000374-22. HEALTH. MANDATORY COVID-19 VACCINATION. Unconstitutionality action against Executive Decree No. 43249-S of 07-10-2021, titled Reforma al Decreto Ejecutivo 42889-S de 10/03/2021, denominado Reforma al Decreto Ejecutivo No. 32722-S de 20/05/2005 Reglamento a la Ley Nacional de Vacunación y Establecimiento de la Obligatoriedad de la Vacuna del COVID-19, article 46 of the Civil Code, Legislative Agreement of 27-10-2021.
\\nOperative part: The action is rejected on the merits regarding the alleged violation of the principles of informed consent (consentimiento informado), hierarchy of norms, conventionality, legal reserve, and informational self-determination (autodeterminación informativa); and of the right to life and health. In all other respects, the action is rejected outright. The joinder motion is rejected. Magistrate Castillo Víquez records a separate note (nota). On procedural grounds and without addressing the merits, Magistrate Rueda Leal issues a dissenting vote (voto salvado) and orders the preventive measure of article 80 of the Ley de la Jurisdicción Constitucional.
ISSUES ANALYZED
On the\\nmandatory nature of vaccination, the principle of legal reserve, and the right\\nto life and health.
On informed\\nconsent (consentimiento informado) and the protection of sensitive information.
On the alleged\\nviolation of the principle of equality.
On the alleged\\nviolation of freedom of expression and thought.
On the alleged\\ninfringement of the principle of legality and of laws enacted after the Ley de Vacunas.
On the alleged\\nviolation of the principles of conventionality, hierarchy of norms, and the\\njurisprudence of the Inter-American Court of Human Rights related\\nto the right to life and informed consent (consentimiento informado).
On the alleged\\nviolation of the principles of reasonableness and proportionality in the penalty for\\nnot being vaccinated.
XIV.-\\nSEPARATE NOTE (NOTA SEPARADA) OF MAGISTRATE CASTILLO VÍQUEZ. I concur with my colleagues in the arguments\\nthey put forward to reject the action outright, since there is no evident and\\nmanifest contradiction between the law and the decree being challenged. The\\nCourt's position, to the effect that when a regulatory norm violates or exceeds\\nthe provisions of a law, it is a matter of legality, whose discussion does not\\ncorrespond to this jurisdiction, is, in general terms, legally correct. There is no doubt\\nthat it is the ordinary Judge who is responsible for determining the scope of the\\ninterpretation and application of the Law and, consequently, it is they who are called upon to\\nestablish whether or not a regulatory norm violates the legal norm. However,\\nthere is an important nuance in this matter, which is that, from my point of view,\\nwhen there is manifest evidence, which is obvious, that the\\nregulatory norm exceeds, suppresses, or contradicts the text of the Law, there is no doubt\\nthat, in a gross manner, the principle of force, authority, or efficacy\\nof the Law is violated; a principle that has constitutional coverage and must be protected\\nby this Court.
As is\\nwell known, the principle of force, authority, or efficacy of law refers us to\\nthe power (active force), the resistance (passive force), and the regime of\\nchallenge of the Law. Based on the first aspect of the concept, the Law, once\\nit comes into force, repeals or modifies any norm of equal or lower rank.\\nBased on the second, the Law cannot be repealed or modified by\\na norm of lower rank. Finally, based on the third, the Law can only\\nbe challenged on grounds of unconstitutionality and, therefore, can only\\nbe annulled through a resolution of the Constitutional Court (Sala Constitucional).
CO01/22
XV.-DISSENTING VOTE (VOTO SALVADO) OF MAGISTRATE RUEDA\\nLEAL. I depart from the majority opinion of this Court and issue a dissenting vote (voto salvado)\\nin this matter, considering that the decision to outright reject this action\\nof unconstitutionality is premature. As I have expressed on multiple\\noccasions (votes no. 2021-26494\\nat 9:20 a.m. on November 24, 2021, 2021-26488 at 9:20 a.m. on\\nNovember 24, 2021, 2021-25377 at 9:20 a.m. on November 10,\\n2021, 2021-18405 at 10:05 a.m. on August 18, 2021, among others), it\\nis unquestionable that the unconstitutionality action is a process, “established\\nwith the purpose of guaranteeing the supremacy of the Political Constitution against\\nnorms or other provisions of a general nature and for that very reason\\na set of formalities must be fulfilled, so that the Court can\\nvalidly hear the merits of the challenge ” as has been\\nindicated in the extensive jurisprudence of this Court. However, it is precisely\\nthe law itself that orders the treatment that must be given to the different\\nformalities and to their eventual non-compliance, as is extracted from the text of\\narticle 80 of the Ley de la Jurisdicción Constitucional which states:
“Artículo\\n80.- If the formalities referred to in the two previous\\narticles are not fulfilled, the President of the Court shall indicate by resolution which are the\\nomitted requirements and shall order them to be fulfilled within three days (…)”
In this\\nmatter, among other requirements, an adequate and sufficient\\nlegal basis is lacking, as required by article 79 of the Ley de la Jurisdicción\\nConstitucional, and therefore the preventive measure (prevención)\\nto the claimant to remedy the detected omission is unquestionably applicable. Likewise, it is not at all superfluous to state for the record that –in my opinion– the interpretation of\\narticles 78 and 79 as well as of article 80 of the Law governing this\\njurisdiction must be broad to the benefit of those who appear before this Court, so\\nthat access to constitutional justice is not unnecessarily\\nlimited. Thus, on procedural grounds and without addressing the merits of the\\nmatter, I issue a dissenting vote (voto salvado) and order that the cited preventive measure (prevención) be carried out.
CO01/22
“…Certainly, the jurisprudence of the Inter-American Court of Human\\nRights provided by the claimant refers to the need for an\\ninformed consent (consentimiento informado) before performing any medical act;\\nhowever, the petitioner should note the context of such\\npronouncements, as they are based on ordinary situations and not on a\\npandemic like the one occurring currently, which implies a different assessment. The\\nforegoing is not intended to harm the fundamental rights of workers,\\nmuch less to compel them to undergo any medical procedure, but rather\\nto protect them and safeguard their lives with a vaccine, in the face of a pandemic,\\nwhich is not an ordinary situation, whose effects transcend beyond a\\nperson or a family, but rather cross borders and have produced serious\\nconsequences worldwide given the high numbers of deaths and the\\nconditions required to provide them with proper medical care in times of\\nhigh or very high demand. Note that the provision in question aims\\nat the protection of collective health and the rights of others,\\namong whom are included those who cannot be vaccinated for medical\\nreasons…” 374-22
CO11/22
*210223410007CO*
\\r\\r\\nExp: 21-022341-0007-CO
\\r\\r\\nRes. Nº 2022000374
\\r\\r\\nCONSTITUTIONAL CHAMBER OF THE SUPREME COURT OF JUSTICE.
\n\nSan José, at nine twenty minutes on January fifth, two thousand twenty-two.\n\nAction of unconstitutionality brought by Arcelio Hernández Mussio, of legal age, married, attorney, identification card number 1-832-451, resident of San José, against “Executive Decree 43249-S, titled “Reform to Executive Decree No. 42889-S of March 10, 2021, called reform to Executive Decree No. 32722-S of May 20, 2005, ‘Regulations to the National Vaccination Law’ and Establishment of the Mandatory Nature of the Covid-19 Vaccine”, Article 46 of the Civil Code, Law No. 63 of September 28, 1887, the agreement adopted by the Legislative Directorate, in Article 11 of Session No. 180-2021, held on October 27, 2021, which introduces Article 61 bis to the Autonomous Regulations of Service of the Legislative Assembly; Law No. 5395 of October 30, 1973, General Health Law, Law No. 8811 “National Vaccination Law” of July 18, 2001, Executive Decree No. 32722 “Regulations to the National Vaccination Law” of May 20, 2005, Executive Decree No. 37808 “National Vaccination Standard” of January 8, 2013, Executive Decree No. 30965-S “Regulations on the management of infectious-contagious waste generated in establishments providing health care and related services” of December 17, 2002, Executive Decree No. 41045-S of May 10, 2016 “General Regulations for the Enablement of Health Services”; the National Guidelines for the Surveillance of COVID-19 disease; the General Guidelines for the use of Personal Protective Equipment (PPE), to prevent exposure to Coronavirus (COVID19); the Procedures Manual for the execution of vaccination against COVID-19 in the health establishments of the Costa Rican Social Security Fund, version #7, June 2021, Ministry of Health, LS-SS-013, Guidelines on vaccination against the SARS-CoV-2 virus for the prevention of COVID-19 – as well as any standard or regulation issued by other public institutions that oppose the principle of prior, free, informed consent.”\n\n**Whereas:**\n\n**1.-** By document filed with the Secretariat of the Chamber on November 4, 2021, it is requested that the following be declared unconstitutional: *“Executive Decree 43249-S, titled “Reform to Executive Decree No. 42889-S of March 10, 2021, called reform to Executive Decree No. 32722-S of May 20, 2005, ‘Regulations to the National Vaccination Law’ and Establishment of the Mandatory Nature of the Covid-19 Vaccine”, Article 46 of the Civil Code, Law No. 63 of September 28, 1887, the agreement adopted by the Legislative Directorate, in Article 11 of Session No. 180-2021, held on October 27, 2021, which introduces Article 61 bis to the Autonomous Regulations of Service of the Legislative Assembly; Law No. 5395 of October 30, 1973, General Health Law, Law No. 8811 “National Vaccination Law” of July 18, 2001, Executive Decree No. 32722 “Regulations to the National Vaccination Law” of May 20, 2005, Executive Decree No. 37808 “National Vaccination Standard” of January 8, 2013, Executive Decree No. 30965-S “Regulations on the management of infectious-contagious waste generated in establishments providing health care and related services” of December 17, 2002, Executive Decree No. 41045-S of May 10, 2016 “General Regulations for the Enablement of Health Services”; the National Guidelines for the Surveillance of COVID-19 disease; the General Guidelines for the use of Personal Protective Equipment (PPE), to prevent exposure to Coronavirus (COVID19); the Procedures Manual for the execution of vaccination against COVID-19 in the health establishments of the Costa Rican Social Security Fund, version #7, June 2021, Ministry of Health, LS-SS-013, Guidelines on vaccination against the SARS-CoV-2 virus for the prevention of COVID-19 – as well as any standard or regulation issued by other public institutions that oppose the principle of prior, free, informed consent”*, considering that they violate the principle of informed consent developed in Articles 20, 21, and 28 of the Political Constitution, Article 22 of the General Health Law, Article 2 of Law No. 8239, “Rights and Duties of Users of Public and Private Health Services”, Articles 1 and 4 of the Regulations of the Costa Rican Social Security Fund (CCSS); the principle of equality and non-discrimination derived from Article 33 of the Political Constitution; freedom of thought and expression developed by Articles 28 and 29 of the Political Constitution, and Articles 19 of the Universal Declaration of Human Rights, 19 of the International Covenant on Civil and Political Rights, 4 of the American Convention on Human Rights, and 13 of the Pact of San José; the principle of legality (Articles 11 of the Political Constitution and 11 of the General Law of Public Administration) due to the application of the term vaccine; the precautionary principle in the face of mandatory vaccination without prior medical examinations; the principle of hierarchy of norms, developed in Articles 7, 48, 129, and 140 subsection 3) of the Political Constitution; the principle of conventionality; laws subsequent to the national vaccine law; the jurisprudence of the Inter-American Court of Human Rights related to the right to life and informed consent; the principle of reasonableness and proportionality in the sanction for not being vaccinated, and for the adoption of the measure itself, the principle of informational self-determination, according to Article 24 of the Political Constitution, related to private information contained in the medical record, the right to life and health, according to Articles 21, 40, 46, 50, 73 of the Political Constitution and Article 5, first subsection, of the American Convention on Human Rights, which protect the value of human life in all its manifestations, such as health and the disposition of the human person over their own body, their physical, psychological, and moral integrity, and to prevent any intervention that is not previously authorized by law, and the limits of regulatory power established in Article 140, subsection 3) and 18) of the Political Constitution, as well as the principle of legal reserve. It states that the matter is the amparo appeal being processed in case file 21-021972-0007-CO, in which he appears as petitioner and has invoked the unconstitutionality of the regulations indicated above. It states that, according to the concept of prior, informed, full, and free consent, as well as informational autonomy, he is not obliged to consent to vaccination, nor to have his sensitive data stored. In addition, he indicates that it is an action that concerns and interests the community. He alleges having received a communication in which his appointment as ad honorem advisor in the Legislative Assembly is put at risk if he does not get vaccinated against covid 19. This is because, by an agreement adopted by the Legislative Directorate, in Article 11 of Session No. 1802021, held on October 27, 2021, it was agreed to add an Article 61 bis to the Autonomous Regulations of Service of the Legislative Assembly. In that document, vaccination against covid-19 is imposed on him as mandatory, under penalty of a possible revocation of his appointment as ad honorem advisor, which implies from now on a threat of sanction, which nullifies his right to give or not give his prior, informed, full, and free consent. According to the concept of prior, informed, and free consent, as well as informational autonomy, he is not obliged to consent to vaccination, nor to have his sensitive data stored; in the referenced agreement, his fundamental right to give or not give his prior, informed consent freely for vaccination is not contemplated, and reference is made to Executive Decree No. 43249-S, which contains a declaration of mandatory nature that is contrary to his fundamental rights, for which the Legislative Assembly acts arbitrarily by giving higher rank and importance to an executive decree, which is below the law and the international agreements signed by Costa Rica. Therefore, this action is brought against Decree No. 42889-S, “Reform Regulations to the National Vaccination Law and numerals 2, 3, and 6 subsection a) of Law No. 8111, National Vaccination Law”, as well as the other regulations already indicated, for infringing principles of international and constitutional law, originating the subjective act of the mandatory nature of covid vaccination in a generalized manner, without prior informed consent, which must be obtained without coercion or threat, in order to be free. It states that said mandatory nature of vaccination indicated in Decree No. 42889-S, “Reform Regulations to the National Vaccination Law in accordance with numerals 2, 3, and 6 subsection a) of Law No. 8111, National Vaccination Law”, grossly violates a series of fundamental and constitutional rights of every human being, by directly affecting their right to life, health, privacy, human dignity, work, autonomy of will, informed consent, informational self-determination, principle of legality, legal certainty, and right to justice; having the privilege of living in a Rule of Law State and a democratic country, with strong bases in the profound respect for the human and fundamental rights of every inhabitant of our national territory. Given the lack of information, his doubts about the quality assurance controls, stability, efficiency, immunity, and adverse effects of the mandatory nature of covid-19 vaccines, among many others, it is offensive to him to be forced to vaccinate against covid-19 in order to continue his work as an advisor, which would nullify his human right to freely consent to inoculation. He indicates that, to this day, there is total obscurity regarding the terms of the State’s contract with Pfizer, it is not known who will be responsible for any health damages resulting from mandatory vaccination, in violation of the principle of full informed consent, that is, with access to all relevant information for decision-making, which must be adopted freely. The mandatory nature of covid-19 vaccination, without written, prior, and duly informed consent, violates, in addition to what has already been indicated above, the right to human dignity (Article 33 of the Constitution), to informational self-determination derived from the autonomy of will (Articles 24, 28, and 46 final paragraph of the Constitution), the right to work, and to justice (Article 41 of the Constitution). This last numeral grants every person and worker the right that *“resorting to the laws, all must find reparation for the injuries or damages they have received in their person, property, or moral interests. Justice must be done promptly, fully, without denial, and in strict conformity with the laws”*, reasons for which, the prior, written, duly informed consent, given freely, without coercion or threat, constitutes a human right for every person obliged to be vaccinated against covid, to possess a document with which they can exercise said constitutional right and, in turn, safeguard their life, health, and well-being, in accordance with Articles 21 and 50 of the Political Constitution. The inertia, omission, and abstention of the public authorities, in the mandatory nature of generalized vaccination without a prior, duly informed, full, and free consent of the person to be inoculated, undoubtedly violates the right to life, health, and to receive adequate and truthful information, according to numerals 21, 27, 46 final paragraph, and 50 of our Political Constitution. That preventive measure is a constitutional right, necessary and essential, to avoid serious or irreparable harm to the health of oneself and any human being, given the possibility of some adverse effect of the covid-19 vaccine, but it is not provided for in its mandatory nature. The principles of respect for human dignity, autonomy of the will, prior, full, and free informed consent, and informational self-determination, have the protection of constitutional principles such as the principle of legality, legal certainty, and the right of access to justice, constitutional rights widely protected in Articles 1, 7, 11, 20, 21, 27, 30, 33, 40, 41, 46 final paragraph, 50, and 148 of the Political Constitution, as well as in the international legal instruments of Articles 3, 5, 6, 7, 8, 12, 18, 19, 23, and 28 of the Universal Declaration of Human Rights, Articles 1:1.2, 2:c.d.e.g, 3:1.2, 4, 5, 6:1.2, 9, 10, 11, 12, 14:1, 15:1, 16, 18:1.2.3, 19:a.b.c.d, 20, 22:1.2, 27, and 28 of the Universal Declaration on Bioethics and Human Rights, Articles 4.1. and 11 of the American Convention on Human Rights, Articles 1.1, 2.3.a.b., 5.2., 6.1, 9.1, 10.1., and 17 of the International Covenant on Civil and Political Rights. The unconstitutionality of Executive Decree No. 42889-S, “Reform Regulations to the National Vaccination Law and numerals 2, 3, and 6 subsection a) of Law No. 8111, National Vaccination Law”, by indicating the mandatory nature of covid-19 vaccination, generates a direct employer request, to demand medical and health information, which constitutes private information, under the protection of Article 24 of the Political Constitution, in accordance with domestic national legislation, according to Articles 1, 2, 3, 4, 10, 19, 22, 152, and 345 subsection 3) of Law No. 5395, General Health Law, Article 1, 3 subsection e), and 7 subsection 1.c) of Law No. 8968, Personal Data Protection Law, Article 1 of Law No. 7425, Law on the Registration, Seizure, and Examination of Private Documents and Intervention of Communications, and Articles 6, 8, 10, and 11 of Law No. 7771, General Law on HIV-AIDS. Constitutionally, both the decree and the numerals claimed, by stating the phrase “mandatory nature” of covid-19 vaccination, are unconstitutional, because they represent an excess of prevention that constitutes repression, in a country that claims to be a Rule of Law State, where minimal intervention is a fundamental part of our democratic system, and therefore, the mandatory nature of covid-19 vaccination with the lack of a guarantee of its quality and stability becomes a strong, arbitrary, and gross intrusion of the power of the state into fundamental and inalienable rights. He points out that the application of the vaccine against covid-19 began at the end of December 2020, and from that moment informed consent was not fulfilled. The alarm of death from the pandemic was simply used as a starting point to violate this right, which is derived from the application of Articles 20 and 21 of the Political Constitution. During almost twelve months of vaccination being applied, the Costa Rican Social Security Fund has not provided insured persons with a document containing prior, duly informed consent. The previous violation is increased by the decree challenged here, since public officials are forced to be vaccinated under threat of losing their job if they do not do so, without a prior medical examination prevailing to prevent serious or irreparable harm to health, thereby being able to guarantee the adequate and tangible exercise of the fundamental right to safeguard life and health. He states that one of the main characteristics of informed consent is based on its prior nature, but above all its free nature, a characteristic collected by various international instruments, signed by our country. In addition to being prior, consent must be given freely (principle of freedom derived from Article 28 of the Political Constitution), that is, consent must be provided freely, voluntarily, autonomously, without pressure of any kind, without being used as a condition for subjection to other procedures or benefits, without coercion, threats, or misinformation. He points out that, from the beginning of vaccination against covid-19, this fundamental right was not provided to vaccinated persons, that is, there has been a total omission by the CCSS in complying with this right. The situation only worsens when the mandatory nature of vaccination is established for public officials and indirectly for all private sector workers, because it is more than evident that, faced with the threat of losing employment (in the health and economic crisis situation we face), there is total coercion, so that, if it were possible to give consent, it would not be free or voluntary. Another issue of great importance is the great misinformation that exists around vaccination, since there are thousands of doubts about the quality, efficacy, stability, immunity, and adverse health effects of the vaccines. There has been no clear and truthful information. The information provided by the professional to the patient must be “adequate information”, that is, providing the patient with “the relevant data of the intervention in question”. In summary, it is said that there must be conformity between the passive subject, holder of the protected legal interest – the human person – and the action carried out by the active subject, the competent research professional, that is, a “meeting of the wills” between both subjects, regarding the same object. Additionally, from a legal perspective, it must be recognized that informed consent includes both ethical aspects of the scientific knowledge involved, and bioethical aspects, and is derived from the inescapable respect for Human Rights enshrined in the international and national legal order, especially the right to life, human dignity, the right to health, freedom of choice, physical and mental integrity, as well as other rights inherent to the human person by virtue of their condition as a human being and by the simple fact of being alive. He makes reference to the judgment of the European Court of Human Rights (ECHR) of June 10, 2010. *“Case of Jehovah’s witnesses of Moscow and others v. Russia, CE: ECHR:2010:0610JUD000030202, para. 136”*. He points out that the ECHR admitted in a matter resolved in the first decade of this century, that “the acceptance or rejection of a medical treatment or the choice of an alternative form of treatment is vital to the principles of self-determination and personal autonomy”. In the face of the omission of informed consent, Articles 20, 21, and 28 of the Political Constitution are infringed, as indicated. From the conjunction of these three articles, informed consent is derived. He references a judgment of this Court. He indicates that, at the legal normative level of Costa Rican domestic law, Article 22 of the General Health Law provides that *“no person may be subjected to medical or surgical treatment that implies serious risk to their physical integrity, health, or life, without their prior consent or that of the person legally authorized to give it if they were unable to do so. Emergency interventions are exempt from this requirement.”