As vaccination campaigns proceed at different speeds around the world, all governments face the same ethical dilemma: how to deal with those who’ve completed their immunization program. The pressure to give back their full personal and social liberties, and to let them contribute in full to the economic recovery will be strong. But states would be unwise to create different classes of citizens.
The vaccines approved so far need two doses to be effective. At least 19 million citizens globally have received both jabs: More than half of them are in the US, 5.3 million in the EU and 2.2 million in Israel. The world’s population is slightly less than 8 billion, so the proportion is tiny. However, as the number of different vaccines increases, and drug companies boost production, this number will grow quickly.
The debate over what to do with this lucky minority is becoming louder. Kyriakos Mitsotakis, the Greek prime minister, wants the EU to adopt a common vaccination certificate to show who’s safe to travel, primarily to rescue his tourist-dependent country from another hard summer. Greece and Israel have already agreed that inoculated people will be allowed to move freely between the two countries when travel restarts. But travel is only one example of what immunized citizens might want to do. Why not let them eat in restaurants, attend concerts and avoid wearing a mask?
There are two things that support the case of preferential treatment for inoculated people. First, governments have withdrawn several constitutional freedoms from their citizens as they’ve tried to limit contagion, rescue lives and avoid overwhelming hospitals. As soon as someone is no longer at risk from falling seriously ill with Covid-19, it’s harder to force them to stay at home.
Second, the return of a small — and growing — part of the population to normal activities would be a boon to businesses that have suffered because of lockdowns and social distancing. Many restaurants would be delighted to host the doctors, nurses and wealthy pensioners who’ve been prioritized in vaccination programs.
However, going down this route would clash with medical and ethical considerations. For starters, we still know little about how far each vaccine can stop or limit people’s infectiousness. The evidence is promising — especially from those shots that use messenger-RNA (mRNA) technology — but we need more studies before loosening the distancing rules. Allowing potentially infectious individuals to roam around with a false sense of security might contribute to contagion.
Even if we do discover that vaccinated individuals cannot spread Covid-19, there are strong moral arguments against unfettered liberty. For now the distribution of vaccines is severely constrained, as politicians and public health experts decide how to allocate their scarce doses. While it’s right that certain vulnerable and exposed categories — such as frontline medical workers and the elderly — get the shots first, it wouldn’t be fair for them to enjoy benefits denied to everyone else. Allowing this would create tensions in society and lay the ground for an ugly fight over access to vaccines, both within countries and between them.
Governments should at least wait until vaccines are available widely before introducing selective freedom. Even then, it might be hard to enforce such rules legally, especially as some individuals may not be able to receive a vaccine for medical reasons.
The question of how to treat the inoculated doesn’t relate only to the state. Should employers be able to fire those workers who refuse to receive a vaccine? And should restaurant owners be allowed to discriminate against vaccine skeptics who don’t have an inoculation certificate, in the same way as they can prohibit someone carrying a weapon? While we may value personal liberty highly, there are contexts in which one could argue for compulsory immunization, especially if we know that a vaccine can limit the transmission. Think, for example, of care-home workers.
Regardless, it’s unethical to start to reopen economies by creating a class of privileged citizens. It may be tempting for businesses to think of happy baby boomers flocking to beaches, football matches and cafes, but inter-generational fairness looms large in this debate: Gen Z has had to accept restrictions to keep their elders healthy, even though the risks of Covid are minimal for younger people. The economic burden of paying for the pandemic will fall mainly on the young over many years.
It’s best to concentrate on a speedy vaccination program, so that everyone can attend the eventual reopening party.
Bloomberg
