Mandatory and voluntary vaccination schemes: Legal and ethical dilemmas

Mandatory vaccination constitutes one of the most complex legal and ethical issues in contemporary public health governance, a challenge rendered particularly acute by the COVID-19 pandemic. The crisis has brought into sharp focus the enduring tension between the protection of public health and the safeguarding of individual autonomy and fundamental rights. This study examines the legal frameworks governing mandatory vaccination, their compatibility with international human rights standards, and the ethical dilemmas arising from state-imposed medical interventions pursued in the name of collective welfare. Employing doctrinal and comparative legal methodologies, the research undertakes a systematic analysis of international judicial practice, with particular emphasis on the jurisprudence of the United States Supreme Court and the European Court of Human Rights (ECtHR). Central to the analysis is Jacobson v. Massachusetts (1905), in which the U.S. Supreme Court articulated the doctrine of state police powers in the context of public health emergencies and affirmed that individual liberty is not absolute when confronted with serious epidemiological threats. The study further examines the Grand Chamber judgment in Vav?i?ka and Others v. Czech Republic (2021), where the ECtHR upheld mandatory childhood vaccination as compatible with Article 8 of the European Convention on Human Rights, relying on the principles of proportionality, legitimate aim, and the margin of appreciation afforded to states in public health policy. The paper also analyses earlier and subsequent ECtHR case-law, including Boffa and Others v. San Marino and Solomakhin v. Ukraine, as well as interim decisions rendered during the COVID-19 pandemic, which collectively demonstrate a consistent judicial approach recognising mandatory vaccination as a legitimate interference with private life when supported by law, scientific evidence, and procedural safeguards. From this jurisprudence, the study distils key legal criteria for the permissibility of vaccination mandates, including legality, necessity, proportionality, the absence of physical coercion, the availability of medical exemptions, and effective review mechanisms. Finally, the research addresses the ethical dimensions of mandatory vaccination, focusing on the relationship between individual autonomy and social solidarity, the principle of the best interests of the child, the limits of religious and philosophical exemptions, and the normative justification of “soft mandates.” The study concludes that, when grounded in a clear legal framework, robust judicial oversight, and sound scientific evidence, mandatory vaccination may be regarded as both legally permissible and ethically justified within a democratic society committed to the protection of public health.

Nino Lipartia is a Doctor of Law, practicing attorney, and academic specializing in medical law, health law regulation, and human rights. She is the Founder and Partner of the Centre of Medical Disputes, a specialized institution focused on the resolution of legal conflicts arising in the healthcare sector. She also serves as a chief legal advisor to medical and insurance institutions. Her professional practice centers on medical liability, informed consent, medical malpractice, patient rights, and legal disputes related to the provision of medical services, with particular attention to regulatory compliance and the interaction between healthcare and insurance law. She is a non-executive member of the Council of the Georgian Bar Association and a member of the World Association for Medical Law. Alongside her legal practice, Nino Lipartia is actively engaged in academia and teaches medical law at leading universities. She also served as a visiting (exchange) professor at Jan Kochanowski University in Kielce, Poland, where she delivered lectures in the field of medical law within the Erasmus+ program. Her academic research interests include patient autonomy, informed consent, transplantation law, mandatory and voluntary vaccination schemes, medical triage, and state responsibility in public health emergencies. She is the author and co-author of numerous scholarly publications and has presented her research at international conferences and academic forums across Europe and beyond. Through her combined academic, professional, and international teaching activities, Nino Lipartia contributes to the development of medical law as an independent and evolving discipline within contemporary legal scholarship.