*. He cites in turn subsections i), h) and i) of Article 2 of the Law on Rights and Duties of Users of Public Services, in relation to the obligation to obtain informed consent. He points out that said regulations find support in the Universal Declaration on Bioethics and Human Rights which, despite not being ratified by our country, contains among its principles respect for individual autonomy and responsibility, by indicating that *“the autonomy of the person in making decisions, assuming responsibility for them and respecting the autonomy of others, shall be respected. For persons lacking the capacity to exercise their autonomy, special measures shall be taken to protect their rights and interests”* (Article 5). He points out that the contested decree contradicts the same “Regulations of the Costa Rican Social Security Fund (CCSS), regarding informed consent. He denotes that informed consent is part of the right to information, requiring the necessary and indispensable information for making prior decisions aimed at whether a person decides or not to get the vaccine, regardless of whether or not they are a public official. He references Article 4 of that same CCSS regulation, and argues that proper communication has not occurred in this case, since, although Decree 48889-S indicates in Article 2: *“When they are summoned by those responsible for such purpose and according to the respective institutional planning, the persons contemplated in the preceding paragraph must be vaccinated, with the exception of those officials for whom, due to a duly declared medical contraindication, it is not possible for them to receive the Covid-19 vaccine…”*, there has been no full information about contraindications, adverse reactions, and drug interactions with other pharmaceutical products, and the meaning of freely given consent is emptied of content. He points out that the decree challenged as unconstitutional makes a groundless distinction between people who work in the public sector versus those who work in the private sector. In the first case, vaccination is made mandatory, while in the second, it is left to the employer's discretion. This entails discrimination without a justifiable basis. Both groups are composed of human beings with equal dignity and value before the law. He considers that the mandatory nature of vaccination against covid-19 for public and private employees, without prior, written, and duly informed consent, is inapplicable because it is contrary to fundamental values and to Articles 33 and 48 of the Constitution, 2.1 and 7 of the Universal Declaration of Human Rights, 11 of the American Declaration of the Rights of Man, 3 and 26 of the International Covenant on Civil and Political Rights, 1.1, 2, and 24 of the American Convention on Human Rights, “Pact of San José”. The simple comparison of the transcribed norms with the provision in question shows that the obligation to vaccinate specifically public sector workers and potentially private sector workers constitutes discrimination to the detriment of the working class, since it loosely creates an inaccurate equivalence between the decree that forces health sector officials to be vaccinated and the obligation to vaccinate all public and private sector officials, thereby contravening the constitutional and universal spirit of equality and non-discrimination. He points out that the decree in question constitutes a gross violation of the principle of equality enshrined in Article 33, given that there is no technical justification demonstrating the need to force all public officials to be vaccinated; that is, the government starts from the condition of being a public official to establish the conditioning of being vaccinated, as a requirement to keep the job, a fact that constitutes an arbitrary action typical of anti-democratic systems. In addition to being a real threat to a public employee or official, which can even be penalized with imprisonment if not complied with. It is no secret to anyone that our country has advanced notably in the principle of non-discrimination in employment, so new forms of discrimination must continue to be confronted.\n\nIn addition to the foregoing, Article 7 of the HIV/AIDS Law guarantees confidentiality, non-discrimination, and the right not to be obliged to give information, and its clauses are an important part of the jurisprudence that has been created over time in the country to prevent forms of discrimination by employers against workers, and paradoxically, it is now the State itself that is issuing odious segregationist and discriminatory practices, without having carried out substantiated scientific research to support those criteria.\n\nThe mandatory vaccination for public officials due to their employment status is discriminatory, and constitutes an imposition under the threat of job loss. Vaccination, as part of a medical procedure, must be a voluntary decision of individuals as part of their freedom of choice, and not simply the decision of a minister or the Executive Branch. It notes that the challenged decree does not obligate the rest of the population to be vaccinated against COVID-19, only the 330,000 public officials, which it estimates violates the norms and principles set forth in this section. Even public officials from other branches, and public entities with levels of autonomy even at a constitutional level, such as local governments and certain autonomous institutions that have autonomy reinforced by constitutional provisions, are being forced, by executive decree, to undergo mandatory vaccination. According to the foregoing, the questioned executive decree does not establish fundamental criteria to justify the mandatory application for the group of public workers, potentially for private sector workers, but not for the rest of the population.\n\nIt indicates that the decree in question violates freedom of thought and expression (Articles 28 and 29 of the Political Constitution, Article 19 of the Universal Declaration of Human Rights, 19 of the International Covenant on Civil and Political Rights, 4 of the American Convention on Human Rights, and 13 of the Pact of San José). Our country has abundant national and international legislation and jurisprudence that protects the right to free expression. It believes that it is necessary for people who do not get vaccinated to have the right to think differently or contrary to people who do wish to do so; if divergent thought is not considered, the doors to authoritarianism begin to open, and this is something very dangerous in a democratic State like ours. It is not possible for health reasons to be admitted as the only cause for exemption from vaccination, since this absolutely curtails free expression and thought, limiting the manifestation of the will of people who, for various reasons, do not wish to be inoculated to a single cause. All people have the right to dissent from receiving the vaccine, since there has been no clear and truthful information about its health effects on the population; therefore, if a person is not clear about the effects it will cause on their health, they have the right to feel safe by not getting vaccinated, since inoculation does not prevent infection. Furthermore, it points out that vaccinated people are not immune to infection and can become infected. The vaccine, moreover, will not protect indefinitely, so vaccinated people do not have permanent immunity. It is not easy to obtain reliable studies with results that match the reality observed in the population. For example, in Costa Rica, 52% of the population has full vaccination (2 doses), and 86% has one dose (https://www.ocss.sa.cr/web/coronavirus/vacunacion). Despite this, hospitals are saturated, and people with 2 doses of vaccination are infected, and some are hospitalized in intensive care units. How is this possible, if the vaccines supposedly protect against hospitalization and death from COVID by more than 90%, as published in a study conducted in France with the same Delta variant of the virus? The country is experiencing more deaths than last year when there were no vaccines. It is scientifically proven that the effectiveness of the vaccines depends greatly on the moment at which it is measured. Two weeks after having received the second vaccine, as is the case in the French study, it is at its moment of maximum effectiveness. If measured 45 months after being vaccinated, the effectiveness is reduced to just 53% to prevent infections for the Pfizer vaccine, and 67% for the AstraZeneca vaccine. After 6 months, its effectiveness against hospitalization is also reduced. In Singapore, where vaccination with two doses has been performed on 78% of people (www.ourworldindata.org, from the University of Oxford), the mortality rate has doubled in relation to the first wave of infections of the pandemic. In Israel, close to 70% have received the double dose, and 45% have the booster (third dose). Currently, its infection rate is among the highest in the world (235/100,000) and far higher than that of Costa Rica (24/100,000). It indicates that some will opine that it is because the virus spreads among unvaccinated people. To know if that is a plausible explanation, the data from the small country of Gibraltar can provide an indication. The country has only 33,680 inhabitants and a full vaccination rate of 99.7%. Furthermore, it is very strict in the requirements to enter the country. They require double vaccination or a negative PCR test, in addition to a mandatory 10-day quarantine. The infection rate was 33.6/100,000 people in the last week. To put this data in perspective, it is a little higher than that of Costa Rica currently, and considered by the CDC (Center for Disease Control of the USA) as a red alert (more than 25/100,000). So, not even with 99.7% of its population vaccinated have they managed to control the virus (data from www.ourworldindata.org and John Hopkins University). Another astonishing example is the number of infections recently occurring at Duke University, North Carolina. They mandated vaccination for students and staff, and despite 98% of students having full vaccination, and 92% of staff, they had a resurgence of 364 positive cases in one week (late August), of which only 8 corresponded to unvaccinated individuals. What happens in countries where the vaccination rate is among the lowest? A very interesting country is India, the most populated country in the world, where the Delta variant of the virus was first identified. It has a vaccination rate of only 19%. In the State of Uttar Pradesh, with 220 million inhabitants, they implemented a strategy of testing and offering people with a positive result and those living in the same household a treatment based on some antiviral medications, among them Ivermectin, vitamin D3, Zinc supplements, among others, both prophylactically and therapeutically. Today, it has a very low COVID-19 infection and mortality rate. It has 34 of the 75 districts free of COVID-19. It points out that it seems the vaccine, whose medium- and long-term side effects are unknown and which is still in an experimental phase, without guarantee or liability on the part of the manufacturer, is not the only alternative to exit the health crisis caused by SARS-CoV-2. Consequently, people who do not wish to be vaccinated have the right to dissent from doing so as part of their right to thought and free expression, which goes hand in hand with the possibility of not giving consent for the application of a vaccine, because human dignity must be above a supposed interest of science or even of society.\n\nIt alleges violation of the principle of legality (Articles 11 of the Political Constitution and 11 of the General Law of Public Administration), the National Vaccination Law, and the Regulation to the National Vaccine Law by the application of the term vaccine. The objective pursued by vaccination with its application is to induce active immunity, a fact which is not what is happening with the mass inoculation that this government is imposing on public and private employees. The acts of the public administration must be framed within the block of legality; if there is a defect, the validity of the decree in question is injured, and therefore, the entire procedure consequent to it. It questions whether mass inoculation can be mandated under a term that does not exist, according to the current regulations that clearly define what a vaccine is. The State must comply, in the issuance of its acts, with the requirements of legality, necessity, and proportionality. Every action or conduct of the public administration (administrative acts, material actions, and public services) must be expressly authorized by the legal system. The principle of legality is characterized by delimiting the actions of the public administration, because it circumscribes it to the prior existence of a written or unwritten norm that permits it. In this case, mass inoculation does not meet the essential objective that characterizes the definition of a vaccine, which is to induce protective active immunity against the corresponding infectious disease. Given the non-existence of the expected effect with the application of the COVID-19 vaccine, the principle of legality is violated, as it creates an obligation based on a term that does not fit within our legal system. The fact is that what the National Vaccine Law, Law number 8111, establishes is the mandatory nature of receiving vaccines, not experimental substances that have not reached that level. Given the lack of certainty, a pro-health principle is imposed, for the benefit of people who do not wish to introduce a substance whose nature is not known with scientific certainty, nor what short-, medium-, and long-term effects it produces. Added to this is the fact that the inoculation does not meet the objective that defines a vaccine. For example, in Costa Rica, 52% of the population has full vaccination (2 doses), and 86% has one dose. Despite this, hospitals are saturated, and people with 2 doses of vaccination are infected, and some are hospitalized in intensive care units. That is, evidently, vaccinated people equally become infected and ill, something that in theory should not happen if a person is vaccinated. On the other hand, an aspect of great importance must be taken into consideration in this action: the general population's lack of knowledge of technical issues, which contributes to the generalization of the denomination of \"vaccine\" to this medication in ongoing clinical trials. This creates a false alarm supported by the ambiguity of political discourse. Furthermore, they are forcing the population to submit to a live clinical trial test, without openly telling them that the vaccine profile is experimental, and without informed consent, in accordance with the Ethics Committees and Principles of Good Clinical Practices (GCP and Key Responsibility of Investigators in the Context of Clinical Trials: WHO Solidarity of Clinical Studies - WHO COVID-19). It indicates that, despite the authorities in their double discourse implying they have full knowledge of this, they are still forcing the population to take a step in an experimental procedure without full knowledge, yet clearly declared by the WHO. The Minister of Health himself agreed with the above, as he made known on May 31, 2021, during his appearance before the Legislative Assembly in extraordinary session #04, where he explicitly told the deputies: \"Regarding how long the immunity of the vaccine lasts, there is still no clarity, studies and follow-up continue by the different companies and we understand that it is expected that there will be immunity for at least 9 months afterwards, there are some more recent studies, we will still have much to learn about this, there is talk of a possibility of immunity for many more years and that is why we must continue to monitor the studies\" (Timeline 2:38:00 hours of the Legislative Plenary, extraordinary session #04, Monday, May 31, 2021). The data obtained and reality completely reflect the opposite of what was indicated by the Minister of Health, as evidence over time shows that the effects of the vaccines diminish over time, to the point that there are already countries applying a third dose, and a fourth is not ruled out. The foregoing denotes that it is a vaccine profile without conclusive clinical studies, according to what Minister Salas himself stated, so it must be taken into account that, although it was prematurely categorized as a \"vaccine\", and now they have approved it as a \"vaccine\", what matters is the real-time clinical study. Furthermore, they confirm that the immunity period is not known; therefore, if neither the effectiveness time is known until the study is completed, the contraindications, interactions, and adverse reactions cannot be known with certainty either. It is clear that the results of the clinical trials are becoming known over time, since these trials are being conducted \"In Vivo\" in the population, and the demonstrable technical-scientific information will only be known upon their completion, at the beginning of 2023, according to the start date of the clinical studies. Based on the foregoing, it considers that the decree challenged through this action is not governed in accordance with the provisions of the regulations of said law, the General Law of Public Administration, or our Constitution. The precautionary principle provides that \"when an activity represents a threat or harm to human health or the environment, precautionary measures must be taken, even when the cause-effect relationship could not be scientifically demonstrated in a conclusive manner.\" Said principle is based on the foundations of medical ethics—the principle of non-maleficence, primum non nocere—and contains many of the attributes of good public health practice, such as primary prevention and the recognition that unforeseen and undesirable consequences of human action are not infrequent; its application involves the dissemination of available scientific information to all involved strata, the promotion of decision-making based on limiting exposure levels (managing exposure in a more restrictive and prudent manner), the formulation of objectives with long-term scope and evaluation, and the search for safer alternatives. The value of the precautionary principle for public health lies in the fact that its implementation requires the use of scientific methodology specific to this field and promotes innovation and technological advances in an environment of transparency and democratic participation. The obligation created in the challenged decree, coupled with the refusal of the Costa Rican Social Security Fund (Caja de Seguro Social) to perform preventive medical examinations, injures this principle, since the application of the COVID-19 vaccines generates strong doubts about their quality, efficacy, stability, immunity, and adverse effects. The risk to life and health is significant and overwhelming given the real and tangible absence of necessary preventive measures, in the face of the mandatory nature of the COVID-19 vaccination, which guarantee the protection of the life of every worker and any human being residing in the Nation, because life does not depend solely on life itself, but also on the prevention of any harm, no matter how minimal, to health. The government has been irresponsible in duly informing the population. The Ministry of Health and other institutions such as the CCSS have assured that the \"vaccines\" are \"safe\". However, the truth is that a double discourse has been handled, because while they affirm that the \"vaccines\" are safe, on the other hand, they accept that studies are needed to demonstrate their effectiveness and safety. It is due to this enormous confusion, lack of data, and studies on the short and long-term effectiveness and safety of the vaccines, that the population must be protected, and under no circumstances should people be forced to get vaccinated, as even the World Health Organization has stated. Furthermore, WHO experts have reiterated throughout this year that vaccines are not enough in the fight against the coronavirus and must be combined with the sanitary measures that were already generalized last year to curb infections, such as the use of masks, frequent hand washing, ventilation of homes, physical distance, or avoiding crowded places. The WHO spokesperson insisted that it is necessary to continue using the measures cited above, because according to her, \"What we want is to reduce transmission. And we do not know if the vaccines can prevent this.\" Given the lack of certainty, it argues that it is not possible that a group of public and private employees is being forced to get vaccinated, differentiating them from the rest of the population, exposing their lives and putting the safety of their families at risk. For all these considerations, it points out that the precautionary principle is violated, given that mandatory vaccination represents a threat to human health, and furthermore, because the cause-effect relationship has not been able to be scientifically demonstrated conclusively, as evidenced by the very statements of the World Health Organization.