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Bioethics in a Pandemic: Misinformation and Mandates

As the spread of the Delta variant of COVID-19 and the reality of inconsistent vaccine uptake lead to growing case numbers across the country, many of us are wondering, how did we get here and what’s next?   

The Threat of Misinformation

As we noted in a previous post, vaccine uptake and the general public's confidence in COVID-19 vaccines are vital to the overall ability of a vaccine to reduce the spread of the novel coronavirus. But, the public’s confidence, and therefore vaccine uptake, have been undermined by the spread of vaccine-related misinformation. In fact, a recent study showed that exposure to misinformation led to a marked decline in intent to receive the vaccines in the US and UK. Last month, the US Surgeon General released an Advisory on Building a Healthy Information Environment (the Advisory), which serves as a warning to the public regarding vaccine misinformation. Misinformation, as defined in the advisory report, is any information that is false, inaccurate, or misleading according to the best available evidence at the time.

The Surgeon General envisions a “healthier, kinder, and more connected world” and insists that everyone play a role in identifying and dispelling the misinformation found in their families and communities. The Advisory emphasizes the importance of certain stakeholders such as tech and social media companies to address the spread of misinformation on their platforms and encourages these companies to confront this issue in a more aggressive manner. The Surgeon General begins by recognizing that:

"During the COVID-19 pandemic, health misinformation has sowed confusion, reduced trust in public health measures, and hindered efforts to get Americans vaccinated. And misinformation hasn’t just harmed our physical health—it has also divided our families, friends, and communities. While health misinformation has always been a problem, today it spreads at unprecedented speed and scale. We are all still learning how to navigate this new information environment. But we know enough to be sure that misinformation is an urgent threat, and that we can and must confront it together."

The Advisory also details how misinformation can be spread intentionally, to trick people into believing something for financial gain or political advantage (usually known as “disinformation”).  But, sometimes misinformation arises because people are raising legitimate concerns while trying to make sense of conflicting information or ask questions. The Surgeon General also notes how the current media landscape allows misinformation to spread faster than ever before.

That said, we can all combat misinformation and the Surgeon General provides concrete recommendations as to how we can do this. To name a few examples, individuals, families, and communities can learn how to identify and avoid sharing misinformation and engage with each other to discuss the topic. Educators can educate students and the public on common tactics used by those who spread misinformation online. While journalists and media organizations can consider headlines and images that inform rather than shock or provoke. The Advisory provides a lot of interesting ideas as to how key stakeholders can address misinformation and we encourage you to check it out for additional details.

A Healthcare Worker’s Ethical Obligation

We see the Surgeon General’s recommendations in action by the recent “Joint Statement in Support of COVID-19 Vaccine Mandates for All Workers in Health Care and Long-Term Care.” This joint statement, made by over 50 healthcare organizations, advocates for an industry-wide vaccine mandate driven by the need for healthcare workers to protect themselves and the vulnerable populations they care for.

Many patient groups such as unvaccinated children or the immunocompromised carry an elevated risk for infection. The statement asserts that it is a health care worker’s ethical commitment to take all steps necessary to ensure patient well-being. Receiving a vaccination for viruses such as influenza, hepatitis B, and pertussis is already required by many health care employers. According to the joint statement, requiring a coronavirus vaccine is a logical continuation of this practice and is a necessary step to fostering trust in healthcare institutions and workers.

Getting Vaccinated: Are Mandates the Answer?

Various polls have found factors such as age and political affiliation may increase or decrease an individual's willingness to be vaccinated. But, many employers and educational institutions are now mandating employees, customers, and students be vaccinated if they wish to return to the workplace or school. Some of these organizations view vaccine mandates as their ethical obligation to combat misinformation and assist in general vaccine uptake. While most organizations requiring mandates allow limited exceptions for medical or religious reasons, others, like the federal government, require vaccination or submission to regular testing, social distancing, mask wearing, and limits on official travel. Outside of the work and school setting, NYC now requires proof of vaccination to participate in indoor activities at restaurants, gyms, and theaters (check out our earlier post on the Vaccine Passport Debate).

While many private entities are taking public health measures into their own hands, the question remains as to how the general public will react to these mandates and how an individual's opinion of vaccines could impact their employment. As mandates become more widespread, it will be important to ensure they do not exacerbate any existing inequities and appropriately balance the public health principles of promoting and protecting the health and needs of the broader population.  That said, the bottom line is clear: vaccines are quickly becoming a prerequisite for many employees looking to return to in-person work. And the fact remains, vaccine mandates may be less of a burden if stakeholders can engage in clear communication regarding the safety and efficacy of vaccines and work to dispel misinformation and disinformation in their respective communities.

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Bridgette advises health care providers, ACOs, health plans, PBMs, and laboratories on regulatory, fraud and abuse, and business planning matters, applying her experience in health system administration and ethics in health care to her health law practice.

Amy Martin

Project Analyst