Injuries of the anterior cruciate ligament (ACL), located in the knee, are typically thought to be caused by acute traumatic events, such as sudden twists. New work analyzing an animal model of ACLs suggests that such injuries can also occur as a result of chronic overuse, specifically due to a reduced ability to repair microtraumas associated with overuse. Importantly, the team said, females also are less able to heal from these microtraumas than males, which may explain why females are two to eight times more likely to tear their ACL ligaments than males.
Read more …Females less likely to heal from ACL injuries than males
Ending pandemics is a social decision, not scientific[1]. Governments and organizations rely on social, cultural and political considerations[2] to decide when to officially declare the end of a pandemic. Ideally, leaders try to minimize the social, economic and public health burden of removing emergency restrictions while maximizing potential benefits.
Vaccine policy is a particularly complicated part of pandemic decision-making, involving a variety of other complex and often contradicting interests and considerations. Although COVID-19 vaccines have saved millions of lives[3] in the U.S., vaccine policymaking throughout the pandemic was often reactive[4] and politicized[5].
A late November 2022 Kaiser Family Foundation poll found that one-third of U.S. parents[6] believed they should be able to decide not to vaccinate their children at all. The World Health Organization and the United Nations Children’s Fund reported that between 2019 and 2021, global childhood vaccination experienced its largest drop[7] in the past 30 years.
COVID-19 is here to stay[15]. Reflecting on the ethical considerations surrounding the rise – and unfolding fall – of COVID-19 vaccine mandates can help society better prepare for future disease outbreaks and pandemics.
Ethics of vaccine mandates
Vaccine mandates are the most restrictive form[16] of vaccine policy in terms of personal autonomy. Vaccine policies can be conceptualized as a spectrum[17], ranging from least restrictive, such as passive recommendations like informational advertisements, to most restrictive, such as a vaccine mandate that fines those who refuse to comply.
COVID-19 vaccine requirements were intended to protect the health and safety of the public. Seth Wenig/AP Photo[27]
Because of ethical considerations, vaccine mandates are typically not the first option[28] policymakers use to maximize vaccine uptake. Vaccine mandates are paternalistic by nature[29] because they limit freedom of choice and bodily autonomy. Additionally, because some people may see vaccine mandates as invasive, they could potentially create challenges in maintaining and garnering trust in public health. This is why mandates are usually the last resort.
Mandates can provide lasting protection[32] against infectious diseases in various communities, including schools and health care settings. They can provide a public good by ensuring widespread vaccination to reduce the chance of outbreaks and disease transmission overall. Subsequently, an increase in community vaccine uptake due to mandates can protect immunocompromised and vulnerable people who are at higher risk of infection.
COVID-19 vaccine mandates
Early in the pandemic, arguments in favor[33] of mandating COVID-19 vaccines for adults rested primarily on evidence that COVID-19 vaccination prevented disease transmission. In 2020 and 2021, COVID-19 vaccines seemed to have a strong effect on reducing transmission[34], therefore justifying vaccine mandates.
COVID-19 also posed a disproportionate threat[35] to vulnerable people, including the immunocompromised, older adults, people with chronic conditions and poorer communities. As a result, these groups would have significantly benefited[36] from a reduction in COVID-19 outbreaks and hospitalization.
However, the emergence of even more transmissible variants[39] of the virus dramatically changed the decision-making landscape surrounding COVID-19 vaccine mandates.
A Mississippi lawmaker considers a flyer on the benefits of vaccines in a 2018 hearing regarding a request for a religious exemption from school vaccine requirements. Rogelio V. Solis/AP Photo[40]
The public health intention (and ethicality) of original COVID-19 vaccine mandates became less relevant as the scientific community understood that achieving herd immunity against COVID-19 was probably impossible[41] because of uneven vaccine uptake, and breakthrough infections[42] among the vaccinated became more common. Many countries like England[43] and various states in the U.S.[44] started to roll back COVID-19 vaccine mandates.
With the rollback and removal of vaccine mandates, decision-makers are still left with important policy questions: Should vaccine mandates be dismissed, or is there still sufficient ethical and scientific justification to keep them in place?
Vaccines are lifesaving medicines that can help everyone eligible to receive them. But vaccine mandates are context-dependent tools that require considering the time, place and population they are deployed in.
Though COVID-19 vaccine mandates are less of a publicly pressing issue today, many other vaccine mandates, particularly in schools[45], are currently being challenged. I believe this is a reflection of decreased trust in public health authorities, institutions and researchers – resulting in part from tumultuous decision-making[46] during the COVID-19 pandemic.
Engaging in transparent and honest conversations surrounding vaccine mandates and other health policies can help rebuild and foster trust in public health institutions and interventions.
Ministers want the check included in the NHS Health Check offered to those aged between 40 and 74.
England outlawed Botox for under-18s two years ago, but there is no law stopping it in Wales.