A Brief Analysis of Citizen's Obligation of Vaccination
Chen Yunliang (Professor of Guangdong University of Foreign Studies Law School, Guangdong Institute of International Strategy)
The successful development and conditional listing of the new crown pneumonia vaccine ushered in a turning point in the prevention and control of the global new crown pneumonia epidemic. What follows is how to promote the new crown pneumonia vaccination work in an orderly and standardized manner in accordance with laws and regulations.
Many domestic and foreign survey reports show that people in various countries have a certain degree of vaccine hesitation and even anti-vaccine sentiment.
In order to increase the vaccination rate, some regions and units in the country have adopted compulsory vaccination methods to trigger discussion.
Article 21 of the Basic Medical and Health Promotion Law of my country (hereinafter referred to as the Basic Medical and Health Law) stipulates: "The state implements a vaccination system and strengthens immunization planning. Residents have the right and obligation to vaccinate vaccinations in accordance with the law. The government provides to residents Provide free immunization program vaccines.” Not only gives citizens the right to vaccinate, but also sets the obligation for citizens to vaccinate.
The correct understanding and application of this article will provide legal support for the current legal and orderly promotion of new coronary pneumonia vaccination work.
1. What is a "vaccination system"
The "vaccination system" is a system that focuses on prevention, according to the surveillance of infectious diseases and the level of population immunization, to implement vaccination in a planned way to improve population immunity, so as to achieve the purpose of controlling and eliminating certain infectious diseases.
In 1980, the "Implementation Measures for Vaccination Work" issued by the former Ministry of Health initially formed the basic framework of my country's current vaccination system and vaccine damage relief system.
The Infectious Disease Prevention and Control Law promulgated and implemented in 1989 incorporated vaccination into the laws formulated by the Standing Committee of the National People's Congress, and related laws have been promulgated and improved continuously since then.
In 2019, the Vaccine Management Law was promulgated, and the Basic Medical and Health Law promulgated in the same year stipulated that “the country implements a vaccination system and strengthens immunization planning. Residents have the right and obligation to vaccinate immunization programs according to law.”
So far, my country has formed a systematic and hierarchical vaccination legal system with the basic medical and health law as the overall plan, the vaccine management law and the infectious disease prevention and control law as the core, and various administrative regulations and departmental rules as the specific content.
2. Why should vaccination become obligatory
Why is vaccination required to be a citizen's obligation?
At the theoretical level, the theoretical basis can be traced from moralism and utilitarianism.
Moralism emphasizes that individuals have both the right to avoid being infected by others and the moral obligation to avoid falling into the dangers of infectious diseases.
For the country, the country should do its utmost to treat infected patients and save lives, and put the lives and health of the people first. At the same time, the country should promptly promote the research and development of new drugs, vaccines and other products to create conditions for protecting the people’s right to life and health. .
The maintenance of public health inevitably requires the coordination of national morality and individual morality. National morality creates conditions to protect public health. Individuals must accept the necessary restrictions on freedom from public power and undertake specific obligations given by law.
As a result, vaccination, which is a moral obligation, may be transformed into a legal obligation.
Utilitarianism also provides strong support for the national vaccination system.
On the one hand, for individuals, vaccination can enable the body to gain resistance to corresponding diseases, thereby reducing the probability of illness and benefiting individual health; on the other hand, vaccines for immunization programs are public products with positive externalities. While vaccinators reduce the probability of their own illness, it is also an external benefit for others.
At the same time, compared with other infectious disease prevention and control measures, the protection brought by vaccination is more thorough and continuous, and it also has higher social benefits.
Therefore, under the premise of affordability, establishing part of the vaccine as a statutory obligation and providing it free of charge by the state finance is a legitimate measure that conforms to the principle of self-interest and can increase the maximum happiness of society.
The introduction of vaccination from a moral obligation to a statutory obligation is not only to better allocate public health resources, it ultimately returns to the basic morality of protecting society.
