Is mandatory vaccination intrinsically wrong?

Florida governor Ron DeSantis and state Surgeon General Dr. Joseph Ladapo have announced that they will be ending all mandatory vaccination in the state.  President Trump has criticized them for this, saying that “some vaccines… should be used otherwise some people are going to catch [diseases] and they endanger other people.”  I have long supported DeSantis and have been critical of Trump, but on this issue Trump is right and DeSantis is wrong. 

That is by no means to say that all mandatory vaccinations are defensible.  As I have argued, the Covid shot should never have been mandatory.  But it goes way too far to claim, as Ladapo does, that all mandatory vaccination as such is “immoral” and amounts to “slavery.”  The truth lies in the middle ground position that while there is a moral presumption against a mandate, in some cases that presumption can be overridden and it can be licit for governments to require vaccination.  Sweeping statements of either extreme kind are wrong, and we need to go case by case.

The relevant natural law principles are straightforward.  Human beings are by nature social animals.  The primary context in which we manifest our social nature is the family, but we do so also in larger social orders, and ultimately in the state, which, as Aristotle and Aquinas teach, is the only complete and self-sufficient social order.  Now, the common good of the social order is higher than private goods.  As Aquinas teaches, “the good of one man is not the last end, but is ordained to the common good” (Summa Theologiae I-II.90.3).  Again, he writes: “The common good is the end of each individual member of a community, just as the good of the whole is the end of each part” (Summa Theologiae II-II.58.9), and “the common good transcends the individual good of one person” (Summa Theologiae II-II.58.12).

By no means does this entail an absorption of families and individuals into some collectivist blob.  The natural law principle of subsidiarity requires as a matter of justice that central authorities do not interfere with lower level social orders (such as the family) when the latter are capable of providing for their own well-being.  At the same time, subsidiarity also requires that central authorities do step in when a social order at some level cannot, on its own, secure its well-being.  And such authorities can compel citizens to do what is necessary for the common good when there is no other way to achieve it.

For example, as the traditional Thomistic natural law theorist Thomas Higgins writes: “Note laws of compulsory military service.  In time of war or grave danger of war they are gravely binding because they then express the Natural Law commanding citizens to preserve the State” (Man as Man: The Science and Art of Ethics, p. 520).  This is so even though, as Higgins goes on to acknowledge, such laws can under some peacetime circumstances be contrary to the common good.  He even argues that a citizen could in such a case licitly try to avoid being drafted, as long as he does not use immoral means to do so.

This example illustrates a point the importance of which cannot be overstated.  To say that the state has a right under some circumstances to compel certain behavior simply does not entail giving it a blank check to do with citizens whatever it likes.  That is a straw man to which too many are drawn today, because of the individualism and excessive hostility to authority that tends to characterize American politics on both the left and the right. 

In any case, the general principle stated by Higgins has also been expressed by the magisterium of the Catholic Church.  Of laws requiring military service during a national emergency, Pope Pius XII taught:

If, therefore, a body representative of the people and a government – both having been chosen by free elections – in a moment of extreme danger decides, by legitimate instruments of internal and external policy, on defensive precautions, and carries out the plans which they consider necessary, it does not act immorally.  Therefore a Catholic citizen cannot invoke his own conscience in order to refuse to serve and fulfill those duties the law imposes. (Christmas message of December 23, 1956)

Now, if there can be circumstances wherein the state can licitly compel citizens to risk dying in battle for the sake of the common good, then it follows a fortiori that there can also be circumstances wherein the state can compel citizens to be vaccinated for the sake of the common good.  In both cases the end is the same, namely to prevent the deaths of large numbers of one’s countrymen.  And in the case of vaccination, the risk to the individual who is compelled is less serious than the risk imposed on those drafted into military service.

The Church herself has indicated that it can be licit for states to require vaccination.  As Roberto de Mattei has noted, “on 20 June 1822, in the Papal States, the Cardinal Secretary of State, Ercole Consalvi, issued a decree which instituted a Central Vaccination Committee for inoculation throughout that territory” (On the Moral Liceity of the Vaccination, p. 55).  In 2005, during the pontificate of Pope Benedict XVI, the Pontifical Academy for Life said the following about the benefits of universal vaccination:

The severity of congenital rubella and the handicaps which it causes justify systematic vaccination against such a sickness.  It is very difficult, perhaps even impossible, to avoid the infection of a pregnant woman, even if the rubella infection of a person in contact with this woman is diagnosed from the first day of the eruption of the rash.  Therefore, one tries to prevent transmission by suppressing the reservoir of infection among children who have not been vaccinated, by means of early immunization of all children (universal vaccination).  Universal vaccination has resulted in a considerable fall in the incidence of congenital rubella.

The document goes on to note that when parents refrain from vaccinating children against German measles, there is

the danger of Congenital Rubella Syndrome.  This could occur, causing grave congenital malformations in the foetus, when a pregnant woman enters into contact, even if it is brief, with children who have not been immunized and are carriers of the virus.  In this case, the parents who did not accept the vaccination of their own children become responsible for the malformations in question.

