4.3 Editorial Material

Vaccine mandates for prospective versus existing employees: reply to Smith

Journal

JOURNAL OF MEDICAL ETHICS
Volume -, Issue -, Pages -

Publisher

BMJ PUBLISHING GROUP
DOI: 10.1136/jme-2023-109410

Keywords

COVID-19; Policy; Ethics; Health Workforce

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Employment-based vaccine mandates have worse consequences for existing employees than prospective ones. However, Smith argues that if vaccine mandates are justified for prospective employees, they are similarly justified for existing employees. This paper responds to Smith's argument by questioning the existence of effective alternative interventions and the asymmetry in the harms of mandates.
Employment-based vaccine mandates have worse consequences for existing than prospective employees. Prospective employees are not yet dependent on a particular employment arrangement, so they are better positioned to respond to such mandates. Yet despite this asymmetry in consequences, Smith argues that if vaccine mandates are justified for prospective employees, they are similarly justified for existing employees. This paper responds to Smith's argument. First, Smith holds that bona fide occupational requirements are actions that are necessary for the safe and effective completion of one's job. As such, they apply to existing and prospective employees alike. However, I argue that the existence of effective alternative interventions precludes vaccination from being considered a bona fide occupational requirement under current circumstances. Second, Smith holds that if a requirement is justified for prospective employees, it is justified for existing employees, despite the asymmetry in consequences. However, I argue that since vaccination is not a bona fide requirement, the asymmetry in the harms of mandates experienced by prospective versus existing employees entails an asymmetry in the justification required to mandate vaccination for each group. As such, vaccination can be considered a requirement for prospective employees while not being required for existing employees.

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