Mandatory COVID-19 vaccination for public employees and confidentiality of vaccination dataObligatoriedad de la vacuna COVID-19 para funcionarios públicos y confidencialidad de los datos

27132-21. HEALTH. PRIVACY. INFORMATION. LABOR. ON MANDATORY VACCINATION AGAINST COVID-19 FOR PUBLIC OFFICIALS AND THE CONFIDENTIALITY OF DATA RELATED TO IT. INFORMATION ON COVID-19 VACCINATION IS A PERSONAL DATA OF RESTRICTED ACCESS BECAUSE IT IS OF INTEREST ONLY TO ITS HOLDER OR TO THE PUBLIC ADMINISTRATION. LEGITIMACY OF THE EMPLOYER TO REQUEST PROOF OF THE COVID-19 VACCINATION SCHEDULE. POSSIBILITY FOR WORKERS TO JUSTIFY THEIR REFUSAL TO RECEIVE THE VACCINE BY VIRTUE OF MEDICAL CONTRAINDICATIONS. THE PETITION IS DECLARED WITHOUT MERIT. VCG01/2022 “(…) I.- Purpose of the appeal. The appellant expresses her disagreement regarding the mandatory nature of the COVID-19 vaccine for the entire public and private sector, ordered through Executive Decree No. 43249-S.

II.- Proven facts. Of importance for the decision on this matter, the following facts are deemed duly proven: a) the appellant holds a regular status in the position class of Civil Service Professional 1 B (Service Management Degree) / Interdisciplinary Teams / Social at the San Felipe educational center of Circuit 06 of the San José Central Regional Directorate of Education (report rendered under oath); b) in accordance with Executive Decree No. 43249-S dated October 7, 2021, published in Supplement No. 206 to Gazette No. 196 of October 12, 2021, which amends the Regulations to the National Vaccination Law of Costa Rica, the mandatory nature of the cited vaccine is stipulated for all public sector officials (evidence provided); c) Decree 43249-S regulated that “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 be vaccinated against COVID-19”. Thus, as the present ministerial instance falls within the scope of the public sector regulated by the cited norm and is also governed by the statutory regime for which the Dirección General de Servicio Civil is constituted as the governing body for human resources in the Civil Service Regime, said Directorate issued instructions through Circular No. DG-015-2021 dated October 21 of the current year, which in pertinent part states: “…the following guideline is issued for application by the Human Resources Offices under its legal scope: The Human Resources Chiefs delegated by this General Directorate are instructed that all personnel appointments, promotions, and their extensions shall be approved only if the official subject to the change meets the requirements for it, and also has completed vaccination against Covid-19 or, failing that, is in the process of completing it, in accordance with the appointment scheduling made by the Caja Costarricense de Seguro Social through its competent bodies. The ORH must ensure compliance with this provision by the means it deems pertinent. If a refusal to vaccinate is encountered by a candidate for entry into any institution of the Civil Service Regime, the respective ORH must desist from the change…” (report rendered under oath); d) the Human Resources Directorate of the Ministerio de Educación Pública is in the gradual development of measures regarding what was instructed by the Dirección General de Servicio Civil concerning personnel changes corresponding to personnel appointments, promotions, and their extensions, which will be carried out only if the official subject to a referenced change meets the requirements for it, and also has completed vaccination against Covid-19 or, failing that, is in the process of completing it or demonstrates a duly declared medical contraindication that makes it impossible for them to receive the Covid-19 vaccine, a situation for which the information provided by the user to the Human Resources Directorate or to the deconcentrated dependencies has confidential treatment, in order to comply with what is required by the governing body in case of being under the referenced assumptions (report rendered under oath); e) given the measures that, as an employer, are being developed in the Ministerio de Educación Pública regarding compliance with what is regulated in Decree No. 43249-S, they are in the process of construction, in observance of the country's legislation and institutional regulations, by reason of the principle of legality (report rendered under oath).

III.- Unproven facts. The following facts of relevance to this resolution are not deemed proven: That the appellant suffers from any ailment or illness that makes it impossible for her to be vaccinated.

IV.- On the specific case. On the regulatory framework governing this matter. In the first place, the Civil Code provides the following:

“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 emphasis is not in the original).

The General Health Law, in relation to the powers of the Minister of Health, orders the following:

“Art. 345. 3. Declare mandatory vaccination against certain diseases as well as certain examinations or practices deemed necessary to prevent or control diseases”.

Moreover, regarding the obligations of the administered, the referred law indicates the following:

“Art. 147.- Every person must comply with the legal or regulatory provisions and practices aimed at preventing the appearance and spread of communicable diseases.

Is especially obligated to comply:

(…)

The preventive measures that the health authority orders when a disease arises”.

Vaccination is precisely a preventive measure to prevent the spread of a communicable disease.

Article 3 of the National Vaccination Law states:

“(…) In accordance with this Law, vaccinations against diseases are mandatory when deemed necessary by the National Vaccination and Epidemiology Commission, created in this Law, in coordination with the Ministry of Health and the Caja Costarricense de Seguro Social.

The approved vaccines must be supplied and applied to the population, without being able to allege economic reasons or lack of supply in the health services provided by state institutions.

These approved vaccines refer to the official basic schedule applied to the entire population, and to the vaccines for special schedules directed at specific risk groups.

