A reasonable map for vaccination decision-making

Public debate about vaccination is not new. Already in the eighteenth century, concerned with the smallpox epidemic, the Swiss mathematician Bernoulli argued for compulsory vaccination for all children based upon a mathematical conjecture, while the French philosopher D’Alembert stressed the limits of his reasoning from a logical and moral perspective, claiming for what we call nowadays ‘informed consent’. 

Since 2021, concerned with the covid-19 pandemic, some governments sought forced vaccination for all, through discriminatory measures against the unvaccinated in many cases, while other ones were more respectful of fundamental rights. For instance, the Japan's Ministry of Health vaccination guidelines state:

“Although we encourage all citizens to receive the COVID-19 vaccination, it is not compulsory or mandatory. Vaccination will be given only with the consent of the person to be vaccinated after the information provided. Please get vaccinated of your own decision, understanding both the effectiveness in preventing infectious diseases and the risk of side effects. No vaccination will be given without consent. Please do not force anyone in your workplace or those who around you to be vaccinated, and do not discriminate against those who have not been vaccinated.” - The Japan's Ministry of Health

All the propaganda and the media battlefield between pro- and anti-vax generated noise and confusion rather than information. Fear and aggression often prevailed over reason.  

Standing on the shoulders of giants, here is a reasonable map that may assist with vaccination decision-making:

This decision may be taken by the person to be vaccinated. But also by a parent responsible for her children, the public health authority concerned with vaccination policy, or the judge confronted with vaccination claims.

The main question concerns the vulnerability of the person to be vaccinated. Vulnerability denotes material absolute risk to be exposed and develop severe outcomes such as medium- and long-term disabilities and death.

When a person is vulnerable, the vaccination decision has to balance the benefits from vaccination with the short- and long-term adverse effects from vaccination. This balance is especially difficult to assess for new vaccines, since critical information is not yet fully available. When the balance is materially favourable, vaccination may be recommended. 

When a person is not-vulnerable, she has no personal reason to prefer vaccination. But she may consider taking it for sake of solidarity with vulnerable people. This solidarity claim stands only if the vaccine under consideration materially reduces further infection and transmission. To be sure, even when this is the case, the non-vulnerable person may be confronted with adverse effects from vaccination. If the latter risks are either material or exceeding the risks from the disease for that person, vaccination cannot be recommended. It would be unfair to voluntary expose her to those excess risks in view to protect the others.