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Proportionality, wrongs and equipoise for natural immunity exemptions: response to commentators
  1. Jonathan Pugh1,
  2. Julian Savulescu1,2,
  3. Rebecca CH Brown1,
  4. Dominic Wilkinson1,2,3
  1. 1 The Oxford Uehiro Centre for Practical Ethics, University of Oxford, Oxford, UK
  2. 2 Murdoch Childrens Research Institute, Parkville, Victoria, Australia
  3. 3 Newborn Care, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
  1. Correspondence to Dr Jonathan Pugh, The Oxford Uehiro Centre for Practical Ethics, University of Oxford, Oxford, UK; jonathan.pugh{at}


We would like to thank each of the commentators on our feature article for their thoughtful engagement with our arguments. All the commentaries raise important questions about our proposed justification for natural immunity exemptions to COVID-19 vaccine mandates. Thankfully, for some of the points raised, we can simply signal our agreement. For instance, Reiss is correct to highlight that our article did not address the important US-centric considerations she helpfully raises and fruitfully discusses. We also agree with Williams about the need to provide a clear rationale for mandates, and to obtain different kinds of data in support of possible policies.

Unfortunately, we lack the space to engage with every one of the more critical comments raised in this rich set of commentaries; as such, in this response, we shall focus on a discussion of hybrid immunity, which underlies a number of different arguments evident in the commentaries, before concluding with some reflections responding to Lipsitch’s concern about the appropriate standard of proof in this context.

  • Coercion
  • Ethics
  • Public Policy

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  • Twitter @Becky_Brown13, @Neonatalethics

  • Contributors JP drafted initial manuscript. JS. RCHB and DW all revised. All authors agreed to final version.

  • Funding This project is supported by Arts and Humanities Research Council (AH/V013947/1) and UK Research and Innovation (AH/V013947/1).

  • Competing interests JP, JS and DW are supported by the UKRI/ AHRC funded UK Ethics Accelerator project, grant number AH/V013947/1. JS receives funding from the Uehiro Foundation on Ethics and Education, NHMRC, Wellcome Trust, Australian Research Council and WHO. He is a Partner Investigator on an Australian Research Council Linkage award (LP190100841, October 2020-2023), which involves industry partnership from Illumina. He does not personally receive any funds from Illumina.

  • Provenance and peer review Not commissioned; internally peer reviewed.