The National Vaccination and Epidemiology Commission must prepare an official list of vaccines, which shall be included in the Regulations of this Law. The list may be reviewed and analyzed periodically, taking into account the frequent technological changes in this field (…)” (the emphasis is not in the original).

In line with this, Article 6 of the same regulatory body, in subsections a), b), and e), recognizes as functions and objectives of the National Vaccination and Epidemiology Commission:

“(…) a) Guarantee the mandatory nature and gratuitousness 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 schedules and vaccines referred to in Article 3 of this Law (…)”.

In light of the foregoing, it is not possible to affirm that the principle of legal reservation in the regulation of fundamental rights has been violated, since the mandatory application of the coronavirus COVID-19 vaccine in public officials was defined by the National Vaccination and Epidemiology Commission, in accordance with the powers granted by the National Vaccination Law. This led to the issuance of Executive Decree No. 43249-S dated October 7, 2021, published in Supplement No. 206 to Gazette No. 196 of October 12, 2021, which amends the Regulations to the National Vaccination Law of Costa Rica, stipulating the mandatory nature of the cited vaccine for all public sector officials. Thus, the inclusion of the coronavirus COVID-19 vaccine in the national vaccination schedule and its mandatory nature for public officials must be understood in light of the provisions of the National Vaccination Law, which defines the general regulatory framework in the matter.

V.- It should be highlighted that mandatory vaccination for COVID-19 cases is not absolute, but rather, as noted, the decree itself contemplates the possibility of a person presenting 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 Caja Costarricense de Seguro Social”, in which what the medical contraindications for vaccination are have been precisely explained. In the first version of said manual, the following contraindications were noted:

“ Do not administer the Pfizer-BioNTech COVID-19 vaccine:

-To persons with a history of a moderate or severe allergic reaction to any of the components of the Pfizer-BioNTech COVID-19 vaccine.

-To persons with a history of a documented moderate or severe allergic reaction to foods, medications, or vaccines; unless they have a referral from a specialist physician indicating that they can be vaccinated.

If there is an indication to vaccinate, this will be carried out at intramural vaccination sites, with access to emergency services in case of requiring anaphylaxis treatment.

-Do not administer in Pregnancy or Lactation.

-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.” In the 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:

“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 a documented moderate or severe allergic reaction to foods, medications, or vaccines; unless they have a referral 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 of requiring anaphylaxis treatment. - 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 have with this intervention, the CNVE agreed that they must be informed that there are no studies in that population and that the risks of applying the vaccine are therefore unknown, and that to proceed with vaccination, the corresponding document must be signed evidencing that they have received the necessary information from the health personnel for the decision-making to be vaccinated, assessing risk/benefit. They do not need to present breastfeeding certificates, nor should they stop breastfeeding their son or daughter. They can be administered the AstraZeneca vaccine or the Pfizer vaccine according to availability at the respective vaccination site.

(…)

Persons receiving the first dose of the COVID-19 vaccine from AstraZeneca must complete the schedule 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 have with this intervention, the CNVE agreed that they must be informed that there are no studies in that population and that the risks of applying the vaccine are therefore unknown, and that to proceed with vaccination, the corresponding document must be signed evidencing that they have received the necessary information from the health personnel for the decision-making to be vaccinated, assessing risk/benefit. They do not need to present LM certificates, nor should they stop breastfeeding their son or daughter. They can be administered the AstraZeneca vaccine or the Pfizer vaccine according to availability at the respective vaccination site.” That is to say, the officials and the physicians examining them could determine when one is in the presence of conditions that medically advise against vaccination. Furthermore, although there might be some margin of doubt about the duration of the vaccine's efficacy or the period of protection it offers, this is not a legitimate reason to reject immunization. What is significant is that, based on the foregoing, elements are accredited to make operational the possibility for people to allege medical contraindications to reject the vaccine in question and, in this way, protect their right to health. But in the specific case, it does not appear that the appellant has manifested any specific clinical condition that justifies the exception.

VI.- Likewise, this Court cannot ignore the evidence provided in other amparo appeals, which are applicable to the specific case, for example, case files 21-008192-0007-CO and 21-008767-0007-CO (held 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 executive decree No. 42889-S on the mandatory nature of the COVID-19 vaccine for health personnel.

Said circular consists of several stages. For example, it reiterates that workers must be vaccinated, with the exception of those officials who, due to a duly declared medical contraindication, cannot receive the vaccine. Additionally, 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 of the workers; and 3) the determination of responsibilities. In said phase, the justifications by the worker are examined, the report of a clinical team formed by the comprehensive worker care physician and the immunization officer, to finally assess the possibility of opening an administrative procedure. By virtue of the foregoing, a margin is also accredited for workers to justify to the employer instances the refusal to receive vaccination by virtue of medical contraindications.

In conclusion, it is clear that the regulatory framework is sufficient and reasonable, and its respect seeks to guarantee the health of singular persons and public health.

