Report on Web Discussion on "Ethics and COVID-19 Vaccines" (Jan. 30/31, 2021)
There were 87 registrants from 23 countries and 13 time zones when registration closed. 49 (56%) were from within IACB. Other participants were from the Order of Malta, Pontifical Academy for Life, and Catholic Theological Ethics in the World Church. Average attendance during the Webinar was 63 participants (72% of those registered). Thanks to Alex Martins, Dan Fleming, Bill Sullivan, Chris De Bono, and Helen McGee for sharing information regarding the Webinar, and to Bernadette Tobin, Bill Sullivan, and MaryKate Gaurke for keeping the conversation orderly.
The Web Discussion was recorded and can be viewed here.
Xavier Symons (Australian Catholic University) and Fr Rob Allore (University of British Columbia) spoke on two topics: allocation of vaccines, especially globally, and vaccine hesitancy. Here are some key messages: The pandemic has caused hardship and suffering for people around the world. Catholics are called to be part of the response to this “cry” of our times. We need to work together with scientists and policy makers, acknowledging that global cooperation resulted in developing safe vaccines at unprecedented speed and levels of effectiveness. Nevertheless, on the issues on which the presenters spoke, there remain major hurdles to get over. Something Catholics can contribute are ethical reflections to support just global distribution of the new vaccines and to address concerns about being vaccinated. Catholic social teaching is one important resource for this, especially the notions of solidarity, the common good, and a preferential option for the poor.
In the discussion that followed the presentations, questions or comments submitted via the Chat and subsequently by e-mail, a number of key questions and issues were flagged.
1. The ethical question of just allocation of vaccines globally touches on not only promoting access to vaccines by countries with fewer resources, but also considerations of which vaccines (those with lower levels of effectiveness?) and under what conditions (surplus of resource-rich countries only? requiring the country to participate in development trials?).
2. It is helpful to bring together the church’s social teaching and teachings on bioethics on an issue like this. Doing this well, however, calls for a broader range of insights and experiences than what is usual in bioethics (e.g., macroeconomics, public health, political science, perspectives from local communities in different parts of the world).
3. Among the concepts in Catholic social teaching that sometimes gets overlooked is subsidiarity. What implications might this notion have for ethics of vaccine allocation? E.g., consider the notion of “horizontal subsidiarity” in decisions regarding the spacing of vaccine doses.
4. There appears to be a disconnect between Catholic leaders and ethicists, who generally support being vaccinated for the common good (or at least propose that there are no compelling ethical reasons not to be inoculated by the currently available vaccines) and many people in the world, including Catholics, who continue to have ethical objections (e.g., over the practice of using fetal body parts in biomedical research or the possible health risks of the vaccines). We need to acknowledge that there are ethical concerns still to be addressed, listen carefully for the reasons behind those concerns, and refrain from giving the impression that those who are vaccine-hesitant are necessarily ill-informed, anti-science or dismissive of the common good. There is also the related issue of mistrusting authorities, whether political, medical or religious. While not a bioethical issue per se, it is significant for discussing the issue of vaccine hesitancy.
5. There are over forty years’ worth of public health evidence on what works in vaccine uptake and equity, and we need to pay heed to this literature.
6. We need to attend not only to vaccine hesitancy but also behaviours that arise from not believing that COVID-19 is a serious illness or a serious public health issue. Are promoting reliable information in media and trust in science bioethical issues?
7. In considering the toll of the pandemic and responding to it (e.g., by setting priorities for vaccination), we should not only focus on biological vulnerability, but also on those who are disproportionately affected by public health restrictions that have resulted in the loss of support services, especially by groups who depend on these for basic needs (e.g., homebound seniors, persons with disabilities, the homeless).
8. The relation between clinical ethics and public health ethics needs to be further explored. During pandemics, we should not simply abandon one framework for the other. There remain questions such as, how do we promote person-centred care even during pandemics? Can vaccination be considered ordinary or ethically obligatory preventive treatment? We will devote the next Web Discussion to this latter question.