COVID-19 Vaccines: How Choosy Can We Be?

July 28, 2021
By: 
Anatoly Angelo R. Aseneta, Ph.D.

Earlier this year, Presidential Spokesperson Roque remarked that when it comes to COVID-19 vaccines, Filipinos cannot be “choosy” due to the law of supply and demand: “wala pong pilian, wala kasing pilitan.” More recently, President Duterte threatened to arrest Filipinos who refuse to be vaccinated. Alternatively, they can leave the country if they do not want to cooperate with the government’s plan to address a public health emergency crisis.
 
Critics were quick to lambast both, arguing that we have the right to be choosy since it involves public funds and, more importantly, our health and safety. I am sure this includes not only myself but those who are reading this who would also want the safest and most effective vaccine available. I am also sure that, like me, we want to bring this pandemic under greater control as soon as possible—to put the brakes if we cannot stop it completely.
 
We cannot dismiss the fact that there is indeed an imbalance between supply and demand—especially in countries like ours which seem to have been left behind in the race to procure certain brands of vaccines. We also cannot deny that we are in a state of public health emergency. How do we make sense of these and being choosy? How choosy can we be?
 
If my years of stay at LST have taught me anything, it is to listen to both sides of an argument and not shrug one off. Perhaps lessons from Catholic bioethics and Catholic social teaching (CST) can help us consider these two goods in tension.

Photo by: Hakan Nural

 
A pillar of both Catholic and secular bioethics is the right of sufficiently free and informed consent in accepting or refusing medical treatment. It involves three elements: information, comprehension, and freedom. All relevant information about the treatment or medicine should be provided including its purpose, risks, benefits, alternatives. Information ought not to be withheld in the interests of eliciting consent because not all subjects are well-versed in medical jargon; this information should be adapted to their capabilities to ensure that they clearly understand these, especially if the risks are serious. Finally, since no one is totally free from all pressure, subjects must at least be free from coercion and undue influence in giving their consent [1]. It is generally held that in cases of life-threatening emergencies when the consent of the patient cannot be obtained, when there is no suggestion that the patient will refuse the treatment, and when there is no competent or legitimate proxy present, informed consent can be waived [2].
 
The COVID-19 pandemic is clearly a life-threatening emergency of a public nature. As far as I am concerned, however, many of those registering and queuing to get vaccinated are conscious and are able to give consent. Following the right of sufficiently free and informed consent and the larger principle of patient autonomy, we can refuse to be vaccinated if we assess that the vaccines offered pose risks and do not offer sufficient protection. In short, yes, we can be choosy. But if we become choosy, how are we going to address the pandemic? Is it right that we wait until our preferred vaccine brands arrive and, possibly, let those available now spoil?
 
The principle of patient autonomy and our right of sufficiently free and informed consent as understood by many ethicists does not exist in a vacuum. It does not favor an individualistic autonomy in which we become a law unto ourselves. Instead, it derives its concrete content from the understanding that human persons are free, responsible, and social beings. Thus, this principle and right go together with our mutual and communal responsibility to each other.
 
This brings us to the principle of common good in CST. The common good “embraces the sum total of those conditions of social living, whereby men are enabled more fully and more readily to achieve their own perfection” [3]. These social conditions include respect for the human person, the social well-being and development of the community, and maintenance of peace and security by authorities [4]. CST stresses that everyone has the right and duty to participate, according to one’s capacity, in the promotion, development, attainment, and enjoyment of the common good [5].
 
Obviously, individual and public health are one of those social conditions that allow us to reach our full human potential and realize human dignity. COVID-19 has shown this, though in a tragic way. The common good, I believe, should temper our choosiness, because of our responsibility towards each other. We can be choosy but this should not come at the expense of public health or of plans to stem the scourge of the pandemic.
 
What, then, should we do? Honestly, I do not know; it is a daunting task. But if I may be so bold, I would like to offer some suggestions. On the part of the government, who bears a greater responsibility in promoting the common good, it should be transparent about the vaccines it rolls out. It should respect the people’s right to choose. It should also respect the people’s preferences, findings of unbiased studies, and establish effective feedback mechanisms. Should the preferred and more effective brands become more available, these should be procured rather than continue acquiring brands to please friends or, worse, feather one’s nest.
 
On our part, perhaps we should be less choosy. Unless there are compelling reasons for us not to get the vaccines available (e.g., serious medical reactions or we are frequently travelling overseas for essential purposes), we should get jabbed. Delaying would simply endanger us, others, and the common good by adding another hurdle to the immunization program.
 
The demands of the common good depend on the social conditions of each period [6]. As the situation develops, so should we also continuously examine these two goods and see if the scales are tipping too much in favor of one. It would require a delicate balancing act which, while difficult and would require everyone’s participation and patience, would be indispensable as we continue to face this pandemic.
 
Sources:
 
[1] B. Ashley, J. Deblois, & K. O’Rourke, Health Care Ethics: A Catholic Theological Analysis, 5th ed. (Washington, D.C.: Georgetown University Press, 2006), 57-58.
[2] USCCB, Ethical and Religious Directives for Catholic Health Care Services, 5th ed., directive 27.
[3] John XXIII, Encyclical Letter on Christianity and Social Progress (Mater et Magistra), no. 65.
[4] USCCB, Summary Report of the Task Force on Catholic Social Teaching and Catholic Education, 25.
[5] Pontifical Council for Justice and Peace, Compendium of the Social Doctrine of the Church, no. 167.
[6] Compendium of the Social Doctrine of the Church, no. 166.

The views expressed in this article do not represent the School of Humanities, Ateneo de Manila University.