VII.- On the other hand, it is verified that the decision to vaccinate public officials and employees as well as the rest of the population is based on a technical criterion from the Immunization Coordination and Technical Secretary of the National Vaccination and Epidemiology Commission of the Health Surveillance Directorate, which was communicated to the Ministry of Education. Thus, this criterion cannot be questioned by this Constitutional Chamber, as it exceeds its competencies. Note that, by means of Ruling No. 2021-000871 at 09:15 hours on January 15, 2021, this Constitutional Chamber established the following: “it does not correspond to this Chamber to determine the appropriateness or not of the application of the vaccination schedule in relation to Covid-19, as it refers to technical, medical, and scientific aspects concerning vulnerability to a virus (…)”. In this way, this Court reiterates that it does not correspond to it to determine the appropriateness or not of the application of the vaccination schedule in relation to Covid-19, as it refers to technical, medical, and scientific aspects concerning vulnerability to a virus.

VIII.- ON THE CONFIDENTIALITY OF DATA RELATED TO COVID-19 VACCINATION.- Now, in the case under study, the appellant also questions that as an official of the respondent Ministry, she must provide information on vaccination against Covid-19, however she considers that the established procedure is violative of her right to privacy, to privacy, as it is in her opinion sensitive data. As a starting point, it is necessary to indicate that by means of executive decree No. 42889-S, the State ordered the mandatory nature of vaccination against COVID-19, and in Ruling No. 2020-0019433, at 09:20 hours on October 9, 2020, the Chamber clearly referred to the general legitimacy of the purpose pursued by establishing the mandatory nature of a vaccine, and indicated that:

“(…) this Chamber has recognized, firstly, the importance of vaccination as part of the essential health assistance that the Costa Rican State must guarantee in order to protect the fundamental right to health of all persons, and, secondly, that safeguarding public health and preventing diseases constitutes a constitutionally legitimate purpose that can validly justify the mandatory nature of vaccines (…)” (the emphasis is not in the original).

By virtue of that, and in compliance with what is instructed in Vaccination Law No. 8111, of July 18, 2002 and executive decree No. 43249-S published in Gazette No. 206 of October 12, 2021, the mandatory nature of the COVID 19 vaccine is established for all public officials. Furthermore, Article 152 of the General Health Law indicates that it is mandatory for every person to present vaccination certificates when the authority so determines. Therefore, regarding this aspect, the respondent acted in accordance with the principle of legality or juridicity enshrined in Article 11 of the Political Constitution, which means that the acts and behaviors of the Administration must be regulated by written norm, which implies, of course, submission to the Constitution, to the law, and in general to all the norms of the legal system. For this reason, public institutions can only act to the extent that they are empowered to do so by the same legal system and normally by express text, consequently they are only allowed what is expressly constitutionally and legally authorized and everything that is not authorized to them is prohibited. In that sense, the respondent authority in its capacity as employer is legitimized to request proof of the Covid-19 vaccination schedule carried out on the appellant and other employees of the Institution, regarding which the authorities of the Ministerio de Educación Pública inform under oath that as an employer they are developing the forms of verification regarding compliance with what is regulated in Decree No. 43249-S, which are in the process of construction. Thus, regarding this aspect, the respondent authority has not injured any fundamental right of the appellant, and it is appropriate to declare this aspect of the appeal without merit.

IX.LEGAL NATURE OF THE INFORMATION CONTAINED IN THE COVID-19 VACCINATION CARD. Additionally, the claim raised by the appellant lies in the access to the appellant's personal data and the treatment and registration mechanism that the respondent Administration uses to achieve that obligation. Indeed, information relating to the clinical history of the diseases a person suffers from as well as the medical opinion or epicrisis have been classified as sensitive data of restricted access. Note that the Law for the Protection of the Person Regarding the Processing of Their Personal Data No. 8968, in its Article 3, subsection e), establishes:

“ For the purposes of this law, the following is defined: (…) e) Sensitive data: information relating to the intimate sphere of the person, such as that which reveals racial origin, political opinions, religious or spiritual convictions, socioeconomic condition, biomedical or genetic information, sexual life and orientation, among others”.

In turn, Article 9, in pertinent part, indicates:

“Article 9.- Particular categories of data.

In addition to the general rules established in this law, for the processing of personal data, the particular categories of data to be mentioned shall be governed by the following provisions:

1.- Sensitive data. No person shall be obliged to provide sensitive data. The processing of personal data revealing racial or ethnic origin, political opinions, religious, spiritual, or philosophical convictions, as well as those relating to health, sexual life, and orientation, among others, is prohibited.

(…)

2.- Personal data of restricted access. Personal data of restricted access are those that, even forming part of records of public access, are not of unrestricted access because they are of interest only to their holder or to the Public Administration. Their processing shall only be permitted for public purposes or if the express consent of the holder is obtained (…)”.

