COVID-19 differentiated measures for unvaccinated individuals: The need for clear goals and strong justifications.
COVID-19 differentiated measures for unvaccinated individuals: The need for clear goals and strong justifications.
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DOI：
10.1016/j.vaccine.2022.06.051
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发表时间：
2022-08-26
期刊：
影响因子：
5.5
通讯作者：
Tam, Clarence C.
中科院分区：
文献类型：
--
作者：
Voo, Teck Chuan;Savulescu, Julian;Schaefer, Owen;Ling, Abel Ho Zhi;Tam, Clarence C.
多个国家及司法管辖区已根据个人疫苗接种状况实施不同的COVID-19公共卫生限制，以减轻未接种疫苗的个人带来的公共卫生风险。尽管在科学和伦理上，引入这种基于疫苗接种的差异化措施作为在持续大流行中恢复高风险活动的基于风险的方法是合理的，但由于缺乏明确的预期目标以及他们打算减轻的具体风险或潜在危害，他们的理由被削弱了。此外，取消差别措施的标准可能不明确，这就有可能在没有明确理由的情况下改变目标，并可能造成不公平的歧视性后果。本文旨在阐明基于公共卫生风险方法的基于COVID-19疫苗接种的差异化措施的伦理理由，重点关注其在国内环境中的部署。我们认为，该等措施应符合COVID-19疫苗接种计划的主要目标，即减少重症患者的发病率及相关的医疗负担，以保护卫生系统。我们基于这一目标，为取消以接种疫苗为基础的差异化措施提供了一些考虑。
Numerous countries and jurisdictions have implemented differential COVID-19 public health restrictions based on individual vaccination status to mitigate the public health risks posed by unvaccinated individuals. Although it is scientifically and ethically justifiable to introduce such vaccination-based differentiated measures as a risk-based approach to resume high-risk activities in an ongoing pandemic, their justification is weakened by lack of clarity on their intended goals and the specific risks or potential harms they intend to mitigate. Furthermore, the criteria for the removal of differentiated measures may not be clear, which raises the possibility of shifting goalposts without clear justification and with potential for unfairly discriminatory consequences. This paper seeks to clarify the ethical justification of COVID-19 vaccination-based differentiated measures based on a public health risk-based approach, with focus on their deployment in domestic settings. We argue that such measures should be consistent with the principal goal of COVID-19 vaccination programmes, which is to reduce the incidence of severely ill patients and associated healthcare burdens so as to protect a health system. We provide some considerations for the removal of vaccination-based differentiated measures based on this goal.
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DOI：
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期刊：
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DOI：
10.1056/nejmoa2101765
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2021-04-15
期刊：
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影响因子：
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