\n\nIt points out that the principle of hierarchy of norms, Articles 7, 48, 129, and 140 subsection 3) of the Political Constitution, and the principle of conventionality are violated. In matters of human rights, there is no formal separation between International Law and Constitutional Law, because it is the same law. Substance prevails over form. What is truly significant is the greater protection, regardless of whether that protection is recognized in an international instrument, the Political Constitution, or a law of the Republic. Due to this, conventionality control, the fundamental basis of our constitutional system in the Rule of Law, should suffice to indicate that Executive Decree No. 42889-S is unconstitutional, because it contravenes the international legal instruments mentioned herein and related to Human Rights, which are of higher rank; therefore, the mandatory COVID-19 vaccination, within our workplace and as human beings, violates said international legal tools, affecting the right to life, health, and human dignity, given the State's interference, in order to maintain international legal respect for human dignity, especially in times of pharmaceutical market globalization. It cites Articles 2, 5, 6, and 7 of the International Covenant on Economic, Social and Cultural Rights, Article 12 of the Universal Declaration of Human Rights, and Articles 1.2, 3, 4, and 5.1 of the American Convention on Human Rights. It argues that, expressly and clearly, this international instrument recognizes the condition of person to every human being and their legal personality, indicating that, as a person, they have the right to have their life respected, and therefore, their health, as well as their physical, mental, and moral integrity. It argues that it is clear that mandatory vaccination violates these internationally recognized fundamental human rights, since it attempts against the physical integrity of people, by forcing public sector employees, and extending it to private sector workers, to introduce a vaccine into their body without prior, full, and free informed consent, without their autonomy of will being respected. Likewise, it seriously transgresses the right to mental and moral integrity of people, by forcing said officials to be inoculated in an intimidating manner, since, if they fail to do so, they are exposed to fines and administrative and criminal sanctions, and even dismissal without employer liability or revocation of their appointment or designation, as the case may be. All the rights described in the cited regulations are directly related to the right to life, to health, and to individual informed consent, which in turn is associated with collective or social informed consent, which allows the application of norms and procedures that directly concern society, such as disease detection campaigns, vaccination campaigns, and research on human beings, among others. Informed consent is individual (a human right) and allows decision-making that must, necessarily, be supported by good information. In addition to good information, it is essential to offer a range of options, where the possibility of making one or several decisions is accurately indicated, if they exist, with knowledge of the consequences, possible side effects, and problems that may arise. All this is evidently not present with the mandatory nature imposed in the decree in question, therefore it violates the rights established in the international regulations duly ratified by this country. In accordance with the foregoing, it points out that the decree violates the principle of conventionality, because the country has committed to guaranteeing the right to health, as well as the impossibility of arbitrary interference by governments in persons. This country would be failing to comply with what was agreed in the cited treaties, and would be regressing in these rights with the application of the accused decree. It argues that the executive decree of mandatory vaccination presents a clear violation of Law No. 8239 of April 2, 2002, \"Law on the Rights and Duties of Users of Public and Private Health Services,\" specifically in relation to the provisions of Article 2, subsection c), as it clearly refers to the duty to obtain informed consent before subjecting an individual to any medical procedure. Based on what was established by the Inter-American Court of Human Rights in the judgment of November 30, 2016, in the case of I.V. Vs. Bolivia, informed consent must be \"given freely, voluntarily, autonomously, without pressure of any kind, without using it as a condition for undergoing other procedures or benefits, without coercion, threats, or disinformation.\" In such a way that the accused decree violates the right to give informed consent, as understood by the Inter-American Court of Human Rights and in the form in which it is enshrined in Law No. 8239 of April 2, 2002. For its part, subsection m) of the cited norm is clear in pointing out the right of every person to maintain total privacy over their clinical history, except when through a special law, notification must be given to the health authorities, which is evidently contrary to Article 1 of the challenged decree, because the decree in question implicitly obliges the worker to reveal private information concerning their clinical history to someone who, according to the decree itself, is not a health authority; therefore, State institutions other than the health authorities are not legitimized to demand such information. The obligation to be vaccinated and to reveal information regarding the medical history violates the provisions of Article 9, subsection 1) of the \"Law for the Protection of Persons Regarding the Processing of their Personal Data,\" and its transgression is sanctioned in Article 31. Thus, no person is obliged to provide data about their health to anyone who is not a health area official; therefore, the challenged decree constitutes a clear transgression of that law.\n\nIt considers that the challenged decree is contrary to the jurisprudence developed by the Inter-American Court in the following rulings: 1) I/A Court H.R. Case of Poblete Vilches et al. Vs. Chile. Merits, Reparations, and Costs. Judgment of March 8, 2018. Series C No. 349. Cites excerpts from paragraphs 106, 109, 113, 114, and 174. 2) I/A Court H.R. Case of Cuscul Pivaral et al. Vs. Guatemala. Preliminary Objection. Merits, Reparations, and Costs. Judgment of August 23, 2018. Series C No. 359. Cites excerpts from paragraphs 79, 83, 84, 85, 86, 93, 105, and 107. 3) I/A Court H.R. Case of Hernández Vs. Argentina. Preliminary Objection. Merits. Reparations and Costs. Judgment of November 22, 2019. Series C No. 39513. Cites paragraphs 62, 73, 76, 78, and 81. 4) I/A Court H.R. Case of Ximenes Lopes Vs. Brazil. Judgment of July 4, 2006. Series C No. 149. Cites paragraphs 89, 90, 96, and 97. 5) I/A Court H.R. Case of Albán Cornejo et al. Vs. Ecuador. Merits. Reparations and Costs. Judgment of November 22, 2007. Series C No. 17118. Cites paragraphs 116, 121, 123, 132, 133, and 134. 6) I/A Court H.R. Case of I.V. Vs. Bolivia. Preliminary Objections, Merits, Reparations, and Costs. Judgment of November 30, 2016. Series C No. 329. Cites paragraphs 160, 161, 166, 167, 175, 176, 181, 182, 184, 189, 191, and 192. 7) I/A Court H.R.\n\nCaso Poblete Vilches y otros Vs. Chile. Merits, Reparations, and Costs. Judgment of March 8, 2018. Series C No. 349. Cites excerpts from paragraphs 160, 161, 162, and 170. 8) I/A Court H.R. Caso Comunidad Indígena Yakye Axa Vs. Paraguay. Merits, Reparations, and Costs. Judgment of June 17, 2005. Series C No. 125. Cites an excerpt from paragraph 162. 9) I/A Court H.R. Caso Comunidad Indígena Sawhoyamaxa Vs. Paraguay. Merits, Reparations, and Costs. Judgment of March 29, 2006. Series C No. 146. Cites paragraph 177. 10) I/A Court H.R. Caso Comunidad Indígena Xákmok Kásek Vs. Paraguay. Merits, Reparations, and Costs. Judgment of August 24, 2010. Series C No. 214. Cites paragraphs 186 and 187. 11) I/A Court H.R. Caso de la “Masacre de Mapiripán” Vs. Colombia. Judgment of September 15, 2005. Series C No. 134. Cites paragraph 162. 12) I/A Court H.R. Caso Vera Vera y otra Vs. Ecuador. Preliminary Objection, Merits, Reparations, and Costs. Judgment of May 19, 2011. Series C No. 226. Cites paragraph 43. 13) I/A Court H.R. Caso Suárez Peralta Vs. Ecuador. Preliminary Objections, Merits, Reparations, and Costs. Judgment of May 21, 2013. Series C No. 261. Cites paragraph 130. 14) I/A Court H.R. Caso Chinchilla Sandoval y otros Vs. Guatemala. Preliminary Objection, Merits, Reparations, and Costs. Judgment of February 29, 2016. Series C No. 312. Cites paragraph 170. 15) I/A Court H.R. Caso Artavia Murillo y otros (Fecundación in Vitro) Vs. Costa Rica. Preliminary Objections, Merits, Reparations, and Costs. Judgment of November 28, 2012. Series C No. 257. Cites paragraph 147. 16) I/A Court H.R. Caso I.V. Vs. Bolivia. Preliminary Objections, Merits, Reparations, and Costs. Judgment of November 30, 2016. Series C No. 329. Cites paragraphs 155 and 270. 17) I/A Court H.R. Asunto B, respecto de El Salvador. Provisional Measures. Order of the Inter-American Court of Human Rights of May 29, 2013. Cites paragraph 15. 18) I/A Court H.R. Caso Poblete Vilches y otros Vs. Chile. Merits, Reparations, and Costs. Judgment of March 8, 2018. Series C No. 349. Cites paragraph 152. 19) I/A Court H.R. Caso I.V. Vs. Bolivia. Preliminary Objections, Merits, Reparations, and Costs. Judgment of November 30, 2016. Series C No. 329. Cites paragraphs 156 and 163. 20) I/A Court H.R. Caso Albán Cornejo y otros Vs. Ecuador. Merits, Reparations, and Costs. Judgment of November 22, 2007. Series C No. 171. Cites paragraph 68. 21) I/A Court H.R. Caso I.V. Vs. Bolivia. Preliminary Objections, Merits, Reparations, and Costs. Judgment of November 30, 2016. Series C No. 329. Cites paragraph 311. 22) I/A Court H.R. Caso Ximenes Lopes Vs. Brasil. Judgment of July 4, 2006. Series C No. 149. Cites paragraphs 103, 125, 126, and 147. It indicates that the cases resolved by the Inter-American Court are emblematic for the States due to the interpretations it makes and because they constitute international standards of protection. Likewise, they establish transcendental jurisprudence for the internal courts of the State, which contributes to the generation of norms and precedents guided in light of International Human Rights Law. The rulings of the Inter-American Court significantly impact the domestic legal system, in such a way that they lead to the implementation or modification of internal norms, as well as the establishment of human rights protection mechanisms aimed at achieving integration between international standards and national law. Hence, it is of great relevance to point out that the issued condemnatory judgments have demonstrated the deficiencies of the legal systems and, thereby, international pressure has been generated to promote reforms, investigations, and the pursuit of proceedings in order to determine and sanction those responsible for committing human rights violations. Therefore, through these, States have had to modify their domestic legal system through constitutional reforms, legal reforms, and interpretative guidelines that allow the insertion of the standards established by the Inter-American Court into domestic law. It requests that the unconstitutionality of Decreto No. 42889-S be declared, since not only is the right to life and health put at risk, but the entire democratic system is violated, such that the foundations of the Rule of Law (Estado de Derecho) are seriously affected due to the direct, totalitarian, and arbitrary intrusion by the Costa Rican State, never before seen in the history of this country, with serious consequences for our entire society. It points out the violation of the principle of reasonableness and proportionality in the sanction for not getting vaccinated (dismissal without employer liability and/or an approximate fine of 500,000 colones), due to the mandatory nature of the measure itself, which threatens the right to work. It indicates that the decree in question injures the principle of reasonableness and proportionality for the following reasons: a) Neither the CCSS nor the Minister of Health, Daniel Salas, have in any way provided technical or scientific substantiation for the degree of efficacy of the vaccine in relation to preventing the spread of covid-19 (by itself and without considering other measures), so it is not possible to carry out an assessment of the proportionality, necessity, and reasonableness of the measure that threatens (or injures) the principle of autonomy of the will. b) The sanctions for not getting vaccinated for public officials (funcionarios públicos) are disproportionate, since the sanctions or penalties that public officials could receive for not getting vaccinated are blank criminal or administrative-sanctioning provisions, which contravene the principle of criminal and administrative-sanctioning specificity (principio de tipicidad), and are excessive, affecting work, which is also a fundamental right. The intent is to open administrative proceedings aimed at dismissing, without employer liability, public officials who do not get vaccinated, or who do not provide information to the entity for which they work about whether or not they have been vaccinated, and whether or not they have the complete vaccination series. Additionally, public officials are threatened with the imposition of an approximate fine of 500,000 colones and the referral of the case to the Public Ministry (Ministerio Público) to determine whether a crime has been committed. Based on the decree that stipulates the declaration of mandatory vaccination, instructions have been issued to the different public institutions and the private sector to sanction, even with sanctions not established in the National Vaccination Law (Ley de Vacunación) such as dismissal, all those persons who do not wish to receive the inoculation of the so-called vaccine. When they are summoned by the responsible parties for such purposes and, in accordance with the respective institutional planning, the persons contemplated in the preceding paragraph must be vaccinated, with the exception of those officials who, due to a duly declared medical contraindication, cannot receive the vaccine against Covid-19. It shall be the employer's responsibility to take the corresponding measures in accordance with the country's legislation and institutional regulations, in the case of workers who do not want to be vaccinated against covid-19. The foregoing has generated immense media pressure, to the point of coercing people who do not want to be vaccinated with the threat of dismissal, as has been published in different media outlets. The mandatory vaccination being challenged goes against the stated principles, as working people are coerced into undergoing a mandatory inoculation, despite their well-founded fears of suffering short- or long-term harm, due to the imminent disciplinary actions, since they may be sanctioned with fines or dismissals. This has meant that, faced with the dilemma of getting vaccinated or losing their jobs, which is the means by which they bring sustenance to their families in the midst of one of the worst economic crises of the last 40 years, people are being forced by the coercion exercised to get vaccinated against their will. It indicates that the lack of reasonableness is also evident in the measure itself (mandatory vaccination), given that it has been alleged that one of the main reasons justifying the decree is the supposed increase in infections and the need to stop the spread of the virus. However, long before the decree was issued, the infection rate had been decreasing significantly, as published by several press outlets. It has even been reported to the population that the CEACO, a specialized hospital for the care of people infected with the virus, is being dismantled at this time, since, according to the Health authorities, it is not required due to the significant reduction in cases. According to a publication from the Central American Population Center (Centro Centroamericano de Población) of the University of Costa Rica: \"The clear trend of the R rate has been downward approximately since August 21. This trend has persisted. This week's rates have maintained a moderate downward trend that is expected to continue in the coming weeks.\" The same article indicates that the reproduction rate of covid-19 in Costa Rica dropped slightly to R = 0.77, according to new diagnosis data updated as of Tuesday, October 19 (Graph 1). It denotes that the report of a new diagnosis has an approximate delay of six days from the moment of contagion, so this estimate of R probably corresponds to Wednesday, October 13, as recorded in the graph. The foregoing shows that long before the publication of Decreto Ejecutivo No. 43249-S, even before the Agreement of the National Commission for Vaccination and Epidemiology (Comisión Nacional de Vacunación y Epidemiología) was adopted, during the extraordinary session XLV2021 of September 23, 2021, the infection rate had already been decreasing since August 21, 2021; at the beginning of September, it had already dropped below 1, and currently, it stands at 0.77, meaning that infections have decreased without the need for mandatory vaccination. Moreover, it cannot be stated that this decrease has been produced by vaccination, as it is rather due to a behavior the virus has exhibited over time, where waves or peaks of infections occur with decreases, regardless of vaccinated people. In Costa Rica, on September 20, 2021, when one of the highest levels of infections was reached, there were 1,514 new cases, despite the fact that 4,872,085 doses had already been administered and 3,144,786 people vaccinated. It refers that the sanctions established in the challenged decree clearly violate the principle of reasonableness and proportionality, as they are disproportionate and unnecessary, by virtue of all the aforementioned arguments. On the other hand, it cannot be overlooked that every administrative act must be duly substantiated. The challenged decree establishes, as a central element of its substantiation, in Considerando III, that: “...health norms are of public order (orden público). Faced with this, the Ministry of Health, as the competent authority, may order and take special measures to avoid risk or harm to people's health, or to prevent these from spreading or worsening, as well as to inhibit the continuation or recidivism in the infraction by private individuals. These legal norms, which establish the competence of the Ministry of Health in health matters, enshrine the power of sovereignty (potestad de imperio) in sanitary matters, which empowers it to dictate all the technical measures that are necessary to confront and resolve states of sanitary emergency…” The concept of public order, as a basis for the decree, is vague, imprecise, and has served for the Directorate of Legal Affairs (Dirección de Asuntos Jurídicos) to issue the general criterion that is also challenged. What must be reaffirmed, then, is that the—inherently indeterminate—concept of public order cannot be a justified basis for arbitrariness, as is happening in this case. It notes that it shares the separate reasons of Magistrate Hernández López, subscribed in relation to the exercise of power by the Executive Branch in times of pandemic, highlighting the following: 1. The limitation of constitutional rights must be authorized by the Legislative Assembly, according to Article 121.7 of the Constitution. 2. Even in a \"state of emergency\" the only rights and guarantees that the Constitution itself allows to suspend are those regulated in Articles 22, 23, 24, 26, 28, 29, 30, and 37. Thus, the guarantees related to the right to work, Articles 56 and 63, are not included among those that may suffer suspensions or limitations in cases of emergency. 3. Even in cases of those guarantees susceptible to suspension, their annulment is not possible, nor can their emergency suspension result in the subsequent impossibility of recovering such rights, nor can their suspension be indefinite. The possibility of the State acting arbitrarily is likewise absolutely limited. 4. This Constitutional Chamber (Sala Constitucional) itself has established the \"reasonableness test\" to determine if a constitutional right has been violated. This test requires verifying the following, at a minimum: a. How necessary the state intervention in the lives of citizens is, taking into account that the principle of minimum intervention prevails here. b. That in the event state intervention is necessary, it must be carried out by the public authority or state entity to which the law grants competence. c. That, in such cases, state action must be subject to the constitutional principles established in Articles 9 and 11 of the Constitution: Division of Powers, Legality, Prohibition of Arbitrariness, and Deviation of Power. d. The Administration must evaluate the various actions that can or must be carried out in the specific case, always having to choose the one that respects the principle of minimum intervention over people's freedoms, in such a way that the necessary intervention respects the temporality of the action and the guarantee of the reestablishment of the constitutional right, \"in what remains of the person's life project. In particular, it must be guaranteed that the sacrifice of the affected person's right or guarantee will be compensated by the benefits that the rest of the people and the person upon whom the limitation was imposed will obtain.