It is indubitable that data referring to a person's health status are considered, in principle, intimate, reserved against the action and knowledge of others, which is what preserves the right to privacy contained in Article 24 of the Political Constitution. The foregoing because information relating to a person's physical or psychic health constitutes an important element of their private life, which attributes to its holder the power to safeguard that reserved sphere for themselves, from unwanted publicity. In principle, they cannot be forced, without any justification or legal mandate, to disseminate data that affect, in a broad sense, their health. However, this subjective right, like all others and without exception, can be limited when it is necessary to preserve other constitutional rights and assets, such as the presence of other general interests like epidemiological studies, situations of serious risk to the health of the community, among others. In any case, the possible limitations of the fundamental right to personal privacy must be based on a legal provision that has constitutional justification, is proportionate, and precisely expresses each and every one of the material presuppositions of the limiting measure. In that sense and regarding what concerns us for the case under study, the Chamber has recognized, firstly, the importance of vaccination as part of the essential health assistance that the Costa Rican State must guarantee in order to protect the fundamental right to health of all inhabitants; secondly, that safeguarding public health and preventing diseases constitutes a constitutionally legitimate purpose that can validly justify the mandatory nature of vaccines; and third, it is mandatory for every person to present vaccination certificates when the authority so determines. Along those lines, the appellant is not correct in indicating that declaring information related to Covid-19 vaccination, issued by the Caja Costarricense de Seguro Social, contains sensitive data, because the information required by the respondent authority constitutes data of the mandatory vaccination schedule carried out by the amparo petitioner, endorsed in Article 150 of the General Health Law, which establishes the obligation of vaccination and revaccination against communicable diseases; and Article 152 of the same regulatory body, which provides the duty for every person to present vaccination certificates when the authority so determines. Thus, the measure taken by the respondent authority is necessary and proportionate to the purpose established by the legal system and does not affect the legal sphere of the amparo petitioner, since every person subject to mandatory vaccination is obliged to show proof that they carried it out. Consequently, the Covid-19 vaccination cards issued by the Caja Costarricense de Seguro Social constitute a mechanism of information that the person received a number of doses of the Covid-19 vaccine, and this does not fall within the conceptualization of biomedical or genetic information or information about health, so it does not qualify as sensitive data, but rather is personal data of restricted access because it is of interest only to its holder or to the Public Administration. Thus, having declared the vaccine mandatory, it is the duty of the amparo petitioner, and of all citizens, to demonstrate to the public administration when so required, that they have complied with what is instructed by the legal system, and this does not constitute a violation of the right to privacy. In this context, the respondent has not injured any fundamental right of the appellant.

X.- Conclusion. In virtue of the foregoing, it is necessary to declare the appeal without merit. (…)” Given the above, since this ministerial proceeding falls within the public-sector scope regulated by the cited norm and is also governed by the statutory regime for which the Dirección General de Servicio Civil is constituted as the governing body for human resources in the Civil Service Regime (Régimen de Servicio Civil), said Directorate issues instructions through Circular No. DG-015-2021 dated October 21 of the current year, which in its relevant part reads: “…the following directive is issued for application by the Human Resources Offices under its legal scope: The Chiefs of Human Resources delegated by this Dirección General are instructed that all personnel appointments, promotions, and their extensions shall be approved provided that the public servant subject to the action meets the requirements for it, and also has completed vaccination against Covid-19 or, failing that, is in the process of completing it, in accordance with the appointment schedule assigned to them by the Caja Costarricense de Seguro Social through its competent bodies. The ORH must ensure compliance with this provision by the means it deems pertinent. Should a refusal to vaccinate be encountered on the part of any candidate for entry into a Civil Service Regime institution, the respective ORH must desist from the action…” (report rendered under oath); d) the Dirección de Recursos Humanos of the Ministerio de Educación Pública is gradually developing measures regarding what was instructed by the Dirección General de Servicio Civil concerning personnel actions corresponding to personnel appointments, promotions, and their extensions, which shall be carried out provided that the public servant subject to any referenced action meets the requirements for it, and also has completed vaccination against Covid-19 or, failing that, is in the process of completing it or demonstrates a duly declared medical contraindication that makes it impossible for them to receive the vaccine against Covid-19, a situation in which the information provided by the user to the Dirección de Recursos Humanos or to the deconcentrated offices is treated confidentially, in order to comply with what is required by the governing body should they fall under the referenced scenarios (report rendered under oath); e) regarding the measures being developed as an employer by the Ministerio de Educación Pública concerning compliance with what is regulated in Decreto N°43249-S, these are under construction, in observance of the country's legislation and institutional regulations, by reason of the principle of legality (report rendered under oath).

III.- Facts not proven. The following facts of relevance to this resolution are not considered proven: That the appellant suffers from any condition or illness that prevents her from being vaccinated.

IV.- On the specific case. On the regulatory framework governing this matter. First, the Civil Code provides the following:

“Art. 46.- Every person may refuse to be subjected to 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 emphasis does not correspond to the original).

The Ley General de Salud, in relation to the powers of the Minister of Health, orders the following:

“Art. 345. 3. To declare vaccination against certain diseases mandatory, as well as certain examinations or practices deemed necessary to prevent or control diseases.” Furthermore, regarding the obligations of the governed, the referenced law states the following:

“Art. 147.- Every person must comply with the legal or regulatory provisions and practices intended to prevent the emergence and spread of communicable diseases. It is especially obligated to comply: (…) With the preventive measures that the health authority orders when a disease appears.” Vaccination is precisely a preventive measure to prevent the spread of a communicable disease.

Article 3 of the Ley Nacional de Vacunación states:

“(…) In accordance with this Law, vaccinations against diseases are mandatory when deemed necessary by the National Commission for Vaccination and Epidemiology (Comisión Nacional de Vacunación y Epidemiología), created by this Law, in coordination with the Ministry of Health and the Caja Costarricense de Seguro Social. The approved vaccines must be supplied and administered to the population, without being able to invoke economic reasons or lack of supply in the health services provided by state institutions. These approved vaccines refer to the official basic scheme applied to the entire population, and to vaccines for special schemes directed at specific risk groups. The National Commission for Vaccination and Epidemiology must prepare an official list of vaccines, to be included in the Regulation of this Law. The list may be periodically reviewed and analyzed, taking into account the frequent technological changes in this field (…)” (the emphasis does not belong to the original).

