Vaccination, human rights, and state responsibility — how does modern law seek a balance?

The issue of vaccination in the modern world no longer belongs only to the field of medicine. Today, it has become one of the most difficult intersections of human rights, state responsibility, bioethics, and public safety. Especially after the COVID-19 pandemic, questions have arisen in society that no longer have simple answers: does the state have the right to require citizens to be vaccinated? Where does personal freedom end and public interest begin? And who is responsible when vaccination causes possible harm?

Answering these questions has become one of the most important challenges for modern democratic states. That is why the topic of vaccination is no longer considered solely in a medical context - it has become part of constitutional law, human rights, social solidarity, and state accountability.

Interestingly, this discussion is not entirely new. As early as the 19th century, several German principalities had mandatory vaccinations, and in 1874, the German Empire first began discussing a unified “vaccination law” for the entire country. The debates of that period bear a striking resemblance to modern realities: To what extent can the state interfere with a person’s personal freedom in the name of public safety? Where is the line between individual autonomy and the common good? And what role should medicine play in the system of state governance?

These questions became especially relevant after the 2019 measles epidemic, when Germany adopted the Masernschutzgesetz - “Measles Protection Law”. The law established mandatory vaccination for children, kindergartens and medical staff. In case of non-compliance, financial sanctions and restrictions on certain social services were envisaged. However, one important circumstance was that physical coercion was completely excluded.

In 2022, the German Federal Constitutional Court once again clarified that mandatory vaccination is constitutional if it is disease-specific, temporary and serves a proportionate purpose. The court particularly emphasized that measles is one of the most contagious diseases and the effectiveness of the vaccine has been scientifically proven for decades. In doing so, the German model has shown that protecting human rights and ensuring public health are not mutually exclusive goals.

A similar approach has developed in France. Until 2018, only three age-specific vaccines were mandatory in the country, but after the increase in epidemiological threats, this number was increased to eleven. The French Constitutional Council considered the aforementioned changes compatible with the constitution and explained that the protection of public health can serve as a legitimate basis for restricting personal rights if such interference is necessary, temporary and proportionate.

The most interesting legal model was created by Italy. Article 32 of the Italian Constitution recognizes health as both an individual right and a collective interest. It is on this idea that the Italian Constitutional Court built its important decisions on vaccination.

In its 1990 and 2018 decisions, the Court explicitly stated that mandatory vaccination serves a constitutional purpose, but at the same time it imposes responsibility on the state for the safety of vaccines. The Italian model also paid special attention to the issue of compensation - if a citizen takes a certain risk in the name of the public interest and the vaccination causes harm, compensation should be provided even without fault, based on the principle of social solidarity.

The Italian court also made an important clarification on the relationship between a recommendation and an obligation. In its assessment, a recommendation in medicine often carries the same authority as a legal obligation. Therefore, moving certain vaccines from the recommended to the mandatory category did not create a fundamentally new reality.

In parallel with European practice, the European Court of Human Rights has also established important standards. The most influential decision was Vavřička and Others v. Czech Republic (2021), where the Strasbourg Court found that compulsory vaccination of children, subject to certain conditions, does not violate the European Convention on Human Rights. The Court explained that the state has a wide margin of appreciation in the field of public health protection, especially when it comes to the safety of children and vulnerable groups.

Previously, in Solomakhin v. Ukraine , the Court had explicitly stated that vaccination constituted an interference with private life, although such interference could be justified on grounds of public health. Even earlier, in Boffa and Others v. San Marino , the European Commission had stressed that state action must be based on a clear legislative basis and that administrative discretion was not sufficient.

The idea of mandatory vaccination did not develop only in Europe. As early as 1905, the Supreme Court of the United States ruled in Jacobson v. Massachusetts that a state may require citizens to be vaccinated during an epidemic when it is necessary to protect public safety. The logic of the court was clear - personal freedom is not absolute when a person's actions endanger the life and health of others.

In light of this international practice, the experience of Georgia is particularly interesting. The 2005 case BS-424-25 was a turning point for Georgian judicial practice. The case concerned a 12-year-old child who developed severe neurological complications after being vaccinated against hepatitis B. The court faced two main questions: whether a causal link could be established between the vaccination and the injury, and who was liable.

After the medical expert assessment, the court noted that a connection could not be ruled out. It was this formulation that became important - the court applied the precautionary principle and divided the responsibility between the state and the manufacturer. The court found that the vaccine documentation did not provide complete information about side effects, and the state supervision system was not functioning properly. As a result, the victim was awarded compensation and the state was ordered to provide long-term assistance.

A 2011 case (AS-260-244-11) presents a different legal picture. In this case, the court explained that an administrative error does not automatically entail liability. It is necessary to prove specific harm and a causal link. This decision showed that in vaccination cases, the main importance is given to expert assessment and the establishment of causality.

In fact, modern legal systems no longer view the issue of vaccination as a purely medical or purely political problem. It is a question of trust, responsibility and social solidarity. A democratic state is obliged to protect public health, but at the same time it is obliged to be transparent, accountable and respectful of human dignity.

That is why an effective vaccination policy cannot be based solely on coercion. Its main foundation is public trust - trust in science, law, and the state. When the state requires citizens to share responsibility for the public interest, it is also obliged to fully share responsibility for each person.

Today it is clear that the issue of vaccination no longer belongs only to the field of medicine. It is a kind of test of the quality of modern democracy - to what extent the state can simultaneously protect public safety and human freedom. It is on this balance that the future of modern law and democratic society rests.