J Public Health. 2022;112(2):255-261. https://doi.org/10.2105/AJPH.2021.306578).