In line with this, Article 6 of the same regulatory body, in its subsections a), b), and e), recognizes the following as functions and objectives of the Commission for Vaccination and Epidemiology:

“(…) a) Guarantee the mandatory nature and free provision 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 (…).” In light of 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 for public servants was defined by the National Commission for Vaccination and Epidemiology, in accordance with the powers granted by the Ley Nacional de Vacunación. This led to the issuance of Executive Decree No. 43249-S (Decreto Ejecutivo No.43249-S) dated October 7, 2021, published in Supplement No. 206 to the Gazette No. 196 of October 12, 2021, which modifies the Regulation of the Ley Nacional de Vacunación of Costa Rica, stipulating the mandatory nature of the cited vaccine for all public sector employees. Thus, the inclusion of the vaccine against the coronavirus COVID-19 in the national vaccination schedule and its mandatory nature for public servants must be understood in light of the provisions of the Ley Nacional de Vacunación, which defines the general regulatory framework in the matter.

V.- It should be highlighted that mandatory vaccination for COVID-19 scenarios is not absolute; rather, as noted, the decree itself contemplates the possibility of the person presenting a medical contraindication. It must 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 precisely the medical contraindications for vaccination have been explained. The first version of said manual listed the following contraindications:

“ Do not administer the Pfizer-BioNTech COVID-19 vaccine: -To persons with a history of a moderate or severe 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 referral from a specialist doctor indicating they can be vaccinated. In the event 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. -Do not administer during Pregnancy or Lactation. -Do not administer the second dose to patients who experienced a mild, moderate, or severe allergic reaction during the application of the first dose of this vaccine.” In the Manual (Code GM-DDSS-ASC-SAVE-18122020, version 07) of June 2021, with the update of authorized vaccines in our country, the following was provided:

“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 referral from a specialist doctor indicating they can be vaccinated. In the event 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 -Breastfeeding • Note: In the case of women from any of the prioritization groups who are in a period of breastfeeding and wish to be vaccinated for the benefit they may obtain from this intervention, the CNVE agreed that they must be informed that no studies exist in that population and that the risks of applying the vaccine are therefore unknown, and that in order to proceed with vaccination, the corresponding document must be signed evidencing that they have received the necessary information from health personnel to make the decision to vaccinate, assessing risk/benefit. It is not necessary to present breastfeeding certificates, nor must they stop breastfeeding their child. They may be administered the AstraZeneca vaccine or the Pfizer vaccine depending on availability at the respective vaccination site. (…) Persons receiving the first dose of the AstraZeneca COVID-19 vaccine must complete the schedule 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 in a period of breastfeeding and wish to be vaccinated for the benefit they may obtain from this intervention, the CNVE agreed that they must be informed that no studies exist in that population and that the risks of applying the vaccine are therefore unknown, and that in order to proceed with vaccination, the corresponding document must be signed evidencing that they have received the necessary information from health personnel to make the decision to vaccinate, assessing risk/benefit. It is not necessary to present breastfeeding certificates, nor must they stop breastfeeding their child. They may be administered the AstraZeneca vaccine or the Pfizer vaccine depending on availability at the respective vaccination site.” That is, the employees and the doctors examining them may determine when conditions are present that medically advise against vaccination. Furthermore, although there might be some margin of doubt regarding the duration of the vaccine's efficacy or the protection period it offers, this does not constitute a legitimate reason to reject immunization. What is significant is that, based on the above, elements are established to make operational the possibility for individuals to claim medical contraindications to refuse the vaccine in question, and thereby protect their right to health. However, in the specific case, there is no record that the appellant has expressed any specific clinical condition that justifies the exception.

VI.- Likewise, this Tribunal cannot ignore the evidence provided in other amparo appeals, which are applicable to the specific case, for example, case files 21-008192-0007-CO and 21-008767-0007-CO (held 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 executive decree No. 42889-S on the mandatory nature of the COVID-19 vaccine for health personnel.

Said circular provides for several stages. For example, it reiterates that workers must be vaccinated, with the exception of those employees who, due to a duly declared medical contraindication, cannot receive the vaccine. Furthermore, in the event of refusal, the authorities must follow a series of steps: 1) a warning to the employee; 2) an analysis of the occupational health conditions of each worker; and 3) a determination of responsibilities. In that phase, the justifications provided by the worker are examined, along with the report from a clinical team composed of the comprehensive worker care physician and the immunization officer, in order to finally assess the possibility of opening an administrative procedure. By virtue of the above, a margin is also established for workers to justify the refusal to receive the vaccination to their employer's bodies based on medical contraindications.

In conclusion, it is clear that the regulatory framework is sufficient and reasonable, and its observance seeks to guarantee the health of individuals and public health.