On the premise of upholding fairness and justice, using utilitarianism to find the most effective way to allocate rights and obligations can provide good theoretical support for vaccination in the immunization program to become a legal obligation.
3. Look at the category and order of vaccination from the interpretation of "immunization program vaccines"
With regard to the understanding of "immunization program vaccines" in the Basic Medical and Health Law, most people fall into the misunderstanding of "vaccines determined by the national immunization program", thinking that they are only a clear and limited list.
In fact, the definition of "immunization program vaccine" in the Vaccine Management Law includes not only the vaccines determined by the national immunization program, but also the immunization program vaccine supplemented by the provincial government, emergency vaccination and mass vaccination.
Among the four types of immunization program vaccines, they can be further divided into routine vaccination and emergency vaccination due to their different use situations.
"Immunization Program Vaccine" is a collection that includes routine vaccination and emergency vaccination. It is not a completely closed legal concept.
Among them, with the exception of the vaccines determined by the national immunization program, which is the common obligation of all citizens, the other three types of immunization program vaccines all show obvious regional and target orientation.
The judgment of the immunization program vaccine cannot be limited to whether it belongs to the 14 types of routine vaccinations and 3 types of emergency vaccinations that have been clearly enumerated. It also needs to be based on the actual situation and the supplementary vaccinations, emergency vaccinations or group vaccinations made by the government. Wait for the administrative decision to further study and judge.
Immunization plan vaccines and non-immunization plan vaccines correspond to citizens' legal and moral obligations, respectively. Among immunization plan vaccines, routine vaccination and emergency vaccination correspond to citizens' regular and emergency duties, respectively.
In the order of obligations, statutory obligations are higher than moral obligations, and among statutory obligations, emergency obligations are higher than conventional obligations.
Of course, the arrangement in this order is only a general theoretical arrangement, and special circumstances are not excluded.
When the two obligations are in conflict and are irreconcilable, the necessary abandonment can be made in accordance with the order of the obligations, and when there is no conflict of obligations, both conventional and emergency obligations are obligations that citizens should perform in accordance with the law.
4. The reconciliation of citizens’ vaccination obligations and rights
The “government to provide residents with free immunization program vaccines” confirms that citizens’ right to vaccination is a beneficiary right rather than a right to freedom from the level of national obligations.
The right basis of vaccination is not only the right to individual health, but also the right to public health.
The right to public health is a health benefit that aims at ensuring the health of all members of society and is shared by all members of the society, emphasizing state leadership and citizen collaboration.
The right to public health is integral. This kind of benefit cannot be divided into every member, and the member decides whether to give up. As a result, its negative liberty attribute has been greatly derogated, showing the attribute of beneficial right.
The enjoyment of this beneficiary right is a necessary prerequisite for citizens to bear the vaccination obligations of the immunization program.
The state should ensure the safety and effectiveness of vaccine quality, ensure sufficient vaccine quantity, ensure that the vaccination personnel are qualified and standardized, and reduce the vaccination risk caused by human factors as much as possible.
In the process of implementing the rule of law, the purpose of guiding and promoting citizens to actively carry out vaccination is achieved through the reconciliation and application of rights and obligations, thereby enhancing its practical significance.
It is possible to increase citizens' willingness to vaccinate through the protection or promotion of rights, or impose disadvantages and burdens to urge citizens to fulfill their vaccination obligations.
However, in the process of selecting measures, it is necessary to grasp the balance between positive incentives and negative punishments to avoid overcorrection and create resistance among citizens.
Although the current vaccination rate in my country has increased substantially and people’s willingness to vaccinate has become stronger, many residents still wait and see, and some even resist it.
In order to protect the whole society from the continued damage of the new crown virus and restore normal work and life as soon as possible, we can establish a compulsory vaccination system and promote the implementation of Article 21 of the Basic Medical and Health Law.
Local COVID-19 prevention and control agencies can set more conveniences for the work, life, and travel of vaccinators for COVID-19, and guide more residents to take the initiative to vaccinate.
(The original article was published in the Journal of East China University of Political Science and Law)