Catholic Medical Quarterly

The Journal of the Catholic Medical Association (UK)

Building knowledge. Building faith. Protecting the vulnerable.

• Home
• CMA (UK) Website
• Contact us
• About Us

Catholic Medical Quarterly Volume 71(4) November 2021

Mandatory Vaccination for Covid and other illnesses: a personal view

Dr Adrian Treloar

A number of people have asked about our views upon mandatory vaccination for Covid-19.

I note that there are many vaccines which have been demonstrated to be highly effective in terms of protecting individuals from particular illnesses. As well as that many vaccines also prevent an infected person from giving that illness to another person. In health care preventing transmission from infected staff to patients may be especially important. Key examples include Hepatitis B and Rubella. Because of the need to prevent the harm to others that comes from infecting patients with Hepatitis B and Rubella, it has been accepted that immunity to these infections is a reason­able requirement for health staff to work with patients. The principle of clearly demanding that healthcare workers are vaccinated for some infections (to protect others) has therefore already, effectively, been accepted. There is wide­spread agreement (including within all whom I have spoken to in the CMA) that that conclusion is correct.

I note that a significant part of the “test” required to require such a vaccination must be that it is highly effective and gives good protection to others from infection. Rubella clearly passes that test in terms of healthcare workers and the prevention of serious disability in un­born children [1]. Indeed, vaccination of adults is legitimately required to protect children who do not actually exist:-they have not yet been conceived.

With regard to Covid vaccinations, I note that the vaccines have been associated with significant reductions in mortality (which is excellent of course) and I have been an enthusiastic advocate of vaccination for that reason. The reduction in serious illness and death for vulnerable people is indeed a compelling reason to advocate vaccination for those (mostly older and vulnerable people) most at risk of serious illness, harm and death. But although evidence is still emerging, the reduction in infectivity is clearly less than was thought earlier on:- both in terms of people’s ability to catch the virus and also their ability to pass it on. Further, it is now clear that while working well to prevent severe disease, double vaccination does not stop people getting Covid or passing it on.

Therefore, while the CMQ has been strongly supportive of vaccination[2,3,4] and has encouraged wide acceptance, some CMA members have told me that they feel that the effectiveness of the vaccines is not so great that the threshold for mandatory vaccination is met. As well as that, there remains little evidence on long term fertility among women of children bearing age. The Joint Committee on Vaccination and Immunisation found that “given the very low risk of serious disease in those aged 12 to 15 years without an underlying health condition.....considerations on the potential harms and benefits of vaccination are very finely balanced.” [5]. In younger healthier people benefit to the individual from vaccination is less.

I do not conclude from that that widespread vaccination is neither useful nor right. Covid is a severe illness that has killed (and is killing) many people. But acceptance of vaccination should be, first and foremost, via consent. Strong encouragement, especially for those who are particularly vulnerable must be right. But in a country where uptake among those groups is already above 90%, little extra may be gained if further vaccines are forced upon people by the state. Consent to treat­ment is a legal requirement for the administration of treatment under UK law, International Law every ethical code I know. The Congregation for Doctrine and the Faith (CDF) also state that vaccination should be voluntary.[6] Mandatory vaccination breaches all those codes that and may turn out to achieve less than is hoped for.