1. Deliberation on Childhood Vaccination in Canada: Public Input on Ethical Trade-Offs in Vaccination Policy
- Author
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O’Doherty, Kieran C., Crann, Sara, Bucci, Lucie Marisa, Burgess, Michael M., Chauhan, Apurv, Goldenberg, Maya J., McMurtry, C. Meghan, White, Jessica, Jans, Donald J., Harreiter, Jurgen, Kautzky-Willer, Alexandra, Damm, Peter, Mathiesen, Elisabeth R., Jensen, Dorte M., Andersen, Liselotte, Dunne, Fidelma, Lapolla, Annunziata, Di Cianni, Graziano, Bertolotto, Alessandra, Wender-Oegowska, Ewa, Zawiejska, Agnieszka, Blumska, Kinga, Hill, David, Rebollo, Pablo, Snoek, Frank J., and Simmons, David
- Subjects
medicine.medical_specialty ,Canada ,Health (social science) ,media_common.quotation_subject ,non-medical exemptions ,education ,Childhood vaccination ,Public administration ,050905 science studies ,immunization ,03 medical and health sciences ,0302 clinical medicine ,Political science ,medicine ,Humans ,030212 general & internal medicine ,value trade-offs ,Child ,media_common ,Vaccines ,Ethical trade ,public deliberation ,Public health ,Health Policy ,05 social sciences ,vaccination policy ,Vaccination ,Bioethics ,Deliberation ,3. Good health ,Philosophy ,Vaccination policy ,Immunization ,Public Health ,0509 other social sciences - Abstract
Background: Policy decisions about childhood vaccination require consideration of multiple, sometimes conflicting, public health and ethical imperatives. Examples of these decisions are whether vaccination should be mandatory and, if so, whether to allow for non-medical exemptions. In this article we argue that these policy decisions go beyond typical public health mandates and therefore require democratic input. Methods: We report on the design, implementation, and results of a deliberative public forum convened over four days in Ontario, Canada, on the topic of childhood vaccination. Results: 25 participants completed all four days of deliberation and collectively developed 20 policy recommendations on issues relating to mandatory vaccinations and exemptions, communication about vaccines and vaccination, and AEFI (adverse events following immunization) compensation and reporting. Notable recommendations include unanimous support for mandatory childhood vaccination in Ontario, the need for broad educational communication about vaccination, and the development of a no-fault compensation scheme for AEFIs. There was persistent disagreement among deliberants about the form of exemptions from vaccination (conscience, religious beliefs) that should be permissible, as well as appropriate consequences if parents do not vaccinate their children. Conclusions: We conclude that conducting deliberative democratic processes on topics that are polarizing and controversial is viable and should be further developed and implemented to support democratically legitimate and trustworthy policy about childhood vaccination.
- Published
- 2021