VII.- Furthermore, it is verified that the decision to vaccinate public servants as well as the rest of the population is based on a technical criterion from the Immunization Coordination and Technical Secretary of the National Commission for Vaccination and Epidemiology of the Health Surveillance Directorate, which was communicated to the Ministerio de Educación. Thus, this criterion cannot be questioned by this Constitutional Chamber (Sala Constitucional), as it exceeds its powers. Note that, through Judgment No. 2021-000871 of 09:15 hours on January 15, 2021, this Constitutional Chamber established the following: “it does not correspond to this Chamber to determine the appropriateness or not of the application of the vaccination schedule regarding Covid-19, as it refers to technical, medical, and scientific aspects concerning vulnerability to a virus (…)”. In this way, this Tribunal reiterates that it is not within its purview to determine the appropriateness or not of the application of the vaccination schedule regarding Covid-19, as it refers to technical, medical, and scientific aspects concerning vulnerability to a virus.

VIII.- ON THE CONFIDENTIALITY OF DATA RELATED TO COVID-19 VACCINATION.- Now, in the case under study, the appellant also questions that, as an employee of the respondent Ministry, she must provide information on vaccination against Covid-19; however, she considers that the established procedure violates her right to intimacy and privacy, as it involves, in her view, "sensitive data." As a starting point, it is necessary to indicate that through executive decree No. 42889-S, the State provided for the mandatory nature of the COVID-19 vaccine, and in Judgment No. 2020-0019433, of 09:20 hours on October 9, 2020, the Chamber clearly referred to the general legitimacy of the purpose pursued by establishing the mandatory nature of a vaccine, and indicated that:

“(…) this Chamber has recognized, first, the importance of vaccination as part of the essential health assistance that the Costa Rican State must guarantee in order to protect the fundamental right to health of all persons, and, second, that protecting public health and preventing disease constitutes a constitutionally legitimate purpose that can validly justify the mandatory nature of vaccines (…)” (the emphasis does not belong to the original).

By virtue of this, and in compliance with what is instructed in the Ley de Vacunación No. 8111, of July 18, 2002, and executive decree No. 43249-S published in Gazette No. 206 of October 12, 2021, the mandatory nature of the COVID-19 vaccine is established for all public servants. Additionally, Article 152 of the Ley General de Salud indicates that it is mandatory for every person to present vaccination certificates when the authority so determines. Thus, regarding this point, the respondent party acted in accordance with the principle of legality or juridical nature enshrined in Article 11 of the Political Constitution, which means that the acts and behaviors of the Administration must be regulated by written norms, which implies, of course, subjection to the Constitution, to the law, and in general to all norms of the legal system. For this reason, public institutions may only act insofar as they are empowered to do so by the system itself and normally by express text; consequently, they are only permitted what is constitutionally and legally authorized expressly, and everything that is not authorized to them is prohibited. In that sense, the respondent authority, in its capacity as employer, is legitimated to request proof of the Covid-19 vaccination schedule administered to the appellant and other employees of the Institution; in this regard, the authorities of the Ministerio de Educación Pública report under oath that as an employer, they are developing the methods of verification regarding compliance with what is regulated in Decreto No. 43249-F, which are under construction. Thus, regarding this point, the respondent authority has not violated any fundamental right of the appellant, and it is appropriate to dismiss this point of the appeal.

IX.LEGAL NATURE OF THE INFORMATION CONTAINED IN THE COVID-19 VACCINATION CARD.- Additionally, the claim raised by the appellant concerns the access to her personal data and the processing and registration mechanism that the respondent Administration uses to fulfill that obligation. Indeed, information relating to a person's clinical history of diseases suffered, as well as the medical assessment or epicrisis, have been classified as sensitive data with restricted access. Note that the Law on the Protection of Persons Regarding the Processing of Their Personal Data No. 8968 (Ley de Protección de la persona frente al tratamiento de sus datos personales n° 8968), in its Article 3, subsection e), establishes:

“For the purposes of this law, the following is defined: (…) e) Sensitive data: information relating to the intimate sphere of the person, such as that which reveals racial origin, political opinions, religious or spiritual convictions, socioeconomic status, biomedical or genetic information, life and sexual orientation, among others.” In turn, Article 9, in its relevant part, indicates:

“Article 9.- Particular categories of data. In addition to the general rules established in this law, for the processing of personal data, the particular categories of data mentioned below shall be governed by the following provisions: 1.- Sensitive data. No person shall be obliged to provide sensitive data. The processing of personal data revealing racial or ethnic origin, political opinions, religious, spiritual, or philosophical convictions, as well as those relating to health, life, and sexual orientation, among others, is prohibited. (…) 2.- Personal data of restricted access. Personal data of restricted access are those which, even if forming part of publicly accessible records, are not of unrestricted access as they are of interest only to their owner or to the Public Administration. Their processing shall be permitted only for public purposes or with the express consent of the owner (…).” It is undeniable that data referring to a person's state of health are considered, in principle, intimate and reserved from the action and knowledge of others, which is what preserves the right to intimacy contained in Article 24 of the Political Constitution. This is because information relating to the physical or mental health of a person constitutes an important element of their private life, granting its owner the power to safeguard that reserved sphere for themselves from unwanted publicity. In principle, they cannot be forced, without any justification or legal mandate, to disseminate data affecting, in a broad sense, their health. However, this subjective right, like all without exception, can be limited when necessary to preserve other constitutional rights and assets, such as the presence of other general interests like epidemiological studies, situations of serious risk to the health of the community, among others. In any case, possible limitations on the fundamental right to personal intimacy must be based on a legal provision that has constitutional justification, is proportional, and expresses with precision each and every one of the material presuppositions of the limiting measure.

