No jab, no job: a case for compulsory vaccination

I have been puzzled by the insistence of politicians and journalists that no-one should feel compelled to be vaccinated.

The place to start, perhaps, might be John Stuart Mill’s classic, On Liberty.

The object of this Essay is to assert one very simple principle … That the only purpose for which power can rightfully be exercised over any member of a civilised community, against his will, is to prevent harm to others. His own good, either physical or moral, is not a sufficient warrant. … The only part of the conduct of any one, for which he is amenable to society, is that which concerns others. In the part which merely concerns himself, his independence is, of right, absolute.

The people who are arguing against compulsory vaccinations have focused on the sentence in the middle: that we should not do things to people just because it is good for them.  Fair enough – but that is not what is being proposed.  The principle behind the slogan, ‘no jab, no job’ is that people have a duty to ensure that they do what they can not to infect others.  That principles protects us, but it also protects other people.

Now, I am not personally a liberal, or anything like as liberal as Mill; I do think that there are clearly defined circumstances where we do exercise power over individuals for their own benefit, and we are right to do so.  One example is compulsory education; another is compulsory sanitation.  There are reservations to make: we do this to enhance people’s independence and autonomy, not to undermine them.  When it comes to subjecting other people to avoidable harm, however, the same reservations do not arise.  People are not entitled deliberately or recklessly to endanger the lives of others, and that’s what the current dispute is about.

There is one part of the case that is uncertain.  It has not yet been shown for certain that vaccines reduce transmission, and transmission, not infection, is crucial to the welfare of others.  The main risk of transmission is probably while the disease is  asymptomatic, so that people carrying the disease do not know that they are infectious.  The current advice from the JCVI, the government’s expert committee, is this:

There is emerging evidence that vaccination may prevent asymptomatic infection, which may be inferred as evidence of an impact on transmission. However, while these data are very encouraging, they are still limited and currently there is no strong real-world evidence of an impact of vaccination on transmission.

I’m going to treat the argument as having two stages.  First, let’s take it that the effect of vaccines on transmission is possible, or even likely, but unproven.  As soon as that is admitted, it raises a critically important question for any employer: is it legitimate for them to expose either their clients, or their workers, to the entirely unnecessary risk of breathing the same air as someone who refuses to be vaccinated?  I think the answer to that has to be ‘no’, and it is unsurprising to read that Care UK  has elected to tell its employees that if they do not get vaccinated, they will be treated as not reporting for work.  What is surprising is that any responsible employer or service provider would think that they might be able to take a different position.  If the obvious happens, and one of the people they serve dies, they are inviting legal action, and saying ‘we weren’t completely sure that the vaccines would actually work’ is a pretty feeble defence.

Second, let’s ask what happens if the link is proved, and it becomes evident that vaccines suppress transmission.  At that point, it becomes clear that the effect of not being vaccinated is to expose other people to serious risk of infection, disability and death; and at that point, the argument for compulsion becomes unanswerable.

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