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Moral Issues

Forced Vaccination

Naina Krishnamurthy asks if it’s ethical or egregious.

Imagine it is 2021, during the Pandemic. Let’s suppose your neighbor is an elderly lady who makes great cookies, and she’s akin to a grandmother to you. One day her family alerts you that unfortunately she’s in the hospital with COVID , on life support, and her doctors think she likely caught it from an unvaccinated carrier. Guiltily, you remember visiting her last week for some of her cookies. You didn’t realize your wish to protect your bodily rights to go unvaccinated could risk her life.

This story illustrates a broader truth: bad vaccination choices can endanger others. A forced vaccination may violate your bodily integrity, but your endangering of others indirectly violates their bodily integrity. So here I want to argue that during times of crisis, it is not merely justifiable but morally necessary. By forced vaccination I don’t mean non-compliant citizens being seized from their homes and held down by security guards while some Nurse Ratched-like figure jabs a needle into their arm. This is not merely disturbing; it would constitute assault. When I discuss forced vaccination in this article, I mean requiring proof of vaccination for entry to settings such as hospitals, care homes, schools or concert venues. For some people, depending on their circumstances, this still amounts to compulsion. I would say that in normal times your vaccination choice is your own, but perhaps during a pandemic this kind of compulsion can be justified. I will show that this conclusion is supported by three influential ethical frameworks: mandated vaccination in such a crisis fulfills the tacit agreement in social contract theory, prioritizes the greater good in utilitarianism, and fits our responsibility in the ethics of care. Refusing vaccination is not simply an expression of individual freedom, but an action of moral negligence, since protecting the vulnerable outweighs any individual reluctance. Doing otherwise both endangers others and impairs the ethical foundations of a just society.

Artwork © Bea Ysolda 2025. For more art by Bea please visit http://yink.art

Social Contract Theory & Vaccination Mandates

Social contract theory holds that there’s an unspoken agreement or ‘social contract’ to which an individual agrees when living in a society – to sacrifice some personal liberties in order to gain the benefits of being in a society. This social contract sustains social order and well-being, so enjoying society’s benefits without fulfilling its duties is morally negligent.

Advocates of social contract theory disagree, however, over the contract’s scope. John Locke (1632-1704) held that the government is obliged to respect individuals’ rights to life, liberty, and property despite the social contract, in accordance with the law of nature. Jean-Jacques Rousseau (1712-78) believed that there’s a common interest, or general will of the people, and so he emphasizes this collective interest, supporting a communal ethic where individuals contribute to societal welfare. This model perhaps better fits the needs of modern society. Under Rousseau’s definition, fulfilling the social contract during an epidemic would mean protecting everyone, including the vulnerable, presumably including participating in collective safeguards like vaccination. If liberty were given then to refuse to get a vaccine, the risk would be externalized onto the health of the vulnerable members of society. Or, weighing the competing interests, the interest of the many aging, ill, and young wanting to live without risking the disease ranks higher than personal objections against vaccines. Allowing individuals to refuse the vaccine for non-medical reasons would jeopardize others’ safety unnecessarily, and so break the social contract, so being morally negligent. It’s essentially an issue of equality – of equalizing the environment for the vulnerable. This is critical for a just society.

But let’s consider a narrower conception of social contract theory that prioritizes personal autonomy and natural rights over collective obligations, as did Locke’s. From that perspective, mandated vaccination could be seen as an infringement of bodily liberty, thus violating Locke’s social contract’s purpose, which is to protect the individual’s natural rights. Yet despite Locke’s strong defense of liberty, he acknowledges that liberty is not absolute, and that one’s liberty ends where another person’s rights begin. Locke’s more developed perspective is that the government exists to protect the individual’s natural rights, but can intervene to prevent harm. An unvaccinated person carrying a deadly disease poses harm to others, so even for Locke social institutions can morally intervene during times of crisis. Here, vaccination during a public health crisis is about protecting the natural right to life – a right the Lockean social contract is meant to protect. Hence it would even be morally negligent not to mandate vaccination during an epidemic.

Thus, for modern-day followers of both Rousseau and Locke, forced vaccination should be seen as ethically justified during times of plague as a defense of both lives and social order.

A precedent for government medical intervention already exists in the US with HIV, as some states made it illegal not to disclose HIV status prior to sex. Dr Gayle Balba, Program Director of Infectious Diseases at Georgetown Hospital, remarked: “Individual rights do not supersede the personal safety of others. One example is if someone infected with an incurable disease, such as HIV, knowingly has unprotected sexual intercourse. This is morally wrong and could in fact be a criminal offense. Safety of the community is more important than personal privacy” (May 2025). Is failing to disclose HIV status prior to sex significantly ethically different from refusing vaccination in a crisis? Refusing a vaccine during a health crisis threatens others’ personal safety, just as failing to disclose HIV status does. Under both Rousseau’s and Locke’s definitions of the social contract, such behavior is morally negligent and violates the social contract.

Rousseau giving a vaccination by Stephen Lahey

Forced Vaccination and Utilitarianism

According to the act utilitarianism of Jeremy Bentham (1748-1832), the morally right action is whichever produces the most (‘greatest’) good. This should be calculted on the basis that no individual’s good matters more than another’s. If an action does not promote the greatest good, it’s morally negligent. This ‘utility’ is maximized by balancing harms against goods.