In that sense and with regard to what concerns us in the case under study, the Chamber has recognized, first, 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 inhabitants; second, that the protection of public health and the prevention of diseases constitutes a constitutionally legitimate purpose that can validly justify the mandatory nature of vaccines; and third, that every person is obligated to present vaccination certificates when the authority so determines. Along these lines, the appellant is not correct in stating that declaring information related to vaccination against COVID-19, issued by the Caja Costarricense de Seguro Social, contains sensitive data, since the information required by the respondent authority constitutes data from the mandatory vaccination schedule undergone by the petitioner, endorsed in Article 150 of the Ley General de Salud, which establishes the obligation of vaccination and revaccination against communicable diseases; and Article 152 of the same normative body, which establishes the duty of every person to present vaccination certificates when the authority so determines. Thus, the measure taken by the respondent authority is necessary and proportional to the purpose established by the legal system and does not affect the legal sphere of the petitioner, since every person subject to mandatory vaccination is obligated to show proof that they underwent it. Consequently, the COVID-19 vaccination cards issued by the Caja Costarricense de Seguro Social constitute a mechanism of information that the person received a certain number of doses of the vaccine against COVID-19, and this does not fall within the conceptualization of biomedical or genetic information or information about health, and therefore it does not qualify as sensitive data, but rather is personal data of restricted access because it is of interest only to its holder or to the Public Administration. Thus, since the vaccine has been declared mandatory, it is the duty of the petitioner, and of all citizens, to demonstrate to the public administration when so required that they have complied with what is instructed by the legal system, and this does not constitute a violation of the right to privacy. In this context, the respondent party has not injured any fundamental right of the appellant.

X.- Conclusion. In view of the foregoing, the appeal must be declared without merit. (...)

By virtue of the foregoing, a margin is also established for workers to justify before their employer the refusal to receive the vaccination due to medical contraindications.

In conclusion, it is clear that the regulatory framework is sufficient and reasonable, and its observance seeks to guarantee the health of individuals and public health.

VII.- On the other hand, it is verified that the decision to vaccinate public officials and the rest of the population is based on a technical criterion of the Immunization Coordination and Technical Secretary of the National Vaccination and Epidemiology Commission of the Health Surveillance Directorate, which was communicated to the Ministry of Education. Thus, this criterion cannot be questioned by this Constitutional Chamber (Sala Constitucional), as it exceeds its jurisdiction. Note that, through Judgment No. 2021-000871 of 09:15 hours on January 15, 2021, this Constitutional Chamber established the following: "it is not for this Chamber to determine the appropriateness or not of the application of the vaccination schedule in relation to Covid-19, because it refers to technical, medical, and scientific aspects that deal with vulnerability to a virus (…)". In this way, this Court reiterates that it is not for it to determine the appropriateness or not of the application of the vaccination schedule in relation to Covid-19, because it refers to technical, medical, and scientific aspects that deal with vulnerability to a virus.

VIII.- ON THE CONFIDENTIALITY OF DATA RELATED TO VACCINATION AGAINST COVID 19.- Now, in the case under study, the petitioner also questions that, as an official of the respondent Ministry, she must provide information on the vaccination against Covid-19; however, she considers that the established procedure violates her right to intimacy and privacy, as it involves, in her opinion, sensitive data. As a starting point, it is necessary to indicate that through executive decree (decreto ejecutivo) No. 42889-S, the State provided for the mandatory nature of the vaccine against COVID-19, given that in Judgment No. 2020-0019433, of 09:20 hours on October 9, 2020, the Chamber clearly referred to the general legitimacy of the purpose pursued by establishing the mandatory nature of a vaccine, and indicated that:

"(…) 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 safeguarding of public health and the prevention of diseases constitutes a constitutionally legitimate purpose that can validly justify the mandatory nature of vaccines (…)" (emphasis not in the original).

By virtue of this, and in compliance with what is instructed in the Vaccination Law (Ley de Vacunación) No. 8111, of July 18, 2002, and executive decree (decreto ejecutivo) No. 43249-S published in Gazette No. 206 of October 12, 2021, the mandatory nature of the vaccine against COVID-19 is established for all public officials. Furthermore, article 152 of the General Health Law (Ley General de Salud) indicates that it is mandatory for every person to present vaccination certificates when the authority so determines. Thus, as to this point, the respondent party acted in accordance with the principle of legality or juridicity enshrined in article 11 of the Political Constitution, which means that the acts and behaviors of the Administration must be regulated by written norm, which implies, of course, submission to the Constitution, to the law, and in general to all the norms of the legal system. For this reason, public institutions can only act to the extent they are empowered to do so by the same system and normally by express text; consequently, they are only permitted what is constitutionally and legally authorized in an express manner, and everything not authorized to them is forbidden. In that sense, the respondent authority, in its capacity as employer, is legitimated to request proof of the vaccination schedule against Covid-19 administered to the petitioner and the other employees of the Institution. In this regard, the authorities of the Ministry of Public Education report under oath that as an employer, they are developing the forms of verification regarding compliance with the regulations in Decree No. 43249-F, which are in the construction process. Thus, as to this point, the respondent authority has not harmed any fundamental right of the petitioner, and it is appropriate to declare this point of the appeal (recurso) without merit.

