Beyond the North-South Divide: Vaccine Ethics, Structural Inequities, And the Quest for Global Health Justice

Abstract

Considerable debate persists, as opponents of compulsory vaccination policies cite ethical issues related to such impositions, particularly amid a global public health crisis. This review examines whether vaccines infringe upon autonomy, self-control, and freedom from a utilitarian and deontological perspective. It draws on benchmark vaccine-related court rulings and vaccine justice principles to evaluate the moral justification of vaccine mandates, particularly with regard to prioritising disadvantaged and marginalised groups. The objective of this paper is to critically analyse how ethical theories and social justice frameworks intersect in shaping vaccine mandate policies across diverse global contexts, and to assess how these frameworks can inform more equitable and participatory approaches to public health governance. While arguing that mandates may be ethically justified in some instances, such as for the immunocompromised, it highlights the need for transparency, proportionality, and public trust that such mandates are evidence-based. From this standpoint, the analysis incorporates ideological and pedagogical dimensions of social justice theory to illuminate silences in knowledge production and advocacy in public health, to critique discourse around health inequalities. It raises questions about whether social justice is consistently defined across varying geopolitical contexts and examines how health policy can be reconfigured to incorporate more participatory and decolonial approaches. This paper argues that effective vaccine advocacy engages impacted communities because community conversation profoundly shifts the perception of how complex health knowledge is constructed and how social knowledge is applied