Orthodox Catholic moral theologians have thus defended the liceity of requiring vaccination, when this is necessary for the common good.  In their book Life Issues, Medical Choices: Questions and Answers for Catholics, Janet Smith and Christopher Kaczor note that “vaccines have virtually eradicated some childhood diseases common in decades past, such as polio, measles, tetanus, smallpox, whooping cough, and diphtheria” (p. 154).  And they observe that when parents have refused these vaccines for their children, the result has sometimes been a recurrence of such diseases.  They acknowledge that vaccines carry some risk, and that there can be cases where exemptions are reasonable.  But nevertheless, they argue:

Rather than risk the outbreak of a disease that could kill or seriously harm many, individuals are reasonably expected to undergo some personal risk.  In order to reduce risks for the whole community – especially those who are particularly susceptible to harm, such as children too young to be vaccinated and those who cannot be vaccinated for health reasons – it is reasonable and just for otherwise healthy members of the community to submit themselves to the small risks of vaccines… The Church teaches that we are all members of the body of Christ and that we are brothers and sisters in the Lord.  Thus, we all have a serious obligation to seek the common good and sometimes to put ourselves and our children at some reasonable risk for the well-being of others. (pp. 153-54)

In recent days, some on Twitter/X have nevertheless claimed that the Church teaches that vaccination cannot ever be mandatory.  One argument along these lines appeals to the following statement made by Pope Pius XI in Casti Connubii:

Public magistrates have no direct power over the bodies of their subjects; therefore, where no crime has taken place and there is no cause present for grave punishment, they can never directly harm, or tamper with the integrity of the body, either for the reasons of eugenics or for any other reason.

But this does not entail that vaccination can never be mandatory.  For one thing, Pius was not addressing the question of vaccination in this passage, but rather the topic of forced sterilization and other bodily mutilations.  Vaccination does not involve mutilation of the body, so inferring from his remark that mandatory vaccination is illicit is simply a non sequitur.  For another thing, the argument would prove too much.  You might as well say that Pius XI’s remark absolutely rules out ever forcing citizens to serve in the military.  But that would contradict the teaching of his successor Pius XII, which I cited above.

Another argument appeals to the 2020 statement from the Congregation for the Doctrine of the Faith on Covid-19 vaccination, which says that “practical reason makes evident that vaccination is not, as a rule, a moral obligation and that, therefore, it must be voluntary.”  But there are two problems with this argument.  First, it ignores the fact that this document is not addressing the morality of vaccination in general, but only the morality of Covid-19 vaccination in particular.  The reason is that many Catholics were concerned that the Covid vaccines were linked to fetal tissue research in a way that made them morally problematic.  The point of the document was to inform Catholics who were inclined to take the vaccine that they could do so in good conscience, while at the same time making it clear to those who were uncomfortable with doing so that they were not obligated to do so.  All of this is clear from the larger immediate context of the line quoted above:

Both pharmaceutical companies and governmental health agencies are therefore encouraged to produce, approve, distribute and offer ethically acceptable vaccines that do not create problems of conscience for either health care providers or the people to be vaccinated.

At the same time, practical reason makes evident that vaccination is not, as a rule, a moral obligation and that, therefore, it must be voluntary.  In any case, from the ethical point of view, the morality of vaccination depends not only on the duty to protect one's own health, but also on the duty to pursue the common good.  In the absence of other means to stop or even prevent the epidemic, the common good may recommend vaccination, especially to protect the weakest and most exposed.  Those who, however, for reasons of conscience, refuse vaccines produced with cell lines from aborted fetuses, must do their utmost to avoid, by other prophylactic means and appropriate behavior, becoming vehicles for the transmission of the infectious agent.  In particular, they must avoid any risk to the health of those who cannot be vaccinated for medical or other reasons, and who are the most vulnerable. (Emphasis in the original)

Note the references to “the epidemic,” “vaccines produced with cell lines from aborted fetuses,” and the encouragement of pharmaceutical companies and governments to produce alternatives “that do not create problems of conscience.”  What the document is addressing is whether the vaccines that were developed in order to deal with Covid-19, specifically, ought to be mandatory. 

Moreover, the CDF statement does not actually say even that Covid-19 vaccination absolutely must in every case be voluntary.  What it says is that “vaccination is not, as a rule, a moral obligation and that, therefore, it must be voluntary.”  The claim is that as a rule (in other words, in general) it is not an obligation.  But that leaves it open that there could nevertheless be particular cases where it would be a moral obligation (for example, for hospital workers, perhaps).  And it leaves it open that in those particular cases vaccination should be mandatory rather than voluntary.  But again, the CDF document is in any case addressing the Covid-19 situation in particular rather than vaccination in general.  So it is not inconsistent with the point I’ve been making.

I hasten to emphasize that that point is a very narrow one.  I am arguing here only that the extreme claim that mandatory vaccination is always and intrinsically wrong cannot be justified on grounds of natural law theory and Catholic moral theology.  That does not by itself show that any particular vaccine mandate is a good idea, all things considered.  One has to go case by case and make a prudential judgment based on the relevant empirical evidence.  But appeal to simplistic slogans like “My body, my choice” can provide no short cut.