Why vaccination should be compulsory

I’m writing from Victoria, the Australian state that became, in 1970, the first jurisdiction in the world to make it compulsory to wear a seat belt in a car.

The legislation was attacked as a violation of individual freedom, but Victorians accepted it because it saved lives. Now most of the world has similar legislation. I can’t recall when I last heard someone demanding the freedom to drive without wearing a seat belt.

Victoria was the first jurisdiction in the world to make it compulsory to wear a seat belt in a car.Credit: Joe Armao

Instead, we are now hearing demands for the freedom to be unvaccinated against the virus that causes COVID-19.

Brady Ellison, a member of the United States Olympic archery team, says his decision not to get vaccinated was “100 per cent a personal choice”, insisting that “anyone that says otherwise is taking away people’s freedoms”.

The oddity here is that laws requiring us to wear seat belts really are quite straightforwardly infringing on freedom, whereas laws requiring people to be vaccinated if they are going to be in places where they could infect other people are restricting one kind of freedom in order to protect the freedom of others to go about their business safely.

Don’t misunderstand me. I strongly support laws requiring drivers and passengers in cars to wear seat belts. In the US, such laws are estimated to have saved about 370,000 lives and to have prevented many more serious injuries.

Nevertheless, these laws are paternalistic. They coerce us to do something for our own good. They violate John Stuart Mill’s famous principle, “the only purpose for which power can be rightfully exercised over any member of a civilised community, against his will, is to prevent harm to others”.

The fact that the coercion is for the individual’s own good is “not a sufficient warrant”.

There is a lot to be said for this principle, especially when it is used to oppose laws against victimless acts like homosexual relations between consenting adults or voluntary euthanasia.

But Mill had more confidence in the ability of members of “civilised” communities to make rational choices about their own interest than we can justifiably have today.

John Stuart Mill had more confidence in the ability of people to make rational choices about their own interest than we can justifiably have today.

Before seat belts were made compulsory, governments ran campaigns to educate people about the risks of not wearing them. These campaigns had some effect, but the number of people who wore seat belts came nowhere near the 90 per cent or more who wear them in the US today (with similar or higher figures in many other countries where not wearing them is an offence).

The reason is that we are not good at protecting ourselves against very small risks of disaster. Each time we get into a car, the chance that we will be involved in an accident serious enough to cause injury, if we are not wearing a seat belt, is very small.

Nevertheless, given the negligible cost of wearing a belt, a reasonable calculation of one’s own interests shows that it is irrational not to wear one. Car crash survivors who were injured because they were not wearing seat belts recognise and regret their irrationality – but only when it is too late, as it always is for those who were killed after sitting on their belts.

We are now seeing a very similar situation with vaccination. Brytney Cobia recently posted on Facebook the following account of her experiences working as a doctor in Birmingham, Alabama:

“I’m admitting young healthy people to the hospital with very serious COVID infections. One of the last things they do before they’re intubated is beg me for the vaccine. I hold their hand and tell them that I’m sorry, but it’s too late. A few days later when I call time of death, I hug their family members and I tell them the best way to honour their loved one is to go get vaccinated and encourage everyone they know to do the same.

“They cry. And they tell me they didn’t know. They thought it was a hoax. They thought it was political. They thought because they had a certain blood type or a certain skin colour they wouldn’t get as sick. They thought it was ‘just the flu’. But they were wrong. And they wish they could go back. But they can’t.”

The same reason justifies making vaccination against COVID-19 compulsory: otherwise, too many people make decisions that they later regret. One would have to be monstrously callous to say: “It’s their own fault, let them die.”

In any case, in the COVID era, making vaccination compulsory doesn’t violate Mill’s “harm to others” principle. Unvaccinated Olympic athletes impose risks on others, just as speeding down a busy street does.

Medical staff prepare vaccine doses at a Melbourne vaccination hub.Credit: Getty

The only “personal choice” Ellison should have had was to get vaccinated or stay at home.

If the International Olympic Committee had said that only vaccinated athletes could compete, that would have freed thousands of athletes from a heightened risk of infection, and would have justified overriding Ellison’s desire to compete without being vaccinated.

This past February, when the Indonesian government became the first to make vaccination mandatory for all adults, the real tragedy was not that it was violating the freedom of its citizens, but that richer countries did not donate the vaccines it needed to implement the law.

As a result, Indonesia is now the epicentre of the virus and tens of thousands of unvaccinated Indonesians have died.

Peter Singer is Professor of Bioethics at Princeton University and founder of the non-profit organisation The Life You Can Save. This piece was first published by Project Syndicate.

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