\" e. According to the constitutional design, there are rights that can only be limited or suspended through the approval of two-thirds of the votes of the Legislative Assembly. Thus, the actions of the Ministry of Health and the Ministry of Labor flagrantly violate the Political Constitution, because the challenged decree, signed on October 7, 2021, establishes that the covid-19 vaccine will be mandatory for personnel in the public sector and the private sector starting October 15, 2021. On October 12, 2021, the Directorate of Legal Affairs of the Ministry of Labor, relying on the decree and basing its reasoning on subsection h of Article 81 of the Labor Code (Código de Trabajo), concludes that: “3. If a public sector official or private sector worker, for whom the employer has made vaccination mandatory at their workplace, explicitly, repeatedly, and unjustifiably refuses to be vaccinated, the employer would be empowered to proceed with dismissal without employer liability, in accordance with subsection h) of Article 81 of the Labor Code.” It indicates that, without any substantiation supporting the legal criterion, the Ministry of Labor establishes, supported by the decree, that anyone who refuses to be vaccinated falls into the category of a person who does not take measures to avoid covid-19. It argues that this is a false fact that contradicts science, since it is also a public and notorious fact that vaccinated people also get sick, and, of relevance here, they also contaminate others by transmitting the virus. The current vaccines against covid-19 do not prevent those who are vaccinated from transmitting the virus. Hence, if in a workplace, public or private, all workers can infect each other, whether vaccinated or unvaccinated, it is absolutely disproportionate and unconstitutional to reach the conclusion that dismissal without employer liability is justified solely for those who do not get vaccinated, falsely concluding that only vaccinated people avoid the disease. Every employer, including the State, is absolutely free to dismiss its workers, as long as it respects the constitutional and legal guarantees to which every worker is entitled. Therefore, if in the case of those who do not get vaccinated, the employer wants to make the decision to dismiss that person, it must do so with employer liability, paying all the due amounts. It cannot be accepted that the Executive Branch, based on an emergency situation and supposedly with a foundation in public order, limits constitutional rights in the way it does, because dismissal without employer liability is absolutely disproportionate, exceeds the limit of the division of competencies, and makes the imposed sanction cease to be temporary and renders the violated right irrecoverable. For with such decisions, the employee definitively loses their job and all the labor rights attached to their employment contract, in addition to the threat of imposing a base salary fine and of referring the case of the official who does not accept vaccination to the Public Ministry. It considers that this clearly constitutes a flagrant violation of the principle of reasonableness and proportionality, both due to the vagueness of the term \"public order\" and in the sanction for public officials and private sector workers who do not get vaccinated. It considers that the challenged decree also violates the principle of informational self-determination (autodeterminación informativa), by requesting private information referring to the medical record (expediente médico) and in the absence of informed consent prior to the inoculation. The right to informational self-determination is one of the fundamental rights derived from Article 24 of the Political Constitution, which ensures respect for intimacy and human dignity through effective protection of personal data contained in files, archives, registries, or databases, regardless of whether these are private or public in nature. Informational self-determination empowers every person to know who possesses recorded information about them, the type of information maintained, and for what purpose. In addition, concurrently, it implies the possibility of rectification, blocking, and deletion of that information. It refers that this Constitutional Chamber (Sala Constitucional) developed and protected this right through abundant and notable jurisprudential development. However, the need was emphasized for a law to be issued that would positively codify the principles derived from the jurisprudence, while simultaneously reinforcing the protection of the country's inhabitants against any undue violation of this right. An expectation that materialized in 2011 with the enactment of the Law on the Protection of the Person Regarding the Processing of Their Personal Data (Ley de Protección de la Persona frente al tratamiento de sus datos personales), a norm that in turn has its own regulations (Decreto Ejecutivo No. 37554-JP of October 30, 2012), both norms being based on the parameters established by the Constitutional Court. Said law protects sensitive data, including health data. The Law on the Protection of the Person Regarding the Processing of Their Personal Data guarantees to any person, regardless of their nationality, residence, or domicile, respect for their right to informational self-determination in relation to their private life or activity and other personality rights, as well as the defense of their freedom and equality with respect to the automated or manual processing of data corresponding to their person or property, as stipulated in Article 1. The classification as \"public order\" highlights the importance of the protected legal interest and the need for its mandatory observance by all subjects, both private and public law. Article 2 of said normative body establishes its scope of action, providing that it covers automated or manual databases, whether belonging to public or private organizations; in addition, it contemplates any modality of subsequent use made of that information. It excludes from its application databases maintained by natural or legal persons for exclusively internal, personal, or domestic purposes. However, if these databases are commercialized, they must adhere to the provisions of the law. The protection refers to data concerning a person or property. In this sense, personal data, i.e., data belonging to an identified and identifiable person. The concept of personal data is broad, as it comprises any data of an identified and identifiable person. However, for protection purposes, the law differentiates between various categories of personal data. Data relating to health is classified as sensitive, and as such, subject to a greater degree of protection. It suffices to recall that, as a general rule, there is a prohibition on the processing of sensitive data; people are not obliged to provide this type of information. The materialization of the right to informational self-determination, around the principles of informed consent and information quality, imposed as basic requirements for data collection the obligation to inform about the database and to have the consent of the data subject or their representative, as well as to ensure the quality of the information (Articles 5, 6, and 7 of the Law on the Protection of the Person Regarding the Processing of Their Personal Data). Therefore, anyone who requests or collects personal data about a person for processing must inexorably observe, at a minimum, the following mandatory guidelines: • Inform the data subjects or their representatives beforehand, in an express, precise, and unequivocal manner, of the existence of a personal database; the purposes pursued with data collection; the recipients of the information and who may access it; • Whether providing answers to the questions asked during data collection is mandatory or not; • The treatment that will be given to the requested data; • The consequences of refusing to provide the data; • The possibility of exercising the rights that assist them; • The address of the database controller (Article 5, first subsection of the Data Protection Law). • Obtain the express consent of the data subject or their representative, consent that must be in writing, in either a physical or electronic document (Article 5, second subsection of the same law). • Ensure the quality of the information, that is, verify that the data are current, truthful, accurate, and suitable for determined, explicit, and legitimate purposes. In addition to the above, a duty is imposed on the database controller to adopt the necessary technical and organizational measures to guarantee the security of personal data and prevent its alteration, accidental or unlawful destruction, loss, unauthorized processing or access, as well as any other action contrary to the mentioned law, contemplating, at a minimum, within those measures, the most appropriate physical and logical security mechanisms in accordance with the technological development prevailing at any given time. Furthermore, a duty of confidentiality regarding such information rests upon said controllers and those who participate in any phase of the personal data processing process, whether due to their professional or functional status (Article 11 of the Data Protection Law). Among the fundamental principles of personal data protection is that of the data subject's consent. The law may except the need for that consent, allowing the collection and transfer of data in certain cases, but in the case at hand, we are not under any of the exceptions established in Article 8 of the cited law, so the principle is violated due to the processing carried out by the government regarding the lack of protection of sensitive information, since it concerns a medical issue, people's health, and now human resources departments request this information from their employees, without any legal legitimation to do so, and on top of everything, injuring what is established in the indicated provisions of the Law on Protection Regarding the Processing of Their Personal Data. It also adds the absence of informed consent (adequate and with varied options) regarding access to the medical record, and with prior information on the possible effects of vaccination, as well as on the examinations prior to said inoculation. The processing of personal data, and especially of sensitive data, is widely safeguarded by the cited law, constitutional jurisprudence, and the Political Constitution. Therefore, it is violative of the principle of self-determination for sensitive data to be in the hands of any person, without the informed consent that should make up the medical record of every person.\n\nThat consent must be given in accordance with the patient's autonomy, and with the rights and obligations regarding clinical information and documentation for every act within the health field, characterizing this consent as being granted freely, voluntarily, and consciously, and not in the manner in which the administration is acting, without even providing this right to the public officials that the challenged decree obligates. He adds that the mandatory nature of vaccination as set forth in the challenged decree, solely by virtue of being a public official, without free and informed consent, without knowing what the possible effects on the health or life of the person subjected to such inoculation may be, without people knowing from a reliable source if they run the risk of suffering serious sequelae, corresponds to the cruel or degrading treatments referred to in Article 40 of the Constitution, especially if the fact that there are people with various ailments is not weighed. In correlation with the fundamental right to life protected in Article 21 of the Constitution, there is Article 20 of the Magna Carta, which guarantees every person's right to liberty and their capacity to dispose of their own body. Both norms constitute the constitutional source of informed consent (consentimiento informado), since from it derives the freedom to choose which treatment is most favorable for restoring one's health, or to choose whether to participate in a formal research process, treating such consent as a fundamental and inherent right of the person, and not as in the case at hand, where vaccination is mandated without guaranteeing prior, duly informed consent to workers, thereby violating their right to life, to health, and to receive adequate and truthful information. He considers that the challenged decree also violates the limits of the regulatory power established in Article 140, subsections 3 and 18, of the Political Constitution, as well as the principle of legal reservation (principio de reserva de ley). He refers to judgment 2010-1668 of this Chamber, from which the following is inferred: 1- The legal framework governing the state policy on health that the competent authorities must develop is regulated by the General Health Law (Ley General de Salud). 2- That the regulations of the Caja Costarricense de Seguro Social, related to human experimentation, as regulations which, by their nature as general norms, do not prove to be the ideal legal mechanism to guarantee the protection of fundamental rights directly related to human experimentation, among them, the right to life, personal liberty, physical integrity, the right to health, and other involved rights. 3- Rights that, due to their characteristic of being fundamental and inherent to the human being, must be regulated and limited solely by a special law issued by the Legislative Assembly, since both the exercise of the freedom of scientific experimentation and the protection of the right to life and human dignity in relation to this type of experimentation are matters and subjects of legal reservation. Scientific interest can never violate or be above the right to life, health, physical or mental integrity, dignity, and any other fundamental right or freedom inherent to the person, by their sole condition of being human, even with free and voluntary consent. All the supposed benefits of procedures such as vaccination against covid-19 for the human being, society, and humanity must be obtained through respect for and protection of the fundamental rights of each and every one of the inoculated; hence, these types of procedures for which information about their possible effects has been omitted cannot be regulated by a regulation, outside the bounds of the right to human life, the right to health, privacy, and human dignity. He insists that Executive Decree (Decreto Ejecutivo) No. 42889-S, \"Reform of the Regulation to the National Vaccination Law and numerals 2, 3, and 6, subsection a) of Law No. 8111, National Vaccination Law,\" by obligating public officials to get vaccinated without the Caja Costarricense de Seguro Social informing them about the possible effects, let alone about their labor rights regarding the occupational risk policy in the event of an adverse effect caused by this mandatory covid-19 vaccination, grossly violates the constitutional rights of all public officials—and potentially of all private-sector workers—regarding the rights to privacy, integrity, and human dignity, as highlighted by the notable jurisprudence of this Chamber in relation to the Caja Costarricense de Seguro Social's regulations on human experimentation. He argues that what is sought with this action implies even a change of criteria in the jurisprudence of this honorable Constitutional Chamber (Sala Constitucional), which is permitted by the Law of Constitutional Jurisdiction (Ley de la Jurisdicción Constitucional). This is because the Constitutional Chamber has defended the mandatory nature of vaccination in certain cases, which must be reviewed by the Chamber, making the necessary adjustments to its jurisprudence. The Chamber has recognized \"the importance of vaccination as part of the essential health care that the Costa Rican State must guarantee, in order to protect the fundamental right to health of all persons, and, secondly, in safeguarding public health and the prevention of diseases constitutes a constitutionally legitimate aim.\" Up to this point, there would be no conflict with the position of the Inter-American Court of Human Rights, because those aims can be achieved without mandatory requirements, through educational and awareness campaigns, but the Constitutional Chamber has gone further and has stated that this importance of vaccination can validly justify the mandatory nature of vaccines, which represents an interpretation contrary to human dignity and international bioethics instruments. Article 13 of the Law of Constitutional Jurisdiction establishes the principle that the jurisprudence and precedents of the Constitutional Chamber are binding erga omnes, except for the Chamber itself. Due to the foregoing, a balancing of potentially conflicting rights must not only be carried out but, once and for all, it must be made clear that the human being must not be seen as a mere instrument to achieve social goals, as happens in the case of mandatory vaccination, but rather that, at all times and in all cases, human dignity must be the guiding principle for decision-making at the legislative, executive, and judicial levels. Only in this way can there be certainty that situations as regrettable as those that have occurred in Costa Rica, due to having it reversed, will not be repeated. He requests that: 1. The present action of unconstitutionality (acción de inconstitucionalidad) be admitted, and the mandatory nature of the inoculation supported by the challenged decree be suspended while this action is resolved on its merits. 2. Decree No. 42889-S, Reform of the Regulation to the National Vaccination Law and numerals 2, 3, and 6, subsection a) of Law No. 8111, National Vaccination Law, be declared unconstitutional and consequently annulled, as well as all regulations that oppose prior, full, and free informed consent, regarding the mandatory nature of vaccination for all public officials and potentially all private-sector workers. 3. The Ministry of Health be prevented from continuing to apply the mandatory nature of vaccination.\n\n2.- By brief incorporated on December 22, 2021, the claimant reiterates his allegations of unconstitutionality and details each of the norms accused of being unconstitutional, with the respective argumentation for each case. FIRST: regarding Article 46 of the Civil Code, Law No. 63 of September 28, 1887, he alleges that the phrase with the exception of cases of mandatory vaccination or other measures relating to public health is unconstitutional, because it violates the principle of prior, informed, and free consent, and human dignity. It is alleged that the phrase with the exception of cases of mandatory vaccination or other measures relating to public health, of this article, is violative of personal liberty, specifically, of the principle of informed consent, which is protected by the jurisprudence of the Inter-American Court of Human Rights, as well as by resolutions of the Inter-American Commission on Human Rights. This norm allows vaccination to be mandatory in Costa Rica, by excluding the possibility of refusing to receive a vaccine that has been included in the mandatory ordinary schedule list by the health authorities. By excluding vaccination from that possibility, the Costa Rican State's obligation to ensure prior, informed, full, and free consent for every person who is to receive a vaccine from the State is grossly violated. SECOND: Article 150 of the General Health Law, Law No. 5395 of October 30, 1973, allows vaccination to be mandatory in Costa Rica, by excluding the possibility of refusing to receive a vaccine that has been included in the mandatory ordinary schedule list by the health authorities. By excluding vaccination from that possibility, the Costa Rican State's obligation to ensure prior, informed, full, and free consent for every person who is to receive a vaccine from the State is grossly violated. THIRD: The same General Health Law, in relation to the powers of the Minister of Health, allows vaccination to be mandatory in Costa Rica, by excluding the possibility of refusing to receive a vaccine that has been declared mandatory by the health authorities. By excluding vaccination from that possibility, the Costa Rican State's obligation to ensure prior, informed, full, and free consent for every person who is to receive a vaccine from the State is grossly violated. FOURTH: From the National Vaccination Law, Law No. 8111 of July 18, 2001, Article 3 indicates that this norm empowers the National Commission for Vaccination and Epidemiology (Comisión Nacional de Vacunación y Epidemiología) to establish the mandatory nature of vaccines \"when it deems it necessary\" in coordination with the Ministry of Health and the Caja Costarricense de Seguro Social, therefore allowing vaccination to be mandatory in Costa Rica, by excluding the possibility of refusing to receive a vaccine that has been declared mandatory by the health authorities. By excluding vaccination from that possibility, the Costa Rican State's obligation to ensure prior, informed, full, and free consent for every person who is to receive a vaccine from the State is grossly violated. FIFTH: From this same Law No. 8111 of July 18, 2001, Article 11 allows the National Commission for Vaccination and Epidemiology, together with the authorities of the Ministry of Health and the CCSS, to determine the sectors of the population that must be vaccinated, whether optionally or mandatorily, and it is here that we find a problem, as the principle of prior, informed, full, and free consent, protected by the American Convention on Human Rights and the jurisprudence of the Inter-American Court of Human Rights and the resolutions of the Inter-American Commission on Human Rights, is violated. Therefore, the phrase \"furthermore, shall decide if the vaccination is mandatory or optional\" is unconstitutional and must be annulled. SIXTH: Article 1, subsection e) of the Regulation to the National Vaccination Law of May 20, 2005 contemplates a category of vaccines that would be mandatory. Mandatory nature, as argued in this action, without the possibility of free consent, is contrary to the individual guarantees provided by the jurisprudence of the Inter-American Court of Human Rights, specifically the judgment of November 30, 2016, Case I.V. vs. Bolivia, and Resolutions 4/2020 and 1/2021 of the Inter-American Commission on Human Rights, among others. SEVENTH: Executive Decree No. 43249-S signed by the Executive Branch on October 7, 2021, formalized Agreement No. XLV-2021 of the National Commission for Vaccination and Epidemiology of September 23, 2021, whose validity takes effect as of October 15, 2021, a decree through which the mandatory nature of the vaccine against Covid-19 was approved for all public-sector officials, as well as for those private-sector employees whose employers, within their internal labor provisions, have chosen to incorporate said vaccination as mandatory in their workplaces. This Executive Decree violates the principle of prior, informed, full, and free consent guaranteed by the jurisprudence of the Inter-American Court of Human Rights, specifically the judgment of November 30, 2016, Case I.V. vs. Bolivia, in which the Inter-American Court stated in its paragraphs 159, 160, and following. In accordance with the foregoing, Resolution 1-21 of the INTER-AMERICAN COMMISSION ON HUMAN RIGHTS, of April 10 of this year, states that informed consent is based on four principles that consolidate its validity, namely, the principle of beneficence, the principle of non-maleficence, the principle of justice, and the principle of autonomy. He requests that the action of unconstitutionality be considered amended, in order to comply with the corresponding formal requirements.\n\n3.- By brief incorporated on January 3, 2022, Mariela Fallas Pacheco requests to be considered as a coadjuvant in this action, based on the same arguments as the claimant.\n\n4.- Article 9 of the Law of Constitutional Jurisdiction empowers the Chamber to reject outright or on the merits, at any time, even from its filing, any motion brought to its attention that proves to be manifestly improper, or when it considers that there are sufficient elements of judgment to reject it, or that it is a mere reiteration or reproduction of a previous equal or similar motion that was rejected.\n\nDrafted by Magistrate Castillo Víquez; and,\n\nConsidering:\n\nI.- Preliminarily. On the motion for coadjuvancy. Through a brief incorporated on January 3, 2022, Mariela Fallas Pacheco requested that a motion for coadjuvancy be filed in this action of unconstitutionality. Article 83 of the Law of Constitutional Jurisdiction establishes, to that effect, that within fifteen days after the first publication of the notice referred to in the second paragraph of Article 81, the parties involved in matters pending at the time of filing the action, or those with a legitimate interest, may appear within it to coadjuvate in the allegations that could justify its admissibility or inadmissibility, or to expand, where appropriate, the grounds for unconstitutionality in relation to the matter that concerns them. In this specific case, the request for coadjuvancy is inadmissible, not only because the motion lacks a signature, authentication, and the corresponding stamp of the Bar Association (Colegio de Abogados), but also because coadjuvancy implies an accessory procedural intervention and its fate follows that of the principal intervention which, for the reasons detailed below, is inadmissible.\n\nII.