Regarding the morality of vaccination

Context

COVID-19 vaccines have demonstrated strong efficacy and an excellent safety profile. Clinical trials showed mRNA vaccines (Pfizer-BioNTech, Moderna) were over 90% effective against symptomatic COVID-19 and nearly 100% effective against severe disease. Real-world studies confirmed high protection against hospitalization and death. The vaccines have saved millions of lives.

Despite persistent criticisms that COVID vaccines are toxic or ineffective, overwhelming clinical safety and efficacy data proves that the vaccines are very safe and highly effective. Serious adverse events are rare. Myocarditis/pericarditis occurs primarily in young males after mRNA vaccination but is rare, with most patients recovering fully. Anaphylaxis occurs at about 5 cases per million doses. Vaccine-related fatalities are extremely rare and difficult to quantify. Fatality from anaphylaxis occurs at rates of approximately 0.02–0.04 per million doses.

False and irrational anti-vaccine propaganda and misinformation have been significant in the US for years. The COVID epidemic greatly amplified the problem. Growing numbers of Americans are refusing to get vaccinated because they believe the false information is truth, and the actual truth is false. The percentage of Americans who falsely believe COVID vaccines caused "thousands of deaths" rose from 22% in 2021 to 28% by July 2024. Those believing it's safer to get infected than vaccinated more than doubled from 10% to 22%.

A moral analysis

If one accepts the scientific evidence that COVID vaccines and all vaccines generally are safe and effective (which they are), what moral judgment, if any, can one cast on people who refuse to get vaccinated? Their refusal is despite publicly available, accurate information proving that vaccines are safe. Does the fact that because probably nearly all of those people have been deceived by anti-vaccine propaganda or crackpot theories, they are excused for whatever adverse outcomes their false belief causes?

Putting the question in harsher terms better highlights the moral question:

Adults are adult. They are responsible for their beliefs, actions and inactions. False vaccine belief and refusal to get vaccinated sometimes hurts or kills the false belief believer or other people. Keeping one's demagoguery, crackpottery and lunacy to ones-self is fine. But when it crosses a line into matters that can affect or even kill others, there is no compelling reason to excuse what is irrational. The US is still a mostly free county. Americans still have access to accurate information. That some people choose to believe liars, crackpots or idiots is entirely their choice. The consequences of acting or failing to act because of their false beliefs dose not free them from moral implications of their actions and inactions.

Discussion

Is there such a thing as an epistemic responsibility or duty to form beliefs rationally (based on available evidence) when false beliefs lead to significant harm or death of others? Is that a legitimate moral imperative or duty? Does irrational distrust of government excuse false vaccine belief that causes serious harm or death to others?

Is this a persuasive argument?

Vaccine refusal isn't purely self-regarding.[1] Unvaccinated individuals are known to sometimes serve as vectors for disease transmission to immunocompromised people, infants, and others. The measles outbreaks of 2024-2025 demonstrate this concretely—children were being hospitalized and dying because of parental decisions based on misinformation. When a person's epistemically negligent beliefs kill other people's children, e.g., "I was confused by the information" is not exculpatory. We don't excuse financial fraud because the perpetrator "genuinely believed" their scheme was legitimate. We hold adults accountable for what they should have known. Why should we excuse easily preventable failure to get vaccinated?

Even if it were rarely provable, would it be good to have laws that made unvaccinated people financially responsible for economic, physical and emotional loss they are proven to cause to others (or their estates if they die) who they infect? Would the good, incentivizing more people to get vaccinated leading to less death and harm, outweigh whatever bad there might be?

Footnote:

1. An anti-vaccine crackpottery believer who was a father with a family got infected. The infection killed him, and his family mourned. His daughter says he was brainwashed by the stuff that he was seeing on YouTube and social media. He said: 'A lot of people will die more from having the vaccine than getting Covid'. He was wrong.

An unvaccinated healthcare worker set off a COVID-19 outbreak at a Kentucky skilled nursing facility in March 2021. The outbreak infected 26 residents, 18 of whom were fully vaccinated. Three residents died, one vaccinated, two unvaccinated. The CDC published this case as evidence for why vaccinating all health care staff is critical.