The unintended consequences of COVID-19 vaccine policy: why mandates, passports and restrictions may cause more harm than good.
The unintended consequences of COVID-19 vaccine policy: why mandates, passports and restrictions may cause more harm than good.
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DOI：
10.1136/bmjgh-2022-008684
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发表时间：
2022-05
影响因子：
8.1
通讯作者：
Baral, Stefan
中科院分区：
文献类型：
--
作者：
Bardosh, Kevin;de Figueiredo, Alex;Gur-Arie, Rachel;Jamrozik, Euzebiusz;Doidge, James;Lemmens, Trudo;Keshavjee, Salmaan;Graham, Janice E.;Baral, Stefan
在COVID-19期间，疫苗接种政策发生了巨大变化，全民疫苗授权、国内疫苗护照和基于疫苗接种状况的差异化限制迅速出现。虽然这些政策引发了道德、科学、实践、法律的和政治辩论，但对其潜在的意外后果的评估有限。在这里，我们概述了一套全面的假设，为什么这些政策可能最终适得其反和有害的。我们的框架考虑了四个领域：（1）行为心理学，（2）政治和法律，（3）社会经济学，（4）科学和公共卫生的完整性。虽然目前的疫苗似乎对降低COVID-19相关的发病率和死亡率负担产生了重大影响，但我们认为，目前的强制性疫苗政策在科学上存在问题，可能会造成更多的社会危害而不是好处。根据COVID-19疫苗接种状况限制人们获得工作、教育、公共交通和社会生活的机会，侵犯了人权，助长了污名化和社会两极分化，并对健康和福祉产生不利影响。目前的政策可能导致健康和经济不平等的扩大，对政府和科学机构的信任产生不利的长期影响，并减少未来公共卫生措施的采用，包括COVID-19疫苗以及常规免疫接种。强制接种疫苗是公共卫生领域最有力的干预措施之一，应谨慎使用，以维护道德规范和对机构的信任。我们认为，应根据我们概述的负面后果重新评估当前的COVID-19疫苗政策。利用基于信任和公众咨询的赋权策略，以及改善医疗服务和基础设施，是优化COVID-19疫苗接种计划以及更广泛地优化公众健康和福祉的更可持续方法。
Vaccination policies have shifted dramatically during COVID-19 with the rapid emergence of population-wide vaccine mandates, domestic vaccine passports and differential restrictions based on vaccination status. While these policies have prompted ethical, scientific, practical, legal and political debate, there has been limited evaluation of their potential unintended consequences. Here, we outline a comprehensive set of hypotheses for why these policies may ultimately be counterproductive and harmful. Our framework considers four domains: (1) behavioural psychology, (2) politics and law, (3) socioeconomics, and (4) the integrity of science and public health. While current vaccines appear to have had a significant impact on decreasing COVID-19-related morbidity and mortality burdens, we argue that current mandatory vaccine policies are scientifically questionable and are likely to cause more societal harm than good. Restricting people’s access to work, education, public transport and social life based on COVID-19 vaccination status impinges on human rights, promotes stigma and social polarisation, and adversely affects health and well-being. Current policies may lead to a widening of health and economic inequalities, detrimental long-term impacts on trust in government and scientific institutions, and reduce the uptake of future public health measures, including COVID-19 vaccines as well as routine immunisations. Mandating vaccination is one of the most powerful interventions in public health and should be used sparingly and carefully to uphold ethical norms and trust in institutions. We argue that current COVID-19 vaccine policies should be re-evaluated in light of the negative consequences that we outline. Leveraging empowering strategies based on trust and public consultation, and improving healthcare services and infrastructure, represent a more sustainable approach to optimising COVID-19 vaccination programmes and, more broadly, the health and well-being of the public.
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影响因子：
10.8
作者：
Bardosh KL;de Vries DH;Abramowitz S;Thorlie A;Cremers L;Kinsman J;Stellmach D
通讯作者：
Stellmach D
DOI：
10.1016/s1473-3099(21)00776-3
发表时间：
2022-01
期刊：
The Lancet. Infectious diseases
影响因子：
--
作者：
Burki T
通讯作者：
Burki T
COVID-19疫苗对轻度和重度疾病的保护持续时间。
DOI：
10.1056/nejmoa2115481
发表时间：
2022-01-27
期刊：
The New England journal of medicine
影响因子：
--
作者：
Andrews N;Tessier E;Stowe J;Gower C;Kirsebom F;Simmons R;Gallagher E;Thelwall S;Groves N;Dabrera G;Myers R;Campbell CNJ;Amirthalingam G;Edmunds M;Zambon M;Brown K;Hopkins S;Chand M;Ladhani SN;Ramsay M;Lopez Bernal J
通讯作者：
Lopez Bernal J
影响因子：
4.6
作者：
Albarracin D;Jung H;Song W;Tan A;Fishman J
通讯作者：
Fishman J
DOI：
10.1056/nejmoa2114114
发表时间：
2021-12-09
期刊：
The New England journal of medicine
影响因子：
--
作者：
Chemaitelly H;Tang P;Hasan MR;AlMukdad S;Yassine HM;Benslimane FM;Al Khatib HA;Coyle P;Ayoub HH;Al Kanaani Z;Al Kuwari E;Jeremijenko A;Kaleeckal AH;Latif AN;Shaik RM;Abdul Rahim HF;Nasrallah GK;Al Kuwari MG;Al Romaihi HE;Butt AA;Al-Thani MH;Al Khal A;Bertollini R;Abu-Raddad LJ
通讯作者：
Abu-Raddad LJ