Listening to vaccine refusers

It must be noted that free riding on herd immunity may explain why vaccine refusal is wrong regardless of whether an agent consciously intends to free ride on herd immunity. In some cases, when herd immunity is not being formed, citizens are not adequately informed about the vaccine program, and when vaccine refusers try to convince others not to vaccinate, the moral analysis of vaccine refusal from the perspective of free riding, may also fail. However, here I argue that the emphasis on treating vaccine refusal as an instance of free riding on herd immunity, even though it does provide a useful moral analysis of the phenomenon, frames the question in a way that may limit other central ethical questions, should not be taken as an analysis of the motivations for vaccine refusal, is counterproductive at the healthcare practice, and may lead to ineffective interventions. Treating vaccine refusal as an exit mechanism not only explains its diverse motivations, but also brings different ethical questions to the fore, and provides better resources for addressing it than the kind of approaches that focus only on individual responsibility not to free ride. I must thank an anonymous reviewer for pressing these distinctions.

The moral analysis of vaccine refusal as free riding on herd immunity may fail when the public good of herd immunity does not get formed, when the agent does not know about the vaccine program, when vaccine refusers are trying to convince others to not vaccinate, or when other necessary features of free riding on herd immunity as a public good are not met.

Thank you to an anonymous reviewer for pointing this out.