The Vaccination Debate in the UK: Compulsory Mandate Versus Voluntary Action in the War Against Infection

The role of vaccination programmes within public health provision is becoming increasingly important. Mistrust of vaccines resulting from scandals has hampered efforts to protect and respond to preventable disease, thus raising the risk of a pandemic. This has coincided with outbreaks of disease worldwide. The UK’s voluntary vaccination system relies upon education and nudging. Other countries have compulsory vaccination. The debate over voluntary or compulsory vaccination raises questions about individual rights and public health. Voluntary vaccination can be adversely affected by external influences, while the effectiveness of compulsory programmes is dependent upon its enforcement. This paper argues that the benefits of compulsory vaccination have been overlooked and downplayed, while the costs have been unduly exaggerated. It is argued that voluntary vaccination programmes do not fully protect public health and while compulsory vaccination raises various challenges, intensifying the level of state intervention through compulsion could offer the potential to improve public health protection. This paper concludes that while several models of compulsion are used around the world, from strong, aggressive systems to moderate, incentive-based ones, a more nuanced approach to coercion may offer an effective middle way.