- On the admissibility requirements for the action of unconstitutionality. The process at hand was instituted with the purpose of guaranteeing the supremacy of the Political Constitution, against norms or other provisions of a general nature. By virtue of this and by the express will of the legislator, it is highly technical, so certain requirements set forth by law must be strictly met for its admissibility. Among the demanded requirements are: the adequate substantiation of the grounds for unconstitutionality with a specific citation of the Constitutional provision considered infringed (Article 78), the signature of the person filing the action duly authenticated by a legal professional with the due payment of legal taxes (Article 78), the accreditation of the standing conditions (powers and certifications), and the literal certification of the filing where the reservation of unconstitutionality was made in the prior matter (Article 79).\n\nIII.- On the standing of the claimant. This Tribunal considers that the claimant's standing comes from the first paragraph of Article 75, insofar as the amparo appeal (recurso de amparo) No. 21-021972-0007-CO is pending resolution and duly processed. In said process, the petitioner argued that he is an \"ad honorem\" advisor in the Legislative Assembly to one of the deputies. Likewise, that, based on Executive Decree No. 43249-S, which reformed Executive Decree No. 42889-S of March 10, 2021, through an agreement adopted by the Legislative Directorate, in Article 11 of Session No. 180-2021 of October 27, 2021, it was ordered to add an Article 61 bis to the Autonomous Service Regulation (Reglamento Autónomo de Servicio) of the Legislative Assembly, which requires proof of the covid-19 vaccine for the regular and confidential personnel of the Legislative Assembly, as well as for those who work on an ad honorem basis; unless, due to a medical contraindication, duly declared by the treating specialist, it is not possible for them to receive it. Otherwise, ad honorem officials —as is his case— will have their appointment revoked, which was communicated to him on October 29th. The base matter states that the foregoing implies a threat of sanction that nullifies his right to grant or not his prior, informed, full, and free consent, that this causes him harm and a loss of opportunities to advise and propose bills. Furthermore, he asserts that he has the right to decide whether or not to get vaccinated, under the principle of informed consent, which must be prior and free; as well as to store and manage his sensitive data, which includes everything related to his medical record; however, the regulation in dispute does not contemplate such a request. In accordance with the foregoing, the base matter constitutes a reasonable means to protect the rights of the claimant as an ad honorem official of a public institution, therefore he has standing to raise his arguments regarding his status as a public official. Therefore, he holds the standing to bring action before this jurisdiction in that sense.\n\nIV.- On other formalities and the admissibility of this action. As this Tribunal has indicated in its jurisprudence, the requirement of sufficient substantiation is not a mere formality, but rather constitutes an essential admissibility requirement. This was set forth in judgment No. 2013-16944 of 14:30 hours on December 18, 2013:\n\n\"II.- INADMISSIBILITY DUE TO LACK OF SUBSTANTIATION. In accordance with Article 78 of the Law of Constitutional Jurisdiction, in the brief filing the action of unconstitutionality, the grounds must be set forth clearly and precisely, with a specific citation of the norms or principles that are considered infringed. This requirement is not a mere formality, but rather an essential admissibility requirement, since by virtue of the pro sentencia principle —developed on other occasions by this Chamber— according to which admissibility requirements must be interpreted in a manner favorable to the action, furthermore, Constitutional Law is of preferential public order and in guarantee of its supremacy and validity there is a public interest by virtue of which obstacles to the admission and resolution on the merits of an action must be interpreted and applied restrictively. Thus, all procedural norms must be interpreted and applied in such a way that the judgment is rendered; the foregoing not only facilitates the administration of justice, but also prevents the imposition of obstacles to not achieving it (see in the same sense, rulings number 93-5175, 3041-97, 01-06, 2874-06, 1622-08, and 2887-08). Consequently, the lack of substantiation of the action prevents the rendering of a duly reasoned judgment that is congruent with what is sought.\"\n\nLikewise, it is improper for this Chamber to rule on the merits of norms challenged in an action when the petitioner fails to state the grounds on which the challenge is based, since that would entail exercising abstract constitutional review as a kind of academic exercise, which is incompatible with the purpose of a proceeding of this nature.\" (Emphasis not in original).\n\nIn the sub examine, the petitioner brings the action against \"Executive Decree No. 43249-S, entitled 'Reform to Executive Decree No. 42889-S of March 10, 2021, called reform to Executive Decree No. 32722-S of May 20, 2005, \"Regulations to the National Vaccination Law\" and Establishment of the Mandatory Nature of the COVID-19 Vaccine', Article 46 of the Civil Code, Law No. 63 of September 28, 1887, the agreement taken by the Legislative Directorate, in Article 11 of Session No. 180-2021, held on October 27, 2021, which introduces Article 61 bis to the Autonomous Service Regulations of the Legislative Assembly; Law No. 5395 of October 30, 1973, General Health Law, Law No. 8811 - 'National Vaccination Law' of July 18, 2001, Executive Decree No. 32722 - 'Regulations to the National Vaccination Law' of May 20, 2005, Executive Decree No. 37808 - 'National Vaccination Standard' of January 8, 2013, Executive Decree No. 30965-S - 'Regulations on the management of infectious waste generated in establishments providing health care and related services' of December 17, 2002, Executive Decree No. 41045-S of May 10, 2016 'General Regulations for the Licensing of Health Services'; the National Guidelines for the Surveillance of COVID-19 disease; the General guidelines for the use of Personal Protective Equipment (PPE) to prevent exposure to Coronavirus (COVID-19); the Procedure Manual for the execution of vaccination against COVID-19 in the health establishments of the Costa Rican Social Security Fund, version #7, June 2021, Ministry of Health, LS-SS-013, Guidelines on vaccination against the SARS-CoV-2 virus for the prevention of COVID-19 — as well as any standard or regulation issued by other public institutions that oppose the principle of prior and free informed consent\"; however, in the grounds provided in the filing brief, it only referred to Decree No. 42889-S of March 10, 2021, and specifically, regarding the partial reform that was introduced to it through Executive Decree No. 43249-S. With respect to the remaining challenged regulations, the action lacks proper grounds, because the petitioner not only omitted to refer to the provisions and content of each challenged regulation or guideline, but also failed to indicate, on an individualized basis, how the constitutional norms and fundamental principles are violated. Although the petitioner subsequently submitted a brief attempting to remedy these deficiencies, the truth is that it was limited to citing the norms without developing each one of them in order to contrast them with Constitutional Law; it merely complains about the mandatory nature of the vaccine without informed consent, but without offering a true foundation and argumentation for each challenged norm. Similarly, it seeks to challenge, in an open and generalized manner \"any standard or regulation issued by other public institutions that oppose the principle of prior and free informed consent,\" which is entirely improper, because it is incumbent upon the petitioner to adequately determine and substantiate the provisions whose nullity is sought in this type of proceeding. Thus, the action is admissible only against Executive Decree No. 42889-S of March 10, 2021, partially reformed through Executive Decree No. 43249-S of October 7, 2021, having fulfilled all the respective formalities. In all other respects, it is considered that the appropriate course is to summarily dismiss the action.\n\nV.- Regarding the object of the action. Having noted the above, the petitioner requests that the unconstitutionality of Executive Decree No. 42889-S of March 10, 2021, partially reformed through Executive Decree No. 43249-S of October 7, 2021, be declared, on the grounds that it violates:\n\n1. The principle of informed consent developed in Articles 20, 21, and 28 of the Political Constitution, Article 22 of the General Health Law, Article 2 of Law No. 8239, \"Rights and Duties of Users of Public and Private Health Services,\" Articles 1 and 4 of the Regulations of the Costa Rican Social Security Fund (CCSS), and the jurisprudence of the Inter-American Court of Human Rights. It argues that the challenged decree is unconstitutional because it does not provide for the existence of free, prior, and informed consent, but rather, quite the contrary, establishes the mandatory nature of vaccination against COVID-19 against the principle of self-determination and with serious consequences in case of noncompliance for public officials and some private-sector workers, without previously providing all the required information that guarantees their life.\n\n2. The principle of equality and non-discrimination derived from Article 33 of the Political Constitution. It indicates that the challenged decree establishes discriminatory treatment to the detriment of the public-sector worker, for whom the vaccine is mandatory; however, for those in the private sector, it leaves it to the discretion of the employer. It states that there is no technical justification demonstrating the need to oblige all public officials to be vaccinated. It questions the fact that, by executive decree, officials of other branches of government and municipalities are obliged to be vaccinated, damaging their autonomy.\n\n3. Freedom of thought and expression developed by Articles 28 and 29 of the Political Constitution, and Articles 19 of the Universal Declaration of Human Rights, 19 of the International Covenant on Civil and Political Rights, 4 of the American Convention on Human Rights, and 13 of the Pact of San José, since people who do not get vaccinated have the right to think differently from or in opposition to people who do wish to do so, because there has been no clear and truthful information about its effects on the health of the population. It indicates that if a person is not clear about the effects it will cause to their health, they have the right to feel safe by not getting vaccinated, because the inoculation does not prevent contagion. Furthermore, vaccinated people are not immune to contagion and can become infected, since the vaccine does not protect indefinitely, meaning vaccinated people do not have permanent immunity. It argues that the medium- and long-term side effects are unknown, and that it is still in an experimental phase, without guarantee or responsibility on the part of the manufacturer, as to it being the only alternative to emerge from the health crisis caused by SARS-CoV-2, therefore people who do not wish to be vaccinated have the right to dissent from doing so as part of their right to thought and free expression, which goes hand in hand with the possibility of not giving consent for the application of a vaccine, because human dignity must prevail over a supposed interest of science or even of society.\n\n4. The principle of legality established in Article 11 of the Political Constitution and Article 11 of the General Law of Public Administration, due to the use of the term vaccine in the case of inoculation against COVID-19, which does not fulfill the main characteristic of inducing active protective immunity against the corresponding infectious disease, according to Article 1, subsection p) of the Regulations to the National Vaccine Law. They are forcing the population to undergo a live clinical trial test without openly telling them that the vaccine profile is experimental, and without informed consent, in accordance with the Ethics Committees and Principles of Good Clinical Practices. It states that it is a vaccine profile without conclusive clinical studies, as stated by Minister Salas himself, so it must be taken into account that, although it was prematurely classified as a \"vaccine,\" and now they approved it as a \"vaccine,\" they confirm that the period of immunity is not known; therefore, if the period of effectiveness is not known until the study is completed, neither can the contraindications, interactions, and adverse reactions be known with certainty.\n\n5. The precautionary principle in health matters, given the mandatory nature of vaccination without prior medical examinations. It points out that a double discourse has been maintained, because while they affirm that the \"vaccines\" are safe, on the other hand, they accept that studies are lacking to demonstrate their effectiveness and safety. It is because of this enormous confusion, the lack of data, and studies on the short- and long-term effectiveness and safety of the vaccines, that the population must be protected and under no circumstances should people be forced to get vaccinated, and even the World Health Organization has stated this.\n\n6. The principle of the hierarchy of norms, developed in Articles 7, 48, 129, and 140, subsection 3) of the Political Constitution, because the questioned decree contradicts international legal instruments relating to Human Rights, such as Articles 2, 5, 6, and 7 of the International Covenant on Economic, Social and Cultural Rights, Article 12 of the Universal Declaration of Human Rights, and Articles 1.2, 3, 4, and 5.1 of the American Convention on Human Rights. The mandatory nature of the vaccine violates these internationally recognized fundamental human rights, since it harms the physical integrity of individuals by imposing on public-sector officials and extending to private-sector workers the requirement to introduce a vaccine into their body without informed, prior, full, and free consent, and without respect for their autonomy of will. It also seriously violates the right to psychic and moral integrity of persons, by forcing said officials to be inoculated in an intimidating manner, because if they do not do so, they face fines, administrative and criminal sanctions, and even dismissal without employer liability or revocation of appointment or designation, as applicable.\n\n7. The principle of conventionality, because the country has committed to guaranteeing the right to health, as well as the impossibility of receiving arbitrary interference by governments in persons.\n\n8. Laws subsequent to the National Vaccine Law, such as Article 2, subsection c) of Law No. 8239 of April 2, 2002, \"Law on the rights and duties of users of public and private health services,\" because it clearly refers to the duty to obtain informed consent before subjecting an individual to any medical procedure. For its part, subsection m) of the cited norm is clear in pointing out the right of every person to maintain total privacy over their clinical history, except when, by special law, notice must be given to the health authorities, which is evidently contrary to Article 1 of the challenged decree, because the decree in question implicitly obliges the worker to reveal private information concerning their clinical history to someone who, according to the decree itself, is not a health authority. It also argues that the obligation to get vaccinated and to reveal information concerning the medical history harms the provisions of Article 9, subsection 1) of the \"Law on the Protection of Persons Regarding the Processing of their Personal Data,\" and its violation is sanctioned in Article 31.\n\n9. The jurisprudence of the Inter-American Court of Human Rights related to the right to life and informed consent, because the challenged decree not only puts the right to life and health at risk, but also violates the entire democratic system, such that the foundations of the Rule of Law are seriously affected due to the direct, totalitarian, and arbitrary intrusion of the State.\n\n10. The principle of reasonableness and proportionality in the penalty for not getting vaccinated (dismissal without employer liability and/or a fine of approximately 500,000 colones), due to the mandatory nature of the measure itself, which harms the right to work. It points out that the authorities have in no way technically or scientifically substantiated the degree of efficacy of the vaccine in relation to preventing the spread of COVID-19, so it is not possible to carry out an assessment of the proportionality, necessity, and reasonableness of the measure that harms the principle of autonomy of will. On the other hand, the sanctions for public officials who do not get vaccinated are disproportionate; they are blank criminal or administrative-sanctioning provisions that contravene the principle of criminal and administrative-sanctioning specificity. The aim is to open administrative proceedings aimed at dismissing, without employer liability, public officials who do not get vaccinated, or who do not provide information to the entity for which they work about whether or not they have been vaccinated, and whether or not they have the complete vaccination schedule. Additionally, public officials are threatened with the imposition of a fine of approximately 500,000 colones and the referral of the case to the Public Ministry to determine whether a crime has been committed. In this way, working people are coerced into submitting to mandatory inoculation, despite their well-founded fears of suffering short- or long-term harm to their health, due to the imminent disciplinary actions. It questions both the term of public order on which the regulation is based, and the sanctions for workers who do not get vaccinated.\n\n11. The principle of informational self-determination, related to the private information contained in the medical record, the right to life and health, according to Articles 21, 24, 40, 46, 50, 73 of the Political Constitution and Article 5, first section of the American Convention on Human Rights, due to the lack of protection of sensitive information, as it concerns a medical matter, since it imposes the obligation to communicate this information to human resources departments, without any legal legitimation to do so, also violating the Law on Protection Regarding the Processing of Personal Data. It also considers it violated by the absence of free and informed consent, without prior information about the possible effects of vaccination, as well as the examinations prior to said inoculation.\n\n12. The right to life and health (Articles 21, 40, 46, 50, and 73 of the Political Constitution), since by the mere condition of being a public official, the obligation to get vaccinated is established, without people previously knowing whether or not they run the risk of suffering severe consequences in their body, which it considers cruel and degrading treatment, by failing to consider that there are people with various ailments, given the absence of free and duly informed consent. Furthermore, it violates the right of every person to dispose of their own body.\n\n13. The regulatory power established in Article 140, subsections 3) and 18) of the Political Constitution, and the principle of legislative reservation, by imposing the mandatory nature of vaccination without free and duly informed consent by means of a decree and not by law. Obliging public officials to get vaccinated without the Costa Rican Social Security Fund informing about the possible effects, and even less about labor rights regarding the occupational hazards policy in the event of an adverse effect caused as a result of this mandatory COVID-19 vaccination, grossly violates the constitutional rights of all public officials, regarding the rights to privacy, integrity, and human dignity.\n\nExecutive Decree No. 43249-S challenged here provides as follows:\n\n\"Article 1.- Reform Article 2 of Executive Decree No. 42889-S of March 10, 2021, called Reform to Executive Decree No. 32722-S of May 20, 2005, called Regulations to the National Vaccination Law and Establishment of the Mandatory Nature of the COVID-19 Vaccine, so that henceforth the following is stated:\n\n\"Article 2.- Based on Article 3 of the National Vaccination Law, Law Number 8111 of July 18, 2001, as well as Articles 2 and 18 of the Regulations to the National Vaccination Law, Executive Decree Number 32722 of May 20, 2005, the COVID-19 vaccine will be mandatory for the personnel established by the National Commission for Vaccination and Epidemiology, in Extraordinary Sessions Number VII-2021 of February 16, 2021, VIII-2021 of February 23, 2021, and No. XLV-2021 of September 23, 2021; in the case of this last agreement, it will be in the terms set by the National Commission for Vaccination and Epidemiology for the public sector and the private sector.\n\nWhen summoned by those responsible for such purpose and in accordance with the respective institutional planning, the persons contemplated in the preceding paragraph must be vaccinated, except for those officials who, due to a duly declared medical contraindication, are not able to receive the vaccine against Covid-19.\"\n\nIt will be the employer's responsibility to take the corresponding measures in accordance with the country's legislation and institutional regulations, in the case of workers who do not wish to be vaccinated against COVID-19.\"\n\nGiven that this Tribunal has already ruled on several of the aspects raised by the claimant, some precedents are cited below, which will allow various allegations to be resolved, jointly or separately, as follows.\n\n**VI.- On the mandatory nature of vaccination, the principle of legal reservation, and the right to life and health.**\n\nIn judgment no. 2021-23195 of 9:15 a.m. on October 15, 2021, recently reiterated in no. 2021-26519 of 1:10 p.m. on November 24, 2021, this Tribunal reaffirmed its criterion, in relation to the mandatory nature of vaccination against covid-19, established in the decree challenged here, stating the following:\n\n\"**V.- ON THE SPECIFIC CASE**. The Chamber notes that, according to the reports rendered by the Minister of Health and the Medical Manager, both of the Caja Costarricense de Seguro Social, the vaccines being applied in the country against the coronavirus COVID-19 are not medications in an experimental phase.\n\n**VI.- REGULATORY FRAMEWORK:** The Civil Code provides as follows:\n\n\"Art. 46.- Every person may refuse to undergo a medical or surgical examination or treatment, **with the exception of cases of mandatory vaccination or other measures relating to public health,** occupational safety, and the cases provided for in article 98 of the Family Code (…) \". (The highlighting does not correspond to the original).\n\nThe Ley General de Salud, in relation to the powers of the Minister of Health, orders the following:\n\n\"Art. 345. 3. Declare mandatory vaccination against certain diseases as well as certain examinations or practices deemed necessary to prevent or control diseases\".\n\nOn the other hand, regarding the obligations of the administered parties, the referred law states the following:\n\n\"Art. 147.