Summary
The current debate about whether individuals should be entitled to work in the healthcare sector if they decline to be vaccinated against SARS-CoV2 has been largely informed by personal opinions and argument by analogy.
In this BMJ opinion piece, Jeffrey K Aronson looks at a benefit:harm balance analysis which suggests that while vaccination has a highly favourable benefit:harm balance, the balance in instituting a “no jab, no job” policy is highly uncertain and may be unfavourable. Furthermore, there are practical difficulties and legal uncertainties. The much misunderstood precautionary principle dictates that if the benefit:harm balance of an intervention is unclear and may be unfavourable, the intervention should not be undertaken. Furthermore, the onus is on those who believe that the benefit:harm balance will be favourable to prove that it is so; it is not for the sceptics to prove that it isn’t. In the absence of good evidence in favour, this is an intervention that would be best avoided.
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