Deciding to vaccinate is not just a personal decision, it is an ethical one. 

On the back of increasing criticism of the rollout of Australia’s vaccination programme the Federal government have asked The Australian Health Primary Protection Committee (AHPPC) to reconsider the issue of mandating vaccination for those working in Aged Care facilities. Prompted by the most recent outbreak in Victoria, it seems that vaccination of residents is now proceeding fairly rapidly across Australia. There are, however, worries about continued low(er) rates of uptake amongst staff, not all of whom are healthcare professionals.

Indeed, this seems to be a broader issue to do with vaccine hesitancy. The absence of COVID-19 from Australia and worries about vanishingly rare cases of blood clotting associated with the AstraZeneca vaccine seems to have led some to delay getting vaccinated. Although some under 50s have taken the initiative and got themselves vaccinated early, those over 50s that are delaying do not seem to be concerned about vaccination in general. Rather what seems to be going on is that they are hedging their bets, calculating that they are at very low risk of contracting COVID-19 because of the lack of cases. Thus, the recent spate of cases in Melbourne has directly resulted in an increase in the numbers of people seeking out a vaccine, something that many of them will have been putting off for the past few weeks. 

At least for some of those working in Aged Care Facilities it is likely that a similar thing is going on. Across Australia there is a relative absence of COVID-19 and this has led some to think that their personal decision risk to delay getting vaccinated does not present a risk to themselves or to those whose care they provide. They suppose, one imagines, that it will always be possible to get vaccinated if and when COVID-19 begins to arrive in Australia or in their particular locale. However, as we have seen this week, COVID-19 may not announce itself before finding its way into Aged Care Facilities. Similarly, we are in the midst of a programme that seeks to vaccinate the entire adult population in a programmatic manner. Delaying does not simply let another go first. 

Seen on a larger scale these personal decisions to delay are a cause for concern. Perhaps, then, requiring those who work in Aged Care Facilities to get vaccinated is justified. If the individual is merely delaying their vaccination, then mandating that they now do so does not represent an outright abrogation of their right to make their own healthcare decisions. Equally, if the current increase in cases means that all those who work in Aged Care Facilities are now likely to get vaccinated sooner rather than later then making vaccination mandatory would not seem necessary. 

Given the connection between low rates of vaccination amongst staff in Aged Care Facilities and delays in the wider vaccination programme then it is perhaps worth trying to reframe the decision to get vaccinated as an ethical, and not simply a personal, matter. The reason why the Federal Government is considering mandating vaccination for those who work in the Aged Care sector is that those who are resident in such facilities are particularly vulnerable to COVID-19. Vaccinating this population should, of course, be a priority. However, this should be rapidly followed by the vaccination of those who are in close or regular contact with this population. 

Prioritising those who work in Aged Care Facilities is done to protect the residents. Thus, when individual workers consider if and when they are going to get vaccinated, they should not only consider their own interests, but the interests of those they support and care for. I have no doubt that those who work in Aged Care Facilities value the health and wellbeing of the residents. Equally, it is easy to forget that getting vaccinated is not something we do in our own interests but in the interest of those around us. 

As such, if an individual working an Aged Care Facility decides that they do not wish to be vaccinated then they should give serious consideration to the implications of that decision for those around them. It is not for governments alone to consider balancing the rights of individuals to make their own healthcare decisions and protecting vulnerable populations. We can all make such calculations and if an individual does not wish to be vaccinated then they should take steps to limit their contact with vulnerable individuals’ populations. This might include seeking alternative employment and if an individual is not prepared to do so, then they should seriously reconsider their decision not to get themselves vaccinated. The decision to not vaccinate is not simply a personal choice, it is an ethical matter and individuals should take responsibility for any decision they make.  

This point is not only something that only applies to those who work in Aged Care Facilities or who regularly encounter other vulnerable individual or populations. It can be applied more generally. Widespread vaccination is the only route out of the pandemic. It is the only way to prevent mass casualties when, inevitably, COVID-19 becomes endemic in the Australian population. It is the only way we will be able to reopen our borders and once again allow families to reunite. 

The actions of those who choose to delay their own vaccination with the intention of getting vaccinated at a later date are not only giving cause for concern about the vaccination programme as a whole. They are also delaying our collective progress along the only route out of the pandemic and effectively risking the spread of COVID-19 across Australia whilst the vaccination programme is at an earlier stage of completion than would otherwise be the case. As such, the personal choices of individuals about the timing of their vaccination can and should be seen as having an ethical dimension. 

Whilst getting yourself vaccinated primarily serves your own interests, it also serves the interests of others and Australia as a whole. Getting vaccinated might be understood as a civic duty, a matter of good citizenship and an exercise in solidarity. Concern about the vaccination status of those who work in Aged Care Facilities is arguably a microcosm of the whole. Whilst an individual might be personally inclined to delay, they should consider the bigger picture and the idea that one has an ethical responsibility to get vaccinated at the proper point in time.