Vaccination against Covid: the CCNE and the CNERER question several ethical issues
One year after the start of the pandemic, the lifting of constraints for vaccinated people living in EHPAD, the vaccination of health professionals and the possibility of introducing a "health pass" are at the heart of the debate. "All these subjects raise ethical questions", point out the CCNE and the CNERER, which have just published an opinion entitled "Ethical issues raised by vaccination against Covid-19".
EHPAD: What about unvaccinated residents?
First of all, the vaccination of elderly people living in EHPAD and medico-social establishments is described as an "undeniable success of vaccination". "These residents were able to benefit from the first campaigns, which led to a drastic drop in serious forms of the disease and a reduction in deaths due to Covid-19", the organisations note, but they nevertheless wonder about the unvaccinated residents. Rather than imposing a general prescriptive approach, the CCNE and the CNERER support the idea that "any decision must be prepared and discussed according to the epidemic environment and the wishes of the residents themselves, as well as their relatives". "Considering that this is an ethic of responsibility, the mobilisation of social life councils, bodies for dialogue within medico-social establishments, to expose what is known and name the uncertainties is an essential issue, recommend the two structures. In this way, in a spirit of benevolence and freedom, the managers of EHPADs could take the most appropriate local measures to ease the situation".
Vaccination of health and medico-social sector personnel
Another point raised in the joint publication is that vaccination of health professionals and the medico-social sector is "too low" for the two organisations. "Recent data obtained in the general population suggest that certain vaccines also have a role to play in reducing the transmissibility of the virus, including in the youngest people", they point out, before adding that: "this situation has led to the observation of several nosocomial infection events in health establishments or in those accommodating people who are frail due to their age or disability". "Now that the question of limiting viral transmission via vaccination seems to have been settled for certain vaccines, the question arises of the obligation for these staff to be vaccinated to protect the people in their care", the CCNE and the CNERER continue, adding that this is a "fundamental ethical and deontological issue: not to harm others". "This principle, through a free choice of vaccines, should provide each carer with the serenity necessary to carry out an essential and remarkable task".
The issue of the "health pass
Finally, the CCNE and the NCEER address, as a preliminary to further work, the ethical issues of the recent debate on the "health pass". "However, even if the application of a "health pass" could be justified for health, economic, social and cultural reasons, it will be necessary to define, in a very rigorous way, the ethical framework in which this device will be deployed", add the two organisations which will continue their reflections in the coming weeks and months.