Vaccines and Ethics

Why is vaccination—one of the most successful public health measures in the history of medicine—a topic of ethical controversy? It is because immunization works best when all those at risk for infection are vaccinated. Hence medicine endorses, and laws sometime insist upon, vaccination of the public, a practice that reinvigorates the ever-present struggle among individuals, science, and the state. This month's authors examine the ethics of mandating vaccination, managing vaccine shortages, conducting human trials for proposed vaccines, developing a vaccine that would interfere with the brain’s response to stress, and more.

Volume 14, Number 1: 1-88 Full Issue PDF
  • From the Editor
    Jan 2012

    Vaccination: A Victim of Its Own Success

    Matthew Janko
    How can we educate individual patients and the public so they can differentiate the science from the rhetoric about vaccines?
    Virtual Mentor. 2012;14(1):3-4. doi: 10.1001/virtualmentor.2012.14.1.fred1-1201.
  • Case and Commentary
    Jan 2012

    The HPV Vaccine and Parental Consent

    Donna T. Chen, MD, MPH, Lois Shepherd, JD, and Daniel M. Becker, MD, MPH, MFA
    When most statutes about confidential treatment of adolescents were adopted, immunization against sexually transmitted infection was not anticipated, so the statutes contain no specific inclusion of such preventive measures.
    Virtual Mentor. 2012;14(1):5-12. doi: 10.1001/virtualmentor.2012.14.1.ccas1-1201.
  • Case and Commentary
    Jan 2012

    Writing an Excuse or Educating the Patient

    John J. Frey III, MD
    Patients who have been encouraged to think of themselves as consumers and a medical system that is driven by individual demands rather than big-picture planning can undermine fairness in the distribution of vaccines.
    Virtual Mentor. 2012;14(1):13-16. doi: 10.1001/virtualmentor.2012.14.1.ccas2-1201.
  • Case and Commentary
    Jan 2012

    Treating Children Whose Parents Refuse to Have Them Vaccinated

    Kimberly Insel, MD, MPH
    Rather than turning away children whose parents refuse to have them vaccinated, pediatricians should engage the parents in discussion about the importance and safety of vaccination.
    Virtual Mentor. 2012;14(1):17-22. doi: 10.1001/virtualmentor.2012.14.1.ccas3-1201.
  • Medical Education
    Jan 2012

    Residents' Role in Immunizing Adults: Rationale, Opportunity, Obstacles, and Strategies

    Jay A. Jacobson, MD
    Because they treat many patients vulnerable to vaccine-preventable infections due to age-related declining immunity, chronic illnesses, or immunosuppressive treatments, medical residents are well placed to improve their patients' health by vaccinating them.
    Virtual Mentor. 2012;14(1):23-29. doi: 10.1001/virtualmentor.2012.14.1.medu1-1201.
  • Health Law
    Jan 2012

    The National Childhood Vaccine Injury Act and the Supreme Court's Interpretation

    Valarie Blake, JD, MA
    The Supreme Court's ruling in Bruesewitz v. Wyeth interpreted the National Childhood Vaccine Injury Act to mean that vaccine manufacturers, unlike the manufacturers of other products, are not liable for injuries caused by defective designs.
    Virtual Mentor. 2012;14(1):31-34. doi: 10.1001/virtualmentor.2012.14.1.hlaw1-1201.
  • Policy Forum
    Jan 2012

    Should Participation in Vaccine Clinical Trials be Mandated?

    Susanne Sheehy, BM BCh, MRCP, DTM&H and Joel Meyer, BM BCh, MRCP
    The decline in numbers of healthy volunteers who participate in clinical trials has the potential to become a key rate-limiting factor in vaccine development.
    Virtual Mentor. 2012;14(1):35-38. doi: 10.1001/virtualmentor.2012.14.1.pfor1-1201.
  • Medicine and Society
    Jan 2012

    The HPV Vaccine Controversy

    Karlie A. Intlekofer, PhD, Michael J. Cunningham, MS, and Arthur L. Caplan, PhD
    When public figures imperil the safety of the public with inaccurate claims that discourage vaccination, it is imperative that both organized medicine and individual physicians speak up.
    Virtual Mentor. 2012;14(1):39-49. doi: 10.1001/virtualmentor.2012.14.1.msoc1-1201.
  • History of Medicine
    Jan 2012

    New Media, Old Messages: Themes in the History of Vaccine Hesitancy and Refusal

    Jason L. Schwartz, MBE, AM
    Physicians, scientists, and public health officials are routinely on the defensive, refuting allegations of unconfirmed risks, justifying the value of vaccines, and striving to preserve public trust in vaccination overall.
    Virtual Mentor. 2012;14(1):50-55. doi: 10.1001/virtualmentor.2012.14.1.mhst1-1201.
  • Viewpoint
    Jan 2012

    Closing Immunization Gaps in the U.S: How a Little Collusion Could Go a Long Way

    Jeremy Konstam
    Both public health agencies and vaccine companies have a stake in promulgating good information about vaccines: where the government sees gaps in immunization coverage, vaccine manufacturers see gaps in market coverage. Why shouldn't they work together to close them?
    Virtual Mentor. 2012;14(1):56-59. doi: 10.1001/virtualmentor.2012.14.1.oped1-1201.
  • Viewpoint
    Jan 2012

    An Ethical Take on the "Stress Vaccine"

    Jennifer M. Ladd and Leo D. J. Ungar, MTS
    Concerns about the deleterious effects of stress on the mind and body have led to the beginnings of a stress vaccine, an injection that will reduce these effects.
    Virtual Mentor. 2012;14(1):60-67. doi: 10.1001/virtualmentor.2012.14.1.oped2-1201.