Page 43 - Preventing pertussis in early infancy - Visser

Voluntary vaccination
Voluntary vaccination programmes are usually provided by healthcare professionals such as doctors in Child Welfare Centres, general practitioners or paediatricians. These programmes all start from the presupposition that the autonomy of individual members of the public should be respected and vaccination should be an individual choice. To enable individuals to make their own choice, accessible and understandable information is provided prior to vaccination. Healthcare professionals who provide vaccination have the task of providing this information as a prerequisite for individuals to make an informed and deliberate choice (Childress et al. 2002).
Historically, arguments in favour of voluntary vaccination originated mostly from concerns about the type of relationship fostered by vaccination programmes between government and individual citizens. In the Netherlands, for example, proponents of voluntary vaccination used arguments that were commonly accepted to defend freedom of religion (Blume 2006). The Bond ter bestrijding van vaccinatiedwang (Association to oppose coercive vaccination), established in 1881, had many clerics amongst its members and saw compulsory vaccination as an infringement of individual liberty, most notably the liberty to choose whether one accepts vaccination on grounds of religious conviction (Blume 2006). Much in line with the tolerant attitude adopted towards religious convictions in other areas of societal life and government in the Netherlands, it was also accepted that the government should be respectful towards objections to vaccination based on private religious beliefs (Blume 2006). Alternatively, in 19th century UK, the debate over compulsory smallpox vaccination became thoroughly intertwined with the emancipatory movement of the working class, who defended the right to make their own choice about vaccination, in much the same way as they defended the right to vote for all citizens (Durbach 2000). These developments emphasised the importance of principles that demand to respect the autonomy, privacy and physical integrity of individuals (van den Hoven et al. 2003, van Delden et al. 2008, Galanakis et al. 2013, Flanigan 2014, Wicker et al. 2014).
As society changed into a more individualised and highly educated society, the religious or emancipatory base for the objections to mandatory vaccination may have changed. However, principles that demand respect for autonomy, privacy and physical integrity have gradually acquired a more and more important place in healthcare since the second half of the 20th century (Faden et al. 1986). At present, the main argument supporting voluntary vaccination still refers to autonomy and protects the free choice of the individual against manipulation, coercion or force exercised by others, such as public health government. However, these arguments promoting voluntary vaccination, which are solely based on respect for individual liberties, are unconvincing for authors who defend compulsory vaccination: they emphasise that vaccination primarily serves a societal good, not only an individual one, and that protection of the health of the public deserves prevalence above respect for individual rights (O'Neill 2003, Verweij et al. 2004).
In recent years ‘nudging’ has been suggested as an attractive alternative to voluntary 42
Mandatory versus voluntay
Mandatory versus voluntary
41