IX.LEGAL NATURE OF THE INFORMATION CONTAINED IN THE COVID-19 VACCINATION CARD. Additionally, the claim raised by the petitioner lies in the access to her personal data and the treatment and registration mechanism that the respondent Administration uses to achieve that obligation. Indeed, the information relating to a person's medical history of illnesses, as well as the medical report or epicrisis, have been classified as sensitive data of restricted access. Note that the Law on the Protection of Persons Regarding the Processing of their Personal Data (Ley de Protección de la persona frente al tratamiento de sus datos personales) No. 8968, in its article 3, subsection e), establishes:

"For the purposes of this law, the following is defined: (…)

• e)Sensitive data: information relating to the intimate sphere of the person, such as that which reveals racial origin, political opinions, religious or spiritual convictions, socioeconomic condition, biomedical or genetic information, life and sexual orientation, among others." In turn, article 9, in the relevant part, indicates:

"Article 9.- Particular categories of data.

In addition to the general rules established in this law, for the processing of personal data, the particular categories of data mentioned below shall be governed by the following provisions:

1.- Sensitive data. No person shall be obliged to provide sensitive data. The processing of personal data revealing racial or ethnic origin, political opinions, religious, spiritual, or philosophical convictions, as well as those relating to health, life, and sexual orientation, among others, is prohibited.

(…)

2.- Personal data of restricted access. Personal data of restricted access are those that, even forming part of records accessible to the public, are not of unrestricted access because they are of interest only to their owner or to the Public Administration. Their processing shall be permitted only for public purposes or if the express consent of the owner is obtained (…)." It is undeniable that data referring to a person's state of health are, in principle, considered intimate and reserved from the action and knowledge of others, which is what preserves the right to intimacy contained in article 24 of the Political Constitution. The foregoing because information relating to a person's physical or mental health constitutes an important element of their private life, which grants its owner the power to safeguard that reserved sphere for themselves, from unwanted publicity. In principle, they cannot be forced, without any justification or legal mandate, to disseminate data that affect, in a broad sense, their health. However, this subjective right, like all without exception, can be limited when it is necessary to preserve other constitutional rights and goods, such as the presence of other general interests like epidemiological studies, situations of serious risk to the health of the community, among others. In any case, the possible limitations of the fundamental right to personal intimacy must be based on a legal provision that has constitutional justification, is proportionate, and precisely expresses each and every one of the material premises of the limiting measure. In that sense, and regarding what interests us for the case under study, the 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 inhabitants; secondly, that the safeguarding of public health and the prevention of diseases constitutes a constitutionally legitimate purpose that can validly justify the mandatory nature of vaccines; and thirdly, it is mandatory for every person to present vaccination certificates when the authority so determines. Along these lines, the petitioner is not correct in stating that providing information related to vaccination against Covid-19, issued by the Costa Rican Social Security Fund (Caja Costarricense de Seguro Social), contains sensitive data, because the information required by the respondent authority constitutes data from the mandatory vaccination schedule carried out by the protected party, endorsed in article 150 of the General Health Law (Ley General de Salud), which establishes the obligation of vaccination and revaccination against communicable diseases; and article 152 of the same regulatory body, which provides the duty for every person to present vaccination certificates when the authority so determines. Thus, the measure taken by the respondent authority is necessary and proportional to the purpose established by the legal system and does not affect the legal sphere of the protected party, since every person subject to mandatory vaccination is obliged to show proof that they carried it out. Consequently, the vaccination cards against Covid-19 issued by the Costa Rican Social Security Fund (Caja Costarricense de Seguro Social) constitute a mechanism of information that the person received a number of doses of the vaccine against Covid-19, and this does not fall within the conceptualization of biomedical or genetic information or information about health, so it does not qualify as sensitive data, but rather is personal data of restricted access because it is of interest only to its owner or to the Public Administration. Therefore, as the vaccine has been declared mandatory, it is the duty of the protected party, and of all citizens, to demonstrate to the public administration, when so required, that she has complied with what is instructed by the legal system, and this does not constitute a violation of the right to intimacy. In this context, the respondent party has not harmed any fundamental right of the petitioner.

X.- Conclusion. By virtue of the foregoing, it is necessary to declare the appeal (recurso) without merit. (…)"

27132-21. SALUD. INTIMIDAD. INFORMACIÓN. TRABAJO. SOBRE LA VACUNACIÓN OBLIGATORIA CONTRA EL COVID-19, PARA LOS FUNCIONARIOS PÚBLICOS Y LA CONFIDENCIALIDAD DE LOS DATOS RELACIONADOS CON LA MISMA. LA INFORMACIÓN SOBRE LA VACUNACIÓN CONTRA EL COVID-19 ES UN DATO PERSONAL DE ACCESO RESTRINGIDO POR SER DE INTERÉS SOLO PARA SU TITULAR O PARA LA ADMINISTRACIÓN PÚBLICA. LEGITIMIDAD DEL PATRONO A SOLICITAR UN COMPROBANTE DEL ESQUEMA DE VACUNACIÓN CONTRA EL COVID-19. POSIBILIDAD DE LOS TRABAJADORES DE JUSTIFICAR LA NEGATIVA A RECIBIR LA VACUNA EN VIRTUD DE CONTRAINDICACIONES MÉDICAS. SE DECLARA SIN LUGAR. VCG01/2022 “(…) I.- Objeto del recurso. La recurrente manifiesta su desacuerdo respecto de la obligatoriedad de la vacuna del COVