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*Corresponding author: E-mail: albertopk2000@yahoo.co.uk; 
 
 
 

Asian Journal of Immunology 
 
4(1): 154-159, 2021; Article no.AJI.80740 
 

 
 

 

 

COVID 19 Vaccinations: Should It Be by Choice or 
Mandatory in Ghana? Our Opinion in Response to 
Political Activists’ Arguments against Compulsory 

Vaccination 
 

Raphael Kumah Abolasom a, Albert Opoku b,c*, Prince Twene d  

and Nicholas Amoah Owusu e 

 
a 
Bono Regional Hospital, Ghana. 

b 
Nursing and Midwifery Training College, Tepa, Trinity Hospital Pankrono, Kumasi, Ghana.  

c
 Adesh University Bathinda, India. 

d 
Aberdeen University, UK. 

e 
Food and Drugs Authority, Ghana.  

 
Authors’ contributions  

 
This work was carried out in collaboration among all authors. Author RKB designed the study and 
contributed to literature search with author AO and PT. Authors AO, RKB and NAO wrote the first 

draft of the manuscript. All authors read and approved the final manuscript for publication. 

 
Article Information 

 
Editor(s): 

(1) Dr. Wagner Loyola, Brazilian Agricultural Research Corporation, Brazil. 
(2) Prof. Cynthia Aracely Alvizo Báez, Autonomous University of Nuevo Leon, Mexico. 

Reviewers: 
(1) M. Zamri Saad, Universiti Putra Malaysia, Malaysia. 

(2) Eeritus Ibrahim Mohamadsaeed Shnawa, University of Qasim And Hilla University, Iraq. 
(3) Amandeep Goyal, University of Kansas Medical Center, USA. 

(4) Mulugeta Berhanu Feyisa,  Ethiopia. 
Complete Peer review History, details of the editor(s), Reviewers and additional Reviewers are available here: 

https://www.sdiarticle5.com/review-history/80740 

 
 
 

Received 20 November 2021  
Accepted 27 December 2021 
Published 30 December 2021 

 
 

ABSTRACT 
 

Some political actors and activists have waged war against compulsory vaccination in Ghana by 
insinuating that such decision by government is an affront to the rights and freedoms of citizens as 
enshrined in the 1992 republican constitution. This paper scrutinizes this position and supports the 
fact that government did not err in its decision to impose compulsory vaccination on persons 
travelling into and out of Ghana. In doing this, relevant materials were reviewed. The World Health 
Organization at its thirteenth world health assembly on 25

th
 April 1960 recommended compulsory 

Opinion Article 



 
 
 
 

Abolasom et al.; AJI, 4(1): 154-159, 2021; Article no.AJI.80740 
 

 

 
155 

 

vaccination. Chapter five (5), article twelve (12) section two (2) of the 1992 constitution makes it 
possible for citizens to enjoy their rights and freedoms but subject to respect for the rights and 
freedoms of others and for public interest”. The Public Health Act, 2012 (ACT 851), part II 
(Vaccination), Section 22, subsection (1), gives power to the Minister of Health, through a 
legislative instrument (LI) to order compulsory vaccination for public interest. The vaccination ACT 
1919, CAP.76 in section 3, subsections (1) and (2) also give powers to minister of health to issue 
such directives. Again, articles 31 and 32 of the 1992 Republican constitution, give room for the 
declaration of state of emergencies making it possible for one to be “legally deprived” of the 
enjoyment of the fundamental human rights and freedoms enshrined in chapter five (5) of the 1992 
constitution in times of natural disasters such as COVID-19. 
 

 
Keywords: COVID 19; vaccination; mandatory; Ghana and political activists. 

 

1. INTRODUCTION  
 

Countries have had to adopt several strategies to 
control the spread of the COVID-19 virus. These 
measures include social distancing (physical 
distancing), suspension or modification of 
working activities, restricted movement and 
obligatory use of facial masks [1]. Although 
necessary, yet these measures have had both 
direct and indirect negative consequences on 
national economies and personal health [2], 
leading to a rise in mental disorders and 
unhealthy behaviors [3]. 
 

In 2020, efforts were made across the world to 
rapidly develop vaccines for COVID-19. In this 
process, scientific and medical communities 
worked together with governmental institutions to 
produce a vaccine in record time [4]. The 
COVID-19 vaccination rollout encountered 
challenges at the early stages [5]. A study 
conducted among 2,734 people in all sixteen 
regions of Ghana showed that some citizens felt 
that the vaccine was unsafe, they were not sure 
of the effects. Others too for cultural, social and 
religious reasons opposed the vaccination 
exercise; people were generally uncomfortable 
[6]. 
 

Unfortunately our dear country is politically 
polarized to the extent that people listen more 
often to the opinions of their party people than 
facts and experts [7]. It is against this backdrop 
that I find the comments made by other stalwarts 
and particularly, Sammi Gyamfi, the National 
Communication’s officer of the NDC as not only 
unfortunate, but dangerous and has the potential 
to do great disservice to the good people of this 
country . For him to posit that, “vaccination 
must be by choice and not by force. The 
imposition of compulsory COVID vaccination 
requirement on all Ghanaians traveling into 
and out of Ghana by the Ghana health 
Service is reprehensible and an affront to the 

1992 constitution” [8], is nauseating and an 

unhealthy position to say the least.  
 

2. IS COMPULSORY VACCINATION 
ETHICAL? 

 
Foremost, healthcare, for that matter clinical 
practice, is guided by both law and ethics [9]. For 
purposes of education, it is imperative to state 
that, to consider an action as ethically right or 
wrong, there is the need to make reference to 
some basic ethical perspectives in healthcare 
practice [10]. Using deontology theory, the end 
result is not the focus but the act or action being 
taken [11]. In essence, Deontologists are of the 
view that the rightness of an action does not 
depend primarily or entirely on the value of the 
consequences of that action [12], but rather on 
the action or intent of the action: whether good or 
bad. On the other hand is consequentialism or 
the consequentialist’s perspective of ethics. With 
consequentialism, the effects of the vaccines 
administered are that on which premium is 
placed [13]. The intent to vaccinate may be a 
good one but if it yields negative consequences 
then it becomes problematic in the sight of the 
consequentialist [14]. Explicitly, the primary focus 
of the consequentialist is the results that will be 
realized after vaccinating citizens [15]. Thus, 
experts are of the view that vaccinating citizens 
will reduce the level of COVID-19 infection [16], 
which in turn is expected to lead to a reduction in 
COVID-19 related deaths and complications.  
 
In addition to the above, another perspective of 
ethics in healthcare practice is “virtue ethics”. It 
places emphasis on the character of a person or 
rests on the person of character [17]. There 
exists a strong relationship between patients and 
care professionals [18]. It is on the basis of this 
perspective that healthcare professionals were 
among the first sect to have received the 
vaccines. This was a deliberate policy advocacy 



 
 
 
 

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156 

 

strategy. The idea is that, when health care 
professionals take the vaccine, because they are 
professionals, citizens will be encouraged to get 
vaccinated [19] thereby helping the government 
to achieve its goal of “vaccination for all. 
Therefore, it is not right and not in the best 
interest of this country for people to advocate 
against compulsory vaccination by looking at 
only one side of the argument.  
 

3. IS COMPULSORY VACCINATION 
LEGAL? 

 
The World Health Organization at its thirteenth 
World Health Assembly on 25

th
 April 1960 

considered the issue of compulsory vaccination 
versus voluntary vaccination and concluded as 
follows:  
 
“It is understandable, therefore, that it can be 
very difficult for the health authorities to adopt a 
position on this matter. It is all the more so in that 
to protect the community effectively from 
diphtheria and smallpox it is known that a 
sizeable proportion of the population - 70 per 
cent or even more - must be immunized. 
Furthermore, it is essential that the immunity thus 
obtained should be consolidated by means of 
booster doses or re- vaccination. Now, to cover 
such a large proportion of the population there is 
no other solution but compulsory vaccination and 
or persuasion through an expensive campaign of 
health education” [20]. In effect the World Health 
Organization approved of compulsory 
vaccination. 
 
In Ghana, the Public Health Act, 2012 (ACT 
851), part II (Vaccination), Section 22, subsection 
(1), gives power to the Minister of Health, 
through a legislative instrument (LI) to give 
orders to whoever the LI may be applicable to be 
vaccinated by the public vaccinator unless in 
cases where the public vaccinator is of the view 
that the vaccination could result in injury and dire 
consequences to the health of the populace. 
Apart from the reasons supra, all health workers 
and citizens if ordered by the Minister to be 
vaccinated, will have no choice than to be 
vaccinated. Sanctions will be visited upon any 
professional or citizen who fails to comply with 
the order according to Section 22; subsection (2). 
One may argue that the patient charter gives the 
patient a right, yes that is true, but such demands 
must be made within the right context. A 
Patient’s right should not cause other citizens to 
be exposed to the virus. This position is 
supported by Chapter five (5), article twelve (12) 

section two (2) of the 1992 constitution. It does 
state that, “ every person in Ghana, whatever his 
race, place of origin, political opinion, color, 
religion, creed or gender shall be entitled to the 
fundamental human rights and freedoms of the 
individual contained in this chapter but subject to 
respect for the rights and freedoms of others and 
for public interest”.  
 
The vaccination ACT 1919, CAP.76 also 
maintains in section 3 “Compulsory Vaccination” 
subsections (1) and (2) as follows: (1) The 
Minister may, by executive instrument, order 
generally or with reference to a particular area, 
district or place, or with respect to a particular 
class or classes of persons, that the persons to 
whom the instrument applies who do not produce 
satisfactory evidence of successful vaccination or 
of having suffered from smallpox shall be 
vaccinated by a public vaccinator, unless in the 
opinion of the public vaccinator vaccination 
would be injurious to health. (2) The instrument 
may prescribe at what age a person is liable to a 
penalty for non-compliance with the terms of the 
instrument, and who is liable in cases where the 
persons failing to be vaccinated have not 
attained that age.  
 
From the above provisions of the vaccination 
ACT, it is clear that the ministry acting through its 
agencies is vested with powers to order for 
compulsory vaccination and also be able to visit 
sanctions upon whoever defies the order. Again, 
articles 31 and 32 of the 1992 Republican 
constitution, give room for the declaration of state 
of emergencies. This provision makes it possible 
for one to be “legally deprived” of the enjoyment 
of the fundamental human rights and freedoms 
enshrined in chapter five (5) of the 1992 
constitution. This further means that, the 
President in consultation with the appropriate 
authorities could declare a state of emergency 
denying citizens of the freedom of movement 
among other rights and hence equally has the 
locus to operate through the ministry of health 
and the Ghana health services to institute 
measures such as compulsory vaccinations in 
times of natural disasters (with reference to 
Articles 31 and 32 of the 1992 constitution). 
Since the list of natural disasters under Article 
thirty (31) is in-exhaustive, natural disasters 
could be likened to this era of the COVID-19 
pandemic. Of course, section 22 of Act 851 gives 
room for the use of discretion by the public 
vaccinator to administer the vaccine or 
otherwise. Logically the decision of a public 
vaccinator to determine the safety or otherwise of 



 
 
 
 

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157 

 

the vaccine must be based on science and 
empirical evidence. Checks conducted reveals 
that no adverse findings against vaccinating 
Ghanaians has been documented or known            
yet. 
Admittedly, the fact that compulsory vaccination 
is both legal and ethical does not mean inferior, 
sub-standard vaccines should be used on the 
people. Vaccine potency, its side effects and its 
ability to yield the desired scientific results must 
be paramount. Vaccination must serve its 
purpose, compulsory vaccination is a fruitless 
venture should it have no positive impact on the 
immunity of the people [21,22]. It is totally 
needless if its unable get populations to reach 
herd immunity and eventually reducing and 
preventing subsequent infections. In the case of 
COVID-19, taking the vaccine is not enough, 
people must continue masking, handwashing, 
social and physical distancing among others. 
 

4. CONCLUSION 
 

Voluntary vaccination lacks compulsion, it is 
therefore most often a time poorly executed, 
people skip doses and it is administered in a 
haphazard manner resulting in an increase of 
disease incidence. Again, patients suffering from 
tuberculosis and chicken pox are isolated from 
other patients so that they do not infect others. 
One would therefore ask, have the rights and 
freedoms of such patients being infringed upon? 
The answer is “yes”, but the isolation is being 
done to promote the common good of the 
society. Some other anti-vaccine movements cite 
religious reasons for their opposition to 
compulsory vaccination. However, many law 
courts in the United States of America have ruled 
contrary to this position and that Religion must 
not be used as a medium to be exempted from 
decisions arising from health legislations. To 
buttress this, the supreme court of the state of 
Florida ruled that “Religious freedom cannot be 
used as a cloak for any person with contagious 
or infectious disease to spread such disease 
because of his religion”.  
 

For the avoidance of doubt, the focus of this 
article is not on whether the COVID-19 vaccines 
are efficacious or not, but as to whether the 
government of Ghana has the mandate to 
embark on compulsory vaccination amidst 
COVID-19 pandemic. Of course, although anti-
vaccine movements exist anytime, anywhere, yet 
vaccination programs get rolled out and 
instituted. Therefore, without mincing words, 
appropriate institutions must subject populations 

to compulsory vaccination in order to prevent a 
further spread of the pandemic as long as the 
vaccines are safe, yield the desired results and 
have been approved for use by the relevant 
international and state institutions. The World 
Health Organization at its thirteenth world health 
assembly on 25

th
 April 1960 recommended 

compulsory vaccination. Chapter five (5), article 
twelve (12) section two (2) of the 1992 
constitution makes it possible for citizens to enjoy 
their rights and freedoms but subject to respect 
for the rights and freedoms of others and for 
public interest”. The Public Health Act, 2012 
(ACT 851), part II (Vaccination), Section 22, 
subsection (1), gives power to the Minister of 
Health, through a legislative instrument (LI) to 
order compulsory vaccination for public interest. 
The vaccination ACT 1919, CAP.76 in section 3, 
subsections (1) and (2) also give powers to 
minister of health to issue such directives. Again, 
articles 31 and 32 of the 1992 Republican 
constitution, give room for the declaration of state 
of emergencies making it possible for one to be 
“legally deprived” of the enjoyment of the 
fundamental human rights and freedoms 
enshrined in chapter five (5) of the 1992 
constitution in times of natural disasters such as 
COVID-19. The above clearly demonstrates that 
government did not err in ordering compulsory 
vaccination.  
 

CONSENT 
 
It is not applicable. 

 
ETHICAL APPROVAL 
 
It is not applicable. 
 

COMPETING INTERESTS 
 
Authors have declared that no competing 
interests exist. 
 

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