- Every person must comply with the legal or regulatory provisions and practices aimed at preventing the appearance and spread of communicable diseases.\n\nThey are especially obligated to comply:\n\n(…)\n\nb) The preventive measures that the health authority orders when a disease appears\".\n\nVaccination is precisely a preventive measure to avoid the spread of a communicable disease.\n\nFurthermore, Article 3 of the Ley Nacional de Vacunación states:\n\n\"(...) In accordance with this Law, **vaccinations against diseases are mandatory when deemed necessary by the Comisión Nacional de Vacunación y Epidemiología, which is created in this Law, in coordination with the Ministerio de Salud and the Caja Costarricense de Seguro Social.**\n\nThe approved vaccines must be supplied and applied to the population, without economic reasons or lack of supply in the health services provided by state institutions being able to be alleged.\n\nThese approved vaccines refer to the official basic scheme applied to the entire population, and to vaccines for special schemes directed at specific risk groups.\n\nThe Comisión Nacional de Vacunación y Epidemiología must prepare an official list of vaccines, which will be included in the Regulations of this Law. The list may be reviewed and analyzed periodically, considering the frequent technological changes in this field (…)\" (the emphasis does not belong to the original).\n\nIn accordance with this, Article 6 of the same regulatory body, in subsections a), b) and e), recognizes as functions and objectives of the Comisión de Vacunación y Epidemiología:\n\n\"a) Guarantee the mandatory and free nature of vaccines and the effective access of the entire population to them (...) b) Formulate the general political and strategic guidelines on vaccination, applicable in the health sector (...) e) Define, jointly with the country's health sector authorities, the schemes and vaccines referred to in Article 3 of this Law\".\n\nFrom the foregoing, **it is not possible to affirm that the principle of legal reservation in the regulation of fundamental rights has been violated**, **given that the mandatory application of the vaccine against the coronavirus COVID-19 was defined by the Comisión Nacional de Vacunación y Epidemiología, in accordance with the powers granted by the Ley Nacional de Vacunación**. This led to the issuance of Decree No. 42889-S \"Reform to the Regulation of the Ley Nacional de Vacunación\" (Decreto Ejecutivo No. 32722-S of May 20, 2005) in order to include the vaccine in question in the national vaccination scheme.\n\nLikewise, in exercise of the same powers, Article 2 of Decree No. 42889-S established the mandatory nature of \"the Covid-19 vaccine for the personnel established by the Comisión Nacional de Vacunación, in extraordinary sessions number VII-2021 of February 16, 2021 and VIII of February 23, 2021\".\n\nOn the other hand, Article No. 18 of Decreto Ejecutivo No. 32722 details the official list of vaccines included in the Esquema Público Básico Universal de Costa Rica, an article reformed by Article 1 of Decreto Ejecutivo No. 42889 of March 10, 2021, specifically, in point No. 15, in which Covid-19 is included.\n\nFor its part, it is important to note that Article No. 150 of the Ley General de Salud, Law No. 5395 of October 30, 1973, of public order that must be complied with by every person inhabiting our country, also mentions the mandatory nature of vaccination and revaccination against communicable diseases determined by the Ministerio de Salud.\n\n**Thus, the inclusion of the vaccine against the coronavirus COVID–19 in the national vaccination scheme and its mandatory nature for health personnel must be understood in light of the provisions of the Ley Nacional de Vacunación, which defines the general regulatory framework on the matter**.\n\n**VII.-** It should be highlighted that the mandatory vaccination for COVID-19 cases is not absolute, but rather, as noted, the decree itself contemplates the possibility of the person presenting a medical contraindication. It should be added that it is public and notorious that the CCSS authorities have publicized the \"Procedures Manuals for the Execution of Vaccination against COVID-19 in the health establishments of the Caja Costarricense de Seguro Social\", in which exactly what the medical contraindications for vaccination are have been explained. In the first version of said manual, the following contraindications were recorded:\n\n\"Do not administer the Pfizer-BioNTech COVID-19 vaccine:\n\n-To persons with a history of a moderate or severe allergic reaction to any of the components of the Pfizer-BioNTech COVID-19 vaccine.\n\n-To persons with a history of documented moderate or severe allergic reaction to foods, medications, or vaccines; unless they have a referral from a specialist doctor indicating that they can be vaccinated.\n\nIn case there is an indication to vaccinate, this will be carried out in intramural vaccination sites, with access to emergency services in case of requiring anaphylaxis treatment.\n\n-Do not administer in Pregnancy or Lactation.\n\n-Do not administer the second dose in patients who have had a mild, moderate, or severe allergic reaction during the application of the first dose of this vaccine.\"\n\nIn the most recent Manual (Code GM-DDSS-ASC-SAVE-18122020, version 07) of June 2021, with the update of the vaccines authorized in our country, the following was provided:\n\n\"Contraindications: Do not administer the Pfizer-BioNTech COVID-19 vaccine: -To persons with a history of an allergic reaction to any of the components of the Pfizer-BioNTech COVID-19 vaccine. To persons with a history of documented moderate or severe allergic reaction to foods, medications, or vaccines; unless they have a referral from a specialist doctor indicating that they can be vaccinated. In case there is an indication to vaccinate, this application will be carried out in intramural vaccination sites, with access to emergency services in case of requiring anaphylaxis treatment. - Pregnancy -Breastfeeding\n\n• Note: In the case of women from any of the prioritization groups who are breastfeeding and wish to be vaccinated for the benefit they may obtain from this intervention, the CNVE agreed that they must be explained that there are no studies in that population and that the risks of the vaccine application are therefore unknown, and that to proceed with the vaccination, the corresponding document must be signed evidencing that they have received the necessary information from the health personnel to make the decision to get vaccinated, assessing risk/benefit. They do not have to present breastfeeding certificates, nor do they have to stop breastfeeding their son or daughter. They can be given the AstraZeneca vaccine or the Pfizer vaccine according to availability at the respective vaccination site.\n\n(…)\n\nPersons receiving the first dose of the COVID-19 vaccine from AstraZeneca must complete the scheme with the AstraZeneca vaccine. • Contraindication: -Hypersensitivity to the active substance or to any of the components of the vaccine. - Pregnancy -Breastfeeding Note: In the case of women from any of the prioritization groups who are breastfeeding and wish to be vaccinated for the benefit they may obtain from this intervention, the CNVE agreed that they must be explained that there are no studies in that population and that the risks of the vaccine application are therefore unknown, and that to proceed with the vaccination, the corresponding document must be signed evidencing that they have received the necessary information from the health personnel to make the decision to get vaccinated, assessing risk/benefit. They do not have to present LM certificates, nor do they have to stop breastfeeding their son or daughter. They can be given the AstraZeneca vaccine or the Pfizer vaccine according to availability at the respective vaccination site.\"\n\nThat is to say, the insured persons and the doctors examining them could determine when there are conditions that medically advise against vaccination. Moreover, although there could be some margin of doubt about the duration of the vaccine's efficacy or the protection period it offers, this is not a legitimate reason to reject immunization.\n\nWhat is significant is that, based on the foregoing, elements are accredited to make operational the possibility for people to claim medical contraindications to reject the vaccine in question and, in this way, protect their right to health.\n\n**VIII.-** Likewise, this Tribunal cannot ignore the evidence provided in other amparo appeals, for example, files 21-008192-0007-CO and 21-008767-0007-CO (taken *ad effectum videndi*) in which it is recorded that the CCSS authorities issued circular no. GG-1156-2021 of April 16, 2021, through which the General Management regulates the institutional application of Decreto Ejecutivo No. 42889-S on the mandatory nature of the COVID-19 vaccine.\n\nSaid circular provides for several stages. For example, it reiterates that working persons must be vaccinated, with the exception of those officials who, due to a duly declared medical contraindication, cannot receive the vaccine. Furthermore, in case of refusal, the authorities must follow a series of steps: 1) the warning to the official; 2) the analysis of the occupational health conditions of each worker; and 3) the determination of responsibilities. In said phase, the justifications by the worker are examined, along with the report from a clinical team comprised of the comprehensive worker care physician and the immunization manager, to finally assess the possibility of opening an administrative proceeding. By virtue of the foregoing, a margin is also accredited for workers to justify before the employer instances the refusal to receive the vaccination due to medical contraindications.\n\nIn conclusion, it is clear that the regulatory framework is sufficient and reasonable, and its respect seeks to guarantee the health of individual persons and public health...\"\n\nThe exposed criterion is fully applicable to the object of this action. This Chamber has ruled out that Decreto Ejecutivo No. 42889-S, modified by Decree No. 43249-S, violates the principle of legal reservation in the regulation of fundamental rights, given that the mandatory application of the vaccine against the coronavirus COVID-19 was defined by the Comisión Nacional de Vacunación y Epidemiología, in accordance with the powers granted by the Ley Nacional de Vacunación, which defines the general regulatory framework on the matter. Hence, the decree challenged here is in accordance with the existing regulations by including the vaccine in question in the national vaccination scheme authorized by law.\n\nOn the other hand, as indicated by the precedent cited above and judgment no. 2021-26519, the personnel to be vaccinated will be defined under the technical criterion of the Coordinación de Inmunizaciones and the Técnico Secretary of the Comisión Nacional de Vacunación y Epidemiología of the Dirección de Vigilancia de la Salud, the basis of which is not subject to review in this jurisdiction, as it involves technical, medical, and scientific aspects concerning vulnerability to a virus. Nor is it a vaccine whose studies, regarding its effects, are in an experimental phase, as this Tribunal has accredited in various amparo appeals. Thus, if the claimant dissents from such a criterion, it is likewise a technical discussion that should not be elucidated in this jurisdiction, but rather in the legality path, through the various means of evidence that this path contemplates and that allows its broad discussion and technical and scientific verification. Therefore, and as stated, it is not considered that the right to health of individuals is being violated; far from it, the intent is to secure it at a collective level, in the public interest.\n\nAs this Tribunal indicated in the aforementioned judgments and in referring to the legitimacy in general of the purpose pursued by establishing the obligatory nature of a vaccine, in judgment No. 2020-0019433 of 09:20 hours on October 9, 2020, by stating the following:\n\n\"(...) this Chamber has recognized, firstly, the importance of vaccination as part of the essential healthcare that the Costa Rican State must guarantee in order to protect the fundamental right to health of all persons, and, secondly, that the protection of public health and the prevention of diseases constitutes a constitutionally legitimate purpose that can validly justify the obligatory nature of vaccines (...)\"\n\nThe precedent previously cited—No. 2021-23195—also discards the claimant's assertion that the population has not been informed of the real effects that the vaccine in question can produce, nor that warnings regarding the risks have been given, by stating:\n\n\"VII.- It must be emphasized that mandatory vaccination for COVID-19 cases is not absolute, but rather, as noted, the decree itself contemplates the possibility that the person presents a medical contraindication. It should be added that it is public and notorious that the CCSS authorities have publicized the 'Procedure Manuals for the execution of vaccination against COVID-19 in the health establishments of the Costa Rican Social Security Fund,' in which precisely what the medical contraindications for vaccination are have been explained. In the first version of said manual, the following contraindications were consigned:\n\n'Do not administer the Pfizer-BioNTech COVID-19 vaccine:\n\n-To persons with a history of a moderate or severe allergic reaction to any of the components of the Pfizer-BioNTech COVID-19 vaccine.\n\n-To persons with a documented history of a moderate or severe allergic reaction to foods, medications, or vaccines; unless they have a reference from a specialist physician indicating that they can be vaccinated.\n\nIf there is an indication to vaccinate, this will be carried out at intramural vaccination sites, with access to emergency services in case anaphylaxis treatment is required.\n\n-Do not administer during Pregnancy or Lactation.\n\n-Do not administer the second dose to patients who have had a mild, moderate, or severe allergic reaction during the application of the first dose of this vaccine.'\n\nIn the most recent Manual (Code GM-DDSS-ASC-SAVE-18122020, version 07) of June 2021, with the update of the vaccines authorized in our country, the following was provided:\n\n'Contraindications: Do not administer the Pfizer-BioNTech COVID-19 vaccine: -To persons with a history of an allergic reaction to any of the components of the Pfizer-BioNTech COVID-19 vaccine. To persons with a documented history of a moderate or severe allergic reaction to foods, medications, or vaccines; unless they have a reference from a specialist physician indicating that they can be vaccinated. If there is an indication to vaccinate, this application will be carried out at intramural vaccination sites, with access to emergency services in case anaphylaxis treatment is required. - Pregnancy -Maternal Lactation\n\n• Note: In the case of women from any of the prioritization groups who are in a period of maternal lactation and wish to be vaccinated for the benefit that they may have with this intervention, the CNVE agreed that they must be explained that studies do not exist in that population and that the risks of the application of the vaccine are therefore unknown, and that to proceed with the vaccination, the corresponding document must be signed that evidences that they have received the necessary information from the health personnel for the decision-making process of getting vaccinated, assessing risk/benefit. They must not present lactation certificates, nor must they stop giving lactation to their son or daughter. They can be given the AstraZeneca vaccine or the Pfizer vaccine according to availability at the respective vaccination site.\n\n(...)\n\nPersons who receive the first dose of the COVID-19 vaccine from AstraZeneca must complete the scheme with the AstraZeneca vaccine. • Contraindication: -Hypersensitivity to the active substance or to any of the components of the vaccine. - Pregnancy -Maternal Lactation Note: In the case of women from any of the prioritization groups who are in a period of maternal lactation and wish to be vaccinated for the benefit that they may have with this intervention, the CNVE agreed that they must be explained that studies do not exist in that population and that the risks of the application of the vaccine are therefore unknown, and that to proceed with the vaccination, the corresponding document must be signed that evidences that they have received the necessary information from the health personnel for the decision-making process of getting vaccinated, assessing risk/benefit. They must not present LM certificates, nor must they stop giving lactation to their son or daughter. They can be given the AstraZeneca vaccine or the Pfizer vaccine according to availability at the respective vaccination site.'\n\nThat is, the protected persons and the physicians who examine them could determine when they are in the presence of conditions that medically advise against vaccination. Moreover, although there might be some margin of doubt regarding the duration of the vaccine's efficacy or the protection period it offers, that does not constitute a legitimate reason to reject immunization.\n\nWhat is significant is that, based on the foregoing, elements are accredited to make operative the possibility for persons to allege medical contraindications to reject the vaccine in question and, in this way, protect their right to health.\"\n\nIt is also not true that the ailments of individuals are not weighed, injuring their right to health. The contested decree excludes from mandatory vaccination against COVID-19 those officials for whom, due to a duly declared medical contraindication, it is not possible to be vaccinated, safeguarding their right to health. For such purposes, the contested Article 2 provides:\n\n\"Article 2.- Based on Article 3 of the National Vaccination Law, Law number 8111 of July 18, 2001, as well as ordinals 2 and 18 of the Regulation to the National Vaccination Law, Executive Decree number 32722 of May 20, 2005, the COVID-19 vaccine shall be mandatory for the personnel established by the National Commission of Vaccination and Epidemiology (Comisión Nacional de Vacunación y Epidemiología), in extraordinary sessions number VII-2021 of February 16, 2021, VIII-2021 of February 23, 2021, and No. XLV-2021 of September 23, 2021, in the case of this last agreement, it will be under the terms set by the National Commission of Vaccination and Epidemiology for the public sector and the private sector.\n\nWhen summoned by those in charge for such effect and in accordance with the respective institutional planning, the persons contemplated in the preceding paragraph must be vaccinated, with the exception of those officials who, due to a duly declared medical contraindication, are not able to receive the vaccine against COVID-19. It shall be the responsibility of the employer to take the corresponding measures in accordance with the country's legislation and institutional regulations, in the case of workers who do not want to be vaccinated against COVID-19.\"\n\nSimilarly, in judgment No. 2021-19469 of 09:20 hours on August 31, 2021, this Chamber, stated: \"That is, the protected persons and the physicians who examine them could determine when they are in the presence of conditions that medically advise against vaccination. Moreover, although there might be some margin of doubt regarding the duration of the vaccine's efficacy or the protection period it offers, that does not constitute a legitimate reason to reject immunization. What is significant is that, based on the foregoing, elements are accredited to make operative the possibility for persons to allege medical contraindications to reject the vaccine in question and, in this way, protect their right to health.\"\n\nAs a corollary of the foregoing, the alleged violations to the right to life, health, the principle of legal reservation (principio de reserva de ley), and self-determination against the mandatory nature of vaccination against COVID-19 are discarded.\n\nVII.- On informed consent and the protection of sensitive information. In judgment No. 2021-24027 of 10:10 hours on October 26, 2021, this Tribunal ruled on this claim, in relation to the decree contested here, reiterating its precedents in the following sense:\n\n\"IX.- The appellant insisted that mandatory vaccination not be applied to them without an informed consent informing patients that it is an experimental medication. In this regard, it is necessary to point out that the competent health authorities on the matter have rejected that it is an experimental medication, as indicated supra. Secondly, it would be advisable to highlight that the recognition of the need for an informed consent to be given stems from the recognition of the autonomy and information rights of patients. That is, based on the information provided by their treating physician, a patient chooses to accept or reject a medical provision. In the specific case, as has been examined, there are sufficient provisions that legitimize the mandatory nature of the vaccine, and therefore, autonomy, in such cases, is diminished in order to protect the interest and general welfare, namely, public health (Art. 21 of the Political Constitution, Art. 1 of the General Health Law, and the aforementioned vaccination regulations). This does not prevent emphasizing that in all cases the right to information of all persons subjected to this mandatory vaccination must be respected. In this regard, it is appropriate to cite again the Procedure Manual for the execution of vaccination against COVID-19 in the health establishments of the Costa Rican Social Security Fund, which precisely requires ensuring the right to information of the users and provides the following:\n\n'8.6 Information to the user:\n\nUser education must be mandatory before, during, and after vaccination:\n\n- Before vaccinating, counseling must be carried out and the person to be vaccinated must be educated, they must be asked if they suffer from any allergy, if they are pregnant, if they are an anticoagulated person (use of Heparin or Warfarin). Since in the case of any of these conditions, the vaccination must be intramural.\n\n-It is of utmost importance to explain to the user which vaccine was applied to them (If Pfizer/BioNTech or AstraZeneca) and to indicate to them that the second dose to be applied must be the same one.\n\nFurthermore, the patient must be reiterated the importance of complying with the application date of the second dose just as indicated.\n\n-Note on the vaccination card the type of vaccine and the application date of the first and second dose.\n\n-Provide information to the user about the benefits of receiving the vaccine and about the main side effects and the importance of consulting the health services in case, during the 3 weeks after vaccination, they present difficulty breathing, chest pain, blurred or double vision, single or multiple hematomas, reddish or purplish spots, swelling or pain in a leg, persistent abdominal pain, intense headache or one that worsens further after 3 days of vaccination).\n\n-Information about reported side effects and about those that could present themselves when it begins to be applied massively in the population. And the way in which they must be notified in case any of them presents after being vaccinated.\n\n-In the case of the AstraZeneca vaccine, the vaccinated person must be indicated the importance of notifying, just as with the Pfizer vaccine, any adverse effect through the already known channels.'