Importantly, utilitarian ethics shift with context. So in ordinary times, forcing vaccination may do more harm than good; but during an epidemic, mandating vaccination minimizes public health risk and so maximizes utility. The harm done to an individual by being required to get a vaccine is small compared to the potential harm to vulnerable others around them. Indeed, vaccinated and unvaccinated people mixing caused a rise in COVID in 2021 even among the vaccinated. So if one is unvaccinated, it is the best utilitarian principle to get vaccinated before going near even vaccinated people. And, under utilitarianism, mandated immunization again becomes the morally right action.

Why is the greater good apparently more important than bodily autonomy in the case of vaccination, but not for abortion? After all, an aborted fetus could have been the next Einstein or have discovered a cure for cancer. Yet that is not about risking public health. Unlike abortion, which directly impacts only the pregnant woman and the fetus, vaccine refusal in a crisis undermines herd immunity, and so endangers many others. So it is one thing to refuse vaccination when there is no health crisis, because, similar to abortion, this decision hardly affects many others since the threat of disease is low. Forced vaccination during times of crisis isn’t comparable whatsoever to abortion, however: pregnancy is far more invasive than a vaccine; existing lives should be prioritized over potential ones; and potential lives only have a chance of benefiting the greater good. Admittedly, there is also only a chance that an unvaccinated person would transmit a disease to a vulnerable individual, but that chance holds potentially far greater consequences, while refusing vaccination outside of a crisis has far less public impact. Even worse, during a COVID pandemic, an unvaccinated person could incubate a new variant, creating a new wave of infections. So the calculus is clear – the rate of infection must be crushed as soon as possible to promote the greatest good, making forced vaccination ethical during a global health crisis under utilitarianism.

Vaccination Mandates and the Ethics of Care

Unlike the abstraction of social contract theory, and the impersonal calculus of utilitarianism, the ‘ethics of care’ developed by thinkers such as Carol Gilligan (1936-) focuses on the moral importance of relationships, including our responsibility to protect the vulnerable. This ethics roots morality in compassion and empathy towards others, centering emotional connection, real-life circumstances, and the responsibilities we have towards those around us, especially those at risk (and if humans do not have that responsibility, are we truly human?).

In the context of public health, the ethics of care surely means recognizing that our decisions may affect more than just ourselves: that your vaccination choice potentially affects the elderly, the immunocompromised, and others who might not survive infection. My opening story of the elderly neighbor in the hospital isn’t just hypothetical, it’s a real example of how someone’s choice causes harm to another. The ethics of care says that this is not a tragic accident but a moral failure, because the visitor ignored the needs of their vulnerable neighbor in favor of their personal belief.

The ethics of care would not view vaccination as a burden, but rather, as an act of protection. Here, mandating vaccination during a crisis is about enforcing the shared responsibility to care for each other, and especially those who cannot protect themselves. Refusing to vaccinate in this context is not simply an assertion of personal freedom, then, but also a refusal to acknowledge one’s moral obligation to act with care. Furthermore, many of those refusing vaccination can afford treatment in the event of disease, which is negligent of those who cannot.

There are three primary categories of vaccine-refusers: the misinformed, who overestimate the real risks of vaccination; the ignorant who strongly believe in vaccine inefficacy; and the selfish, who prioritize their personal feelings over others’ well-being. Most of those refusing vaccines fall into one or other of those three categories. One outlier category is those who cannot afford or are allergic to certain vaccines, and so these people are part of the vulnerable. But the other three, while differing in motivation, all share a disregard for how their personal stance puts others at risk. The misinformed may act in good faith but fail to fully factor in how their hesitation harms the vulnerable. The ignorant, who are unaware of or ignore the scientific consensus, also prioritize their narrow worldview over the lives of others. And the selfish, who place personal convenience or conviction over communal safety, embody the exact moral failure the ethics of care wishes to avert. In all cases there’s a lack of attention to how interconnected humanity is, and a refusal to act with compassion toward those who depend on collective responsibility – making forced vaccination for their protection not only scientifically sound, but ethically essential. Therefore the ethics of care approach should suggest that vaccine refusal during an epidemic is not simply an individualistic freedom, but flagrant moral negligence. The vulnerable cannot thrive in a society that does not recognize its moral obligation towards them.

Conclusion

Overall, in times of plague, forced vaccination is an ethical imperative grounded in the deepest philosophical principles. We understand through social contract theory that living in a society requires some sacrifices to protect others, and act utilitarianism reinforces this by reminding us that the moral action is the one that produces the greatest good – an outcome served by widespread immunization. Meanwhile, the ethics of care compels us to act out of empathy for the vulnerable among us. Refusing vaccination on the basis of personal belief, convenience, or misinformation, ignores these ethical frameworks and endangers entire communities.

Three moral philosophies rooted in quite different assumptions align on this issue. Mandated vaccination during public health crises is not a violation of individual freedom but a defense of our fellow citizens. A just society would not tolerate the unnecessary endangerment of its vulnerable; rather, it acts to protect them. That’s not tyranny, it’s a practical implementation of sound ethics.

Naina Krishnamurthy is a philosophy enthusiast from Virginia who hopes to one day become a lawyer. She hopes you enjoy her article as much as she enjoyed writing it.