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The Ethics of Universities Requiring COVID Vaccination

KATE STOCKRAHM, HOST: Cornell University is the latest to join a growing list of American colleges planning to mandate COVID vaccinations for their students. It’s a sticky subject for schools, which have to weigh the benefits of increased vaccination against potential burdens on individuals and their freedoms.

Dr. Erin Paquette is a bioethicist, and assistant professor of both pediatrics and law at Northwestern University. I asked her, given that vaccine mandates have been around since the early 1900s, why is there still debate around these requirements?

DR. ERIN PAQUETTE: So I think with the Coronavirus vaccine, a couple of things come up that are challenging with respect to mandating vaccination. The first is you, um, you know, you want to avoid things that are overly burdensome to individuals or put them at an undue risk or undue burden. And I think some have objected to mandatory vaccination currently because the vaccines that are available are available in our emergency use authorization, not yet with formal approval. And the second is, depending on where a mandate is coming into play is: is it the least restrictive way to accomplish increased vaccination rates, and to meet the goals for whatever environment in which the mandate is being applied?

STOCKRAHM: New York State specifically does not allow for nonmedical exemptions to school vaccine requirements. Are there specific ethical or legal concerns that arise from that policy?

PAQUETTE: In the setting of various outbreaks—including recently measles outbreaks—the question of whether places should, uh, states or regions or individual schools should allow nonmedical exemptions to vaccination um, comes up -- and intermittently as we see flares of vaccine preventable diseases. And so the the American Academy of Pediatrics actually, in addition to many states that have removed nonmedical exemptions, um, has put forth the idea that nonmedical exemptions should not be permitted, because for vaccine preventable diseases, students should be receiving those vaccines where obviously the safety data is present.

STOCKRAHM: I'm thinking about international students who are in our higher education system who may be coming from countries where vaccine access is limited. Um, is there an ethical or legal mandate there for the colleges that are requiring this of them, that they should be considering as well?

PAQUETTE: Legally, I think that if we look at the historic, the law historically in the United States, um, I think that it is legally permissible to put mandatory requirements in place. That being said, I think that there are equity issues involved for international students, um, for students who are coming from communities in the United States where there is not ready— readily available appointments for vaccination that those students will be disproportionately burdened by these requirements.

STOCKRAHM: And I guess my one last question is really more geared toward your own personal take, um, you know, what keeps you up at night right now about all of this?

PAQUETTE: If you’re asking, personally, like what, what gets me the most, it is really the risk for, for perpetuating inequities. I think that in all of the policies that we implement—whether it is locally at an institution, or more broadly, at a governmental level—I think we have a societal obligation to think about not the limited outcome that we're seeking with a policy and in this case, increased vaccination. But I think we're obligated to look at things through a lens of equity.

STOCKRAHM 4: Dr. Paquette is the assistant professor of pediatrics for Feinberg School of Medicine at Northwestern University. She is also an assistant professor at their School of Law. Dr. Paquette, thank you for being here today.

PAQUETTE: Thank you for having me.

Photo Credit: Daniel Schludi, Unsplash


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