Deliberation on Childhood Vaccination in Canada: Public Input on Ethical Trade-Offs in Vaccination Policy

Kieran O'Doherty, Sara Cranna, Lucie Marisa Bucci, Michael M. Burgess, Apurv Chauhan, Maya J. Goldenberg, C. Meghan McMurtrya , Jessica White, Donald J. Willison

    Research output: Contribution to journalArticlepeer-review


    Background: Policy decisions about childhood vaccination require consideration of multiple, sometimes conflicting, public health and ethical imperatives. Examples of these decisions are whether vaccination should be mandatory and, if so, whether to allow for non-medical exemptions. In this article we argue that these policy decisions go beyond typical public health mandates and therefore require democratic input. Methods: We report on the design, implementation, and results of a deliberative public forum convened over four days in Ontario, Canada, on the topic of childhood vaccination. Results: 25 participants completed all four days of deliberation and collectively developed 20 policy recommendations on issues relating to mandatory vaccinations and exemptions, communication about vaccines and vaccination, and AEFI (adverse events following immunization) compensation and reporting. Notable recommendations include unanimous support for mandatory childhood vaccination in Ontario, the need for broad educational communication about vaccination, and the development of a no-fault compensation scheme for AEFIs. There was persistent disagreement among deliberants about the form of exemptions from vaccination (conscience, religious beliefs) that should be permissible, as well as appropriate consequences if parents do not vaccinate their children. Conclusions: We conclude that conducting deliberative democratic processes on topics that are polarizing and controversial is viable and should be further developed and implemented to support democratically legitimate and trustworthy policy about childhood vaccination.

    Original languageEnglish
    Pages (from-to)1-14
    Number of pages14
    JournalAJOB Empirical Bioethics
    Publication statusPublished - 30 Jul 2021

    Bibliographical note

    This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives License (
    licenses/by-nc-nd/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited, and is not
    altered, transformed, or built upon in any way


    • childhood vaccination
    • immunisation
    • public deliberation
    • non-medical exemptions
    • vaccination policy
    • value trade-offs
    • bioethics
    • Childhood vaccination
    • immunization


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