\n\nFrom the foregoing it is concluded that the authorities are instructed on the obligation to respect the right to information of the patients, and it is not evident that they have omitted what is necessary so that it has been exercised. Consequently, this aspect of the appeal is dismissed.\"\n\nBased on the foregoing, the position of this Tribunal, whose criterion it maintains, is that, even when vaccination is mandatory for those cases in which it is not medically contraindicated, the necessary information must be provided to the person, for the purpose of safeguarding their life and health beforehand, adopting the measures deemed pertinent. That said, as this Tribunal has indicated therein and as the claimant himself notes, there are other provisions that complement the decree contested here in relation to the duty to provide sufficient and adequate information prior to vaccination; just as there are special regulations that order the safeguarding of the private data of persons, and that must be guaranteed by public or private bodies (Article 2 of the Law on the Protection of the Person regarding the processing of their personal data). So, the fact that this provision does not expressly contemplate it does not imply its unconstitutionality, since at the time of its application, the public officials are not exempt from the obligations established in the rest of the legal system, in the terms indicated here; and equally, there are instances legally charged with verifying its compliance. For example, Article 13 of that same referenced law establishes as an effective guarantee: \"Every interested person has the right to a simple and rapid administrative procedure before the Prodhab, in order to be protected against acts that violate their fundamental rights recognized by this law. The foregoing without prejudice to the general or specific jurisdictional guarantees that the law establishes for this same purpose.\" Consequently, the accused violations are discarded.\n\nVIII.- On the accused violation of the principle of equality. The claimant indicates that the contested regulations injure that principle, since they establish discriminatory treatment to the detriment of the public sector worker, for whom the vaccine is mandatory; however, for those in the private sector, it leaves it to the discretion of the employer. He refers that no technical justification exists that demonstrates the need to oblige all public officials to be vaccinated. He questions that, by executive decree, officials of other branches of government and municipalities are compelled to be vaccinated, injuring their autonomy. However, the claimant omits to ground his argument, applying the due test of reasonableness to the questioned regulations. This Chamber, on repeated occasions, has stated the following:\n\n\"To undertake a test of reasonableness of a norm, the Constitutional Tribunal requires that the party provide evidence or at least elements of judgment on which to base their argumentation, and an equal procedural burden corresponds to whoever rebuts the arguments of the action, and the failure to comply with these requirements makes the allegations of unconstitutionality unacceptable. The foregoing, because it is not possible to analyze 'reasonableness' without the existence of a coherent argumentative line that is probatively supported. This, of course, when it does not involve cases whose 'unreasonableness' is evident and manifest\" (Judgment No. 1999-5236 of 14:00 hours on July 7, 1999, reiterated in judgments 2016-14392 of 09:05 hours on October 5, 2016, 2019-6935 of 11:20 hours on April 24, 2019, and 2021-11995 of 16:31 hours on May 26, 2021).\n\nWithout the respective test having been performed, the claimant's argumentative line lacks foundation, since from the petitioner's simple affirmation, two relationships are denoted that are not comparable, as he intends to compare a public employment relationship with a private one, despite dealing with two regimes with totally different regulations. On repeated occasions, this Tribunal has ruled on the statutory regime and its difference from the private sector in this sense:\n\n\"III.- On the statutory regime.\n\nOur original constituents enshrined in the 1949 Political Constitution the requirement for an administrative labor regime to regulate relations between public servants and the State, in order to protect the former from arbitrary dismissals (job stability) and to professionalize the public function (pursuit of efficiency in service and the suitability of the official). The purpose of this mandate was to ensure that the Public Administration had organizational factors enabling it to satisfy citizens' right to the proper functioning of public services. To this end, the procedure for selecting and appointing a servant in the Public Administration must comply with the fundamental principles set forth in Articles 191 and 192 of the Constitution, thereby seeking suitable personnel to fill a public post, with the purpose of guaranteeing efficiency and effectiveness in the public function. The civil service regime is therefore not erected as a corporate privilege, but as a guarantee of institutional impartiality. For this, the normative framework that regulates the public function must guarantee the selection of personnel based on criteria of merit and capacity, as well as a fair balance between the rights and responsibilities of public employees. Also, said legislation must provide instruments that facilitate the different administrations in the planning, ordering, and most efficient use of their personnel. Hence, the public employment labor relationship is subject to certain specificities and principles, such as those of merit and capacity in access, and also to certain public law norms, such as the regime of incompatibilities, which guarantee objectivity and impartiality in the provision of public service…\n\nHaving stated the foregoing, it is clear and evident that, from 1949 onward, the legal system regulating the employment relationship between the public administration and its servants in our country is governed by public law, a principle reiterated in Article 112 of the General Law of Public Administration (see, to this effect, judgment No. 1995-3125 of 4:24 p.m. on June 14, 1995). This regime necessarily implies — as indicated in the precedent cited above — that this relationship, by its very nature, is based on its own general principles, which are not only distinct from those of (private) labor law, but often even contrary to them…\n\nEven less so, when such labor provisions could be imposed on the State in its capacity as employer by bodies external to it, where extraneous interests, and sometimes interests contrary to the purposes of the public administration, converge. According to what was indicated by the Chamber in judgment No. 2003-10615, the final wording given to Article 191, together with the process of profound decentralization that the Costa Rican State underwent from 1949 onward, has led to the current validity of the existence of diverse statutory relationships within the Administration, in consideration of the functional independence and administrative autonomy that the legal system ensures for various public institutions. However, \"what is not legitimate —as was stated— is that the relations between each Administration-employer and its officials be governed by concerted (contractual) rules between both parties, as validly occurs in private employment relations.\" The Chamber has recognized that there are two broad categories of employees who provide their services to the State: those who have the status of \"public official,\" \"public servant,\" or \"public employee,\" and those who work for state enterprises or economic services, entrusted with activities subjected to common law. The former have been defined as those who, in the performance of their duties, carry out the public management of the State, to whom —consequently— the public employment regime is applicable, with all the principles and characteristics derived from the provisions of numerals 191 and 192 of the Political Constitution; and the latter are those laborers, workers, and employees who, although they work for the State, do not have the status of public officials or servants because they do not participate in the public management of the administration, given that they are contracted by public enterprises or economic services of the State entrusted with activities subject to common law in accordance with the exercise of their private law capacity, by virtue of which their employment regime is governed by the norms of common law, that is, ordinary labor legislation (see judgment No. 2006-14416).\n\nCorollary to the foregoing, the public employment relationship that applies to public servants is a special, public-law or statutory relationship, which by such legal nature has limitations regarding the application of common labor law. Likewise, its regulation is subject to Articles 11, 191, and 192 of the Political Constitution…\". (Judgment No. 2018-231 of 11:00 a.m. on January 10, 2018). (The emphasis is not from the original).\n\nIn addition to the foregoing, regarding the claim that an executive decree compels the vaccination of officials of other branches of government and municipalities, harming their autonomy, the claimant must be warned that this Chamber has repeatedly stated that the defense of the autonomy of public institutions is only invocable by their own bodies and not by a third party (see judgments No. 2019-16766 of 9:20 a.m. on September 4, 2019, and 2021-11995 of 4:31 p.m. on May 26, 2021, among others). In this sense, the claimant lacks standing to raise such a reproach. Consequently, the allegations regarding the principle of equality are inadmissible.\n\nIX.- On the alleged violation of freedom of expression and thought. The claimant argues that people who do not get vaccinated have the right to think differently or contrary to those who do wish to do so, since there has been no clear and truthful information about the effects of what they call a vaccine against COVID-19 on the health of the population. He indicates that, if a person is not clear about the effects it will have on their health, they have the right to feel safe by not getting vaccinated, since the inoculation does not prevent contagion. Furthermore, vaccinated people are not immune to contagion and can become infected, as the vaccine does not protect indefinitely, so vaccinated people do not have permanent immunity. He argues that the medium- and long-term side effects are unknown, and that it is still in the experimental phase, without guarantee or liability on the part of the manufacturer, and that it is the only alternative to emerge from the SARS-CoV-2 health crisis; therefore, people who do not wish to be vaccinated have the right to dissent from doing so as part of their right to thought and free expression, which goes hand in hand with the possibility of not giving consent for the application of a vaccine, because human dignity must take precedence over a supposed interest of science or even of society. The reasons for which the claimant alleges a violation of freedom of thought and expression have been dismissed in the previous recitals, in which it has been established that information regarding vaccination and its effects has indeed been disseminated, and that it is not in an experimental phase. It has also been pointed out that the mandatory vaccination ordered in the challenged decree stems from a public interest in safeguarding the health of the community, which is legally justified in Article 46 of the Civil Code, Article 147, subsection 3 of Article 345 of the General Health Law, and numeral 3 of the National Vaccination Law. It has been disseminated in which cases it is contraindicated, and it has been established that, despite the mandatory nature of vaccination, individuals indeed have the right to obtain prior information necessary to safeguard their health.\n\nRegarding these rights, this Court, in judgment No. 2018-17048 of 9:15 a.m. on October 12, 2018, has stated the following:\n\n\"On freedom of thought and expression, the American Convention on Human Rights prescribes in Article 13 the following:\n\n\"Article 13. Freedom of Thought and Expression.\n\n1. Everyone has the right to freedom of thought and expression. This right includes freedom to seek, receive, and impart information and ideas of all kinds, regardless of frontiers, either orally, in writing, in print, in the form of art, or through any other medium of one's choice.\n\n2. The exercise of the right provided for in the foregoing paragraph shall not be subject to prior censorship but shall be subject to subsequent imposition of liability, which shall be expressly established by law and be necessary to ensure:\n\na) respect for the rights or reputations of others; or\n\nb) the protection of national security, public order, or public health or morals.\n\n3. The right of expression may not be restricted by indirect methods or means (…)\" (emphasis added).\n\nIn this line, the Inter-American Court has been consistent in pointing out that, in light of Articles 13 and 29 of the American Convention on Human Rights, limitations on freedom of expression must be compatible with the legitimate needs and purposes of a democracy, be established in a law in the formal sense, and be necessary and useful to pursue such purposes. Thus, it has been indicated that \"the only legitimate restrictions on the right to freedom of expression are exercised through subsequent liability in the event that this right is abused. However, the imposition of such liability must satisfy four requirements to be valid under Article 13(2): 1) the grounds for establishing liability must be previously established; 2) these grounds must be expressly and precisely set forth within the framework of the law; 3) the purposes pursued must be legitimate; and, 4) the grounds for establishing liability must be necessary to ensure the legitimate purpose sought.\" (Report on the Compatibility of Desacato Laws with the American Convention on Human Rights, IACHR, http://www.cidh.oas.org/annualrep/94span/cap.V.htm).\"\n\nNow, the decree in question does not prevent people from thinking differently and expressing their disagreement about it. And although it orders that, despite what they think, they must submit to mandatory vaccination, this is due to a public order limitation, which is why the exercise of fundamental rights can indeed be limited. Precisely, the Chamber, when resolving legislative consultation No. 00-009914-0007-CO, regarding what is currently the National Vaccination Law, in judgment No. 2000-11648, ruled in the following sense:\n\n\"V.- Mandatory nature of vaccination, Articles 2, 3, 6, and 11 of the bill. Before analyzing the claim raised by the consulting deputies, the norms that, in the opinion of the consultants, could be unconstitutional for being contrary to the principle of freedom of choice will be transcribed. The articles state the following:\n\n\"Article 2.- FREE PROVISION AND EFFECTIVE ACCESS\n\nThe mandatory nature and free provision of vaccines, as well as effective access to vaccination, is guaranteed to the entire population, especially for children, immigrants, and sectors below the poverty index.\"\n\n\"Article 3.- MANDATORY NATURE\n\nIn accordance with this Law, vaccinations against diseases are mandatory when deemed necessary by the National Commission for Vaccination and Epidemiology, created under this Law, in coordination with the Ministry of Health and the Costa Rican Social Security Fund...\"\n\n\"Article 6.- FUNCTIONS\n\nThe Commission shall have the following basic functions and objectives:\n\na) Guarantee the mandatory nature and free provision of vaccines and the effective access of the entire population to them...\"\n\n\"Article 11.- TARGET POPULATION, CONDITIONS, AND AUTHORIZATION\n\nThe Commission, together with the authorities of the Ministry of Health and the Costa Rican Social Security Fund, shall determine the population sectors that must be vaccinated; furthermore, it shall decide whether vaccination is mandatory or optional or shall stipulate under what conditions vaccines should be administered, in accordance with the programs established for this purpose...\"\n\nTaking into account the provisions of the transcribed norms, as well as the statement of motives for the bill under consultation, this Chamber does not consider that the consultants are correct in stating that establishing the mandatory nature of vaccines violates the right to freedom of choice. Health as a means and as an end for the personal and social fulfillment of man constitutes a human and social right whose recognition is beyond discussion. It is one of the rights of man that emanates from his dignity as a human being. From this right arises, for the individual and the organized community, as well as for the State itself, a responsibility regarding health. International instruments and constitutional declarations of social rights include the right to health, to whose recognition must be added the imposition of the duty to care for one's own health and that of others. Thus, within a global social policy aimed at solving the effects of social deficiencies, the observance of the principle of coherence of purposes dictates that actions concerning working conditions, social security, education, housing, nutrition, and population be harmonized with those of health, due to the interconnectedness and interdependence of one with the other. In this way, the enunciation in the consulted bill of the provision of free and mandatory medical assistance for the entire population in no way violates the principle of freedom of choice, but rather guarantees essential health care in safeguarding the inescapable responsibility of the State to watch over the health of each and every one of the citizens.\"\n\nLikewise, and particularly regarding the limitations that apply to other fundamental rights in relation to the right to life and health, this Court has established the following:\n\n\"Regarding the first issue, it must be indicated that, indeed, Constitutional Law expressly recognizes every person's right to freedom of thought, conscience, and religion. Even, in the specific case of children, Article 14 of the cited Convention on the Rights of the Child expressly establishes:\n\n\"Article 14\n\n1. States Parties shall respect the right of the child to freedom of thought, conscience, and religion.\n\n2. States Parties shall respect the rights and duties of the parents and, when applicable, legal guardians, to provide direction to the child in the exercise of his or her right in a manner consistent with the evolving capacities of the child.\n\n3. Freedom to manifest one's religion or beliefs may be subject only to such limitations as are prescribed by law and are necessary to protect public safety, order, health, or morals, or the fundamental rights and freedoms of others.\" (The underlining is not from the original).\n\nWith which it is confirmed that said numeral recognizes the possibility of imposing reasonable limits on the exercise of the referred rights to protect public health. In which case, it is worth reiterating that this Chamber has already recognized that safeguarding public health and preventing diseases constitutes a constitutionally legitimate purpose that can validly justify the mandatory nature of vaccines. Note that, in this case, the application of the referred vaccines is intended not only to protect the life and health of the protected minor, but also the life and health of other members of the community —including, especially, other children—, insofar as said vaccination plan seeks to avoid the potential risk of epidemic outbreaks of infectious diseases that can even cause permanent disabilities (e.g., congenital rubella) or death (e.g., measles) of infected persons, thus the preservation and safeguarding of public health is at stake.\n\nIt must therefore be recalled that this Chamber has emphasized: \"(…) The preponderance of life and health, as supreme values of individuals, is present and indicated as requiring mandatory protection from the State, not only in the Political Constitution, but also in various international instruments signed by the country such as the Universal Declaration of Human Rights, the American Convention on Human Rights, the American Declaration of the Rights and Duties of Man, and the International Covenant on Civil and Political Rights. The relevance of the values for which the plaintiff seeks protection must be clear, as well as the degree of commitment that the Costa Rican State has acquired to defend them in an unquestionable and unconditional manner. (judgment number 2000-01954 of 8:53 a.m. on March 3, 2000)\" (Judgment No. 2020-19433 of 9:20 a.m. on October 9, 2020)\n\nIn the sub examine, it has been demonstrated that both freedoms—thought and expression—like all fundamental rights, are not absolute. In any case, the challenged decree does not prevent, in any way, the freedom to seek, receive, and impart information and ideas of all kinds, even those contrary to vaccination against covid-19. And while the expression of these ideas cannot be exercised by opposing vaccination, the truth is that this is a reasonable limitation considering the State's need to protect the fundamental right to health of all persons and prevent diseases, which, as in this case, has had publicly verifiable devastating global effects. In judgment No. 2021-26519 of 1:10 p.m. on November 24, 2021, this Court reiterated that vaccination against covid-19 is a suitable measure that protects the civil servants themselves, helps achieve a prompt reactivation not only of health services but in general, reducing the inherent costs of the situation this pandemic has caused. Furthermore, it helps prevent any workplace from becoming a source of contagion, and to date, there is no other alternative or tool with equal or greater effectiveness to protect the health of the entire population. The claimant must consider that the benefits of the measure under study transcend society as a whole—regarding the right to life, health, and the improvement of economic and social conditions, as can be inferred from the reasoning provided in the regulatory framework in question—aspects that, as has already been indicated, outweigh the impact that a single worker might receive. Consequently, the point in question is rejected on its merits.\n\nX.- Regarding the alleged violation of the principle of legality and of laws subsequent to the Vaccine Law. The claimant argues that the principle of legality has been violated, since, in his view, the use of the term vaccine in the case of inoculation against covid-19 does not meet its main characteristic, which is to induce protective active immunity against the corresponding infectious disease, according to article 1, subsection p) of the Regulations to the National Vaccine Law (Reglamento a la Ley Nacional de Vacunas). They are forcing the population to submit to a live clinical trial without openly telling them that the vaccine profile is experimental, and without informed consent, in accordance with the Ethics Committees (Comités de Ética) and Principles of Good Clinical Practices (Principios de Buenas Prácticas Clínicas). He states that it is a vaccine profile without conclusive clinical studies, and that if the duration of effectiveness is unknown until the study is completed, contraindications, interactions, and adverse reactions cannot be accurately known either.\n\nIn this regard, it is necessary to reiterate that this Chamber has dismissed that Executive Decree No. 42889-S, modified by Decree No. 43249-S, violates the principle of legal reserve (principio de reserva de ley) in the regulation of fundamental rights, given that the mandatory application of the coronavirus COVID-19 vaccine was defined by the National Vaccination and Epidemiology Commission (Comisión Nacional de Vacunación y Epidemiologia), in accordance with the powers granted by the National Vaccination Law (Ley Nacional de Vacunación), which defines the general regulatory framework on the matter. In that sense, the decree challenged here is in compliance with existing regulations by including the vaccine in question in the national vaccination scheme authorized by law, so it also does not violate the principle of legality. It is also reiterated that the personnel to be vaccinated will be defined under the technical criteria of the Immunization Coordination (Coordinación de Inmunización) and Technical Secretary of the National Vaccination and Epidemiology Commission of the Health Surveillance Directorate (Dirección de Vigilancia de la Salud), the basis of which is not subject to review in this jurisdiction, as it involves technical, medical, and scientific aspects concerning vulnerability to a virus; and that it is also not a vaccine whose studies, regarding effects, are in an experimental phase. Therefore, the argument raised in that sense is dismissed, and it is reiterated to the claimant that if he disagrees with the criteria of the public authorities regarding such aspects, including calling it a \"vaccine,\" it is likewise a technical discussion that would not be appropriate to resolve in this jurisdiction, but rather through the legality proceeding (vía de legalidad), by means of the different evidentiary tools (medios de prueba) that this proceeding contemplates and that allows for its broad discussion and technical and scientific verification.\n\nOn the other hand, this Court has warned, on repeated occasions—see judgment 2021-11972 of 9:30 a.m. on May 26, 2021—that the apparent conflict between a legal norm and a decree involves a legality conflict (conflicto de legalidad), the discussion of which does not fall within this jurisdiction. Hence, the point raised by the claimant regarding the violation of other norms of lower rank than the Political Constitution must also be rejected.\n\nXI.- Regarding the alleged violation of the principles of conventionality, hierarchy of norms, and the jurisprudence of the Inter-American Court of Human Rights related to the right to life and informed consent.\n\nThe petitioner states that the challenged decree contravenes international legal instruments relating to Human Rights, such as articles 2, 5, 6, and 7 of the International Covenant on Economic, Social and Cultural Rights, article 12 of the Universal Declaration of Human Rights, and articles 1.2, 3, 4, and 5.1 of the American Convention on Human Rights, because mandating the covid-19 vaccine for workers, without prior, full, and free informed consent (consentimiento informado), and without respecting their autonomy of will, violates the physical integrity of persons. The international instruments in question state the following:\n\nOf the International Covenant on Economic, Social and Cultural Rights:\n\n\"Article 2\n1. Each State Party to the present Covenant undertakes to take steps, individually and through international assistance and co-operation, especially economic and technical, to the maximum of its available resources, with a view to achieving progressively the full realization of the rights recognized in the present Covenant by all appropriate means, including particularly the adoption of legislative measures.\n2. The States Parties to the present Covenant undertake to guarantee that the rights enunciated in the present Covenant will be exercised without discrimination of any kind as to race, colour, sex, language, religion, political or other opinion, national or social origin, property, birth or other status.\n3. Developing countries, with due regard to human rights and their national economy, may determine to what extent they would guarantee the economic rights recognized in the present Covenant to non-nationals.\"\n\n\"Article 5\n1. Nothing in the present Covenant may be interpreted as implying for any State, group or person any right to engage in any activity or to perform any act aimed at the destruction of any of the rights or freedoms recognized herein, or at their limitation to a greater extent than is provided for in the present Covenant.\n2. No restriction upon or derogation from any of the fundamental human rights recognized or existing in any country in virtue of law, conventions, regulations or custom shall be admitted on the pretext that the present Covenant does not recognize such rights or that it recognizes them to a lesser extent.\"\n\n\"Article 6\n1. The States Parties to the present Covenant recognize the right to work, which includes the right of everyone to the opportunity to gain his living by work which he freely chooses or accepts, and will take appropriate steps to safeguard this right.\n2. The steps to be taken by a State Party to the present Covenant to achieve the full realization of this right shall include technical and vocational guidance and training programmes, policies and techniques to achieve steady economic, social and cultural development and full and productive employment under conditions safeguarding fundamental political and economic freedoms to the individual.\"\n\n\"Article 7\nThe States Parties to the present Covenant recognize the right of everyone to the enjoyment of just and favourable conditions of work which ensure, in particular:\na) Remuneration which provides all workers, as a minimum, with:\ni) Fair wages and equal remuneration for work of equal value without distinction of any kind, in particular, women being guaranteed conditions of work not inferior to those enjoyed by men, with equal pay for equal work;\nii) A decent living for themselves and their families in accordance with the provisions of the present Covenant;\nb) Safe and healthy working conditions;\nc) Equal opportunity for everyone to be promoted in his employment to an appropriate higher level, subject to no considerations other than those of seniority and competence;\nd) Rest, leisure and reasonable limitation of working hours and periodic holidays with pay, as well as remuneration for public holidays.\"\n\nOf the Universal Declaration of Human Rights:\n\n\"Article 12\nNo one shall be subjected to arbitrary interference with his privacy, family, home or correspondence, nor to attacks upon his honour and reputation. Everyone has the right to the protection of the law against such interference or attacks.\"\n\nOf the American Convention on Human Rights:\n\n\"Article 1\nObligation to Respect Rights\n1. The States Parties to this Convention undertake to respect the rights and freedoms recognized herein and to ensure to all persons subject to their jurisdiction the free and full exercise of those rights and freedoms, without any discrimination for reasons of race, colour, sex, language, religion, political or other opinion, national or social origin, economic status, birth, or any other social condition.\n2. For the purposes of this Convention, \"person\" means every human being.\"\n\n\"Article 3\nRight to Juridical Personality\nEvery person has the right to recognition as a person before the law.\"\n\n\"Article 4\nRight to Life\n1. Every person has the right to have his life respected. This right shall be protected by law and, in general, from the moment of conception. No one shall be arbitrarily deprived of his life.\n2. In countries that have not abolished the death penalty, it may be imposed only for the most serious crimes and pursuant to a final judgment rendered by a competent court and in accordance with a law establishing such punishment, enacted prior to the commission of the crime. The application of such punishment shall not be extended to crimes to which it does not presently apply.\n3. The death penalty shall not be reestablished in states that have abolished it.\n4. In no case shall capital punishment be inflicted for political offenses or related common crimes.\n5. Capital punishment shall not be imposed upon persons who, at the time the crime was committed, were under 18 years of age or over 70 years of age; nor shall it be applied to pregnant women.\n6. Every person condemned to death shall have the right to apply for amnesty, pardon, or commutation of sentence, which may be granted in all cases. Capital punishment shall not be imposed while such a petition is pending decision by the competent authority.\"\n\n\"Article 5\nRight to Humane Treatment\n1.\n\nEvery person has the right to have their physical, psychological, and moral integrity respected.\"\n\nHaving reviewed the provisions of the instruments invoked by the petitioner cited supra, this Court considers it necessary to reiterate what was previously indicated, in the sense that the decree challenged here does not harm the right to life and health of persons; far from it, it seeks the greatest well-being of the general population. It was also clearly established that this is not a solution in an experimental phase. Thus, precisely, when weighing fundamental rights, the mandatory nature of vaccines to ensure the right to public health is neither unconstitutional nor harmful to the international instruments invoked. What was indicated by this Court in relation to the Ley General de Vacunación is reiterated in that regard:\n\n\"…Which confirms that said numeral recognizes the possibility of imposing reasonable limits on the exercise of the aforementioned rights to protect public health. In which case, it is worth reiterating that this Chamber has already recognized that safeguarding public health and preventing diseases constitutes a constitutionally legitimate purpose that can validly justify the mandatory nature of vaccines. Note that, in this case, the application of the aforementioned vaccines is intended not only to protect the life and health of the protected minor, but also the life and health of the other members of the community -including, especially, other children-, to the extent that said vaccination plan seeks to avoid the potential risk of epidemic outbreaks of infectious diseases that can even cause permanent disabilities (e.g., congenital rubella) or death (e.g., measles) of those infected, so the preservation and safeguarding of public health is at stake. It must therefore be remembered that this Chamber has highlighted: '(...) The preponderance of life and health, as supreme values of persons, is present and indicated as requiring obligatory protection by the State, not only in the Political Constitution, but also in various international instruments signed by the country such as the Universal Declaration of Human Rights, the American Convention on Human Rights, the American Declaration of the Rights and Duties of Man, and the International Covenant on Civil and Political Rights. It must be clear not only the relevance of the values for which the petitioner seeks protection, but also the degree of commitment that the Costa Rican State has acquired in terms of unquestionably and unconditionally coming to their defense.' (judgment number 2000-01954 of 8:53 a.m. on March 3, 2000)\" (Judgment No. 2020-19433 of 9:20 a.m. on October 9, 2020)\n\nIn the same vein, as stated, regarding the right to prior informed consent, \"there are sufficient provisions that legitimize the mandatory nature of the vaccine, so that autonomy, in such cases, is diminished in order to protect the general interest and welfare, namely, public health…\" (Judgment No. 2021-24027 of 10:10 a.m. on October 26, 2021). And it was likewise added: \"This does not preclude emphasizing that in all cases the right to information of all persons subjected to this mandatory vaccination must be respected.\" And for such purposes, reference was made to the Manual de Procedimientos for the execution of COVID-19 vaccination in the health establishments of the Caja Costarricense de Seguro Social, which precisely requires ensuring the right to information of users and exempting from vaccination those workers who present a medical contraindication. Certainly, the jurisprudence of the Inter-American Court of Human Rights provided by the petitioner refers to the need for informed consent before carrying out any medical act; however, the petitioner must note the context of such pronouncements, as they are based on ordinary situations and not on a pandemic as currently occurs, which implies a different assessment. The foregoing does not intend to harm the fundamental rights of workers, much less compel them to undergo any medical procedure, but rather, to protect them and safeguard their lives with a vaccine, in the face of a pandemic, which is not an ordinary situation, the effects of which transcend beyond one person or one family, but cross borders and have produced serious consequences worldwide given the high numbers of deaths and the conditions required to provide them proper medical attention in times of high or very high demand. Note that the provision in question aims at protecting collective health and the rights of others, among whom are included those who cannot be vaccinated for medical reasons. In that sense, the decree in question does not harm the principle of hierarchy of norms, as it does not contravene the provisions of international agreements, but rather applies their provisions in an integral and harmonious manner, seeking the exercise of the same without detriment to that upon which the exercise of all other human rights depends: life. Consequently, it is appropriate to reject on the merits the allegations of the petitioner.\n\nXII.- On the alleged violation of the principle of reasonableness and proportionality in the penalty for not getting vaccinated.\n\nIt is alleged that establishing sanctions such as dismissal without employer liability and/or an approximate fine of 500,000 colones, for failing to get vaccinated against COVID-19, violates the right to work and the principle of reasonableness and proportionality. It indicates that the authorities have in no way technically or scientifically substantiated the degree of efficacy of the vaccine in relation to preventing the spread of COVID-19, so it is not possible to assess the proportionality, necessity, and reasonableness of the measure that violates the principle of autonomy of will. On the other hand, it states that the sanctions for not getting vaccinated for public officials are disproportionate; they constitute blank criminal or administrative-penalty types, which contravene the principle of criminal legality and administrative-penalty legality. It indicates that the intention is to open administrative procedures aimed at dismissing public officials without employer liability who do not get vaccinated, or who do not provide information to the entity for which they work about whether they have been vaccinated or not, and whether they have the complete vaccination card or not. Additionally, public officials are threatened with the imposition of an approximate fine of 500,000 colones and the referral of the case to the Public Ministry to determine if a crime has been committed. In this way, it assures that workers are coerced into submitting to mandatory inoculation, despite their well-founded fears of suffering short or long-term damage to their health, due to the imminent disciplinary actions. It questions both the public order term on which the regulation is based and the sanctions for workers who do not get vaccinated.\n\nNotwithstanding the foregoing, the petitioner does not specify which regulatory provisions establish the sanctions whose proportionality he questions, which prevents this Court from ruling on the matter. Note that Decreto Ejecutivo N° 43249-S, challenged here and whose unconstitutionality was invoked in the underlying matter, reformed only Article 2 of Decreto Ejecutivo N° 42889-S of March 10, 2021, and from the text thereof, the sanctions challenged by the petitioner do not arise.\n\nDecreto Ejecutivo N° 43249-S, regarding which this action is brought, provides the following:\n\n\"Article 1.- Reforms Article 2 of Decreto Ejecutivo N° 42889-S of March 10, 2021, entitled Reform to Decreto Ejecutivo N° 32722-S of May 20, 2005, entitled Reglamento a la Ley Nacional de Vacunación and Establishment of the Mandatory Nature of the COVID-19 Vaccine, so that henceforth the following is stated:\n\n\"Article 2.- Based on Article 3 of the Ley Nacional de Vacunación, Law number 8111 of July 18, 2001, as well as numerals 2 and 18 of the Reglamento a la Ley Nacional de Vacunación, Decreto Ejecutivo number 32722 of May 20, 2005, the COVID-19 vaccine shall be mandatory for the personnel established by the Comisión Nacional de Vacunación y Epidemiología, in extraordinary sessions number VII-2021 of February 16, 2021, VIII-2021 of February 23, 2021, and N° XLV-2021 of September 23, 2021; in the case of this last agreement, it shall be under the terms set by the Comisión Nacional de Vacunación y Epidemiología for the public sector and the private sector.\n\nWhen summoned by those in charge for such purpose and according to the respective institutional planning, the persons contemplated in the preceding paragraph must get vaccinated, with the exception of those officials who, due to a duly declared medical contraindication, cannot receive the COVID-19 vaccine. It shall be the employer's responsibility to take the corresponding measures in accordance with the country's legislation and institutional regulations, in the case of workers who do not wish to get vaccinated against COVID-19.\"\n\nBy virtue of the foregoing, the lack of precision by the petitioner entails a material impossibility for this Court to rule, and regarding such extreme, it is appropriate to reject the action outright.\n\nXIII.- As a corollary to the foregoing, it is appropriate to reject on the merits the action regarding the alleged violation of the principles of informed consent, hierarchy of norms, conventionality, legal reserve, and informational self-determination; and the right to life and health. In all other respects, the action is rejected outright.\n\nXIV.- SEPARATE NOTE BY JUDGE CASTILLO VÍQUEZ. I concur with my colleagues in the arguments they put forward to reject the action outright, since there is no evident and manifest contradiction between the law and the decree being challenged. The Court's position, in the sense that when a regulatory norm violates or exceeds what is provided in a law, it is a matter of legality, the discussion of which does not correspond to this jurisdiction, is generally legally correct. There is no doubt that it is the ordinary judge who is competent to determine the scope of the interpretation and application of the Law and, consequently, it is they who are called to establish whether a regulatory norm violates or not the legal norm. However, there is an important nuance in this matter, which is that, from my point of view, when there is manifest evidence, obvious at first glance, that the regulatory norm exceeds, suppresses, or contradicts the text of the Law – there is no doubt that the principle of force, authority, or efficacy of the Law is grossly violated; a principle that has constitutional coverage and must be protected by this Court.\n\nAs is well known, the principle of force, authority, or efficacy of law refers us to the power (active force), the resistance (passive force), and the regime of challenge of the Law. Based on the first aspect of the concept, the Law, once it enters into force, repeals or modifies any norm of equal or lower rank. Based on the second, the Law cannot be repealed or modified by a norm of lower rank. Finally, based on the third, the Law can only be challenged for reasons of unconstitutionality and, therefore, can only be annulled through a resolution of the Constitutional Chamber.\n\nXV.- DISSENTING VOTE OF JUDGE RUEDA LEAL. I separate myself from the criterion of the majority of this Court and dissent from the vote on this matter, considering that the decision to reject this action of unconstitutionality outright is premature. As I have expressed on multiple occasions (votes No. 2021-26494 of 9:20 a.m. on November 24, 2021, 2021-26488 of 9:20 a.m. on November 24, 2021, 2021-25377 of 9:20 a.m. on November 10, 2021, 2021-18405 of 10:05 a.m. on August 18, 2021, among others), it is unquestionable that the action of unconstitutionality is a process, \"established for the purpose of guaranteeing the supremacy of the Political Constitution over norms or other provisions of a general nature and that for this very reason a set of formalities must be complied with, so that the Chamber can validly hear the merits of the challenge,\" as has been indicated in the extensive jurisprudence of this Chamber. However, it is precisely the law itself that orders the treatment to be given to the different formalities and their eventual non-compliance, as extracted from the text of Article 80 of the Ley de la Jurisdicción Constitucional which states:\n\n\"Article 80.- If the formalities referred to in the two previous articles are not fulfilled, the President of the Chamber shall indicate, by resolution, which are the omitted requirements and shall order compliance within three days (…)\"\n\nIn this matter, among other requirements, an adequate and sufficient basis is lacking, as required by Article 79 of the Ley de la Jurisdicción Constitucional, so the application of the prevention order to the petitioner to remedy the detected omission is unquestionable. Likewise, it is by no means superfluous to state that – in my opinion – the interpretation of Articles 78 and 79 as well as of Article 80 itself of the Law governing this jurisdiction must be broad in benefit of those who come before this Chamber, so that access to constitutional justice is not unnecessarily limited. This being the case, for reasons of form and without referring to the merits of the matter, I dissent and order that the cited prevention order be issued.\n\nXVI.- Documentation provided to the case file. The parties are warned that if they have provided any document on paper, as well as objects or evidence contained in any additional electronic, computer, magnetic, optical, telematic device, or produced by new technologies, these must be withdrawn from the office within a maximum period of 30 business days counted from the notification of this judgment. Otherwise, all material not withdrawn within this period will be destroyed, in accordance with the provisions of the \"Reglamento sobre Expediente Electrónico ante el Poder Judicial\", approved by the Corte Plena in session N° 27-11 of August 22, 2011, Article XXVI and published in the Boletín Judicial number 19 of January 26, 2012, as well as the agreement approved by the Consejo Superior del Poder Judicial, in session N° 43-12 held on May 3, 2012, Article LXXXI.\n\nTherefore:\n\nThe action is rejected on the merits regarding the alleged violation of the principles of informed consent, hierarchy of norms, conventionality, legal reserve, and informational self-determination; and the right to life and health. In all other respects, the action is rejected outright. The intervention as coadjuvant is rejected. Judge Castillo Víquez records a note.\n\nFor reasons of form and without addressing the merits, Judge Rueda Leal dissents and orders the prevention set forth in Article 80 of the Ley de la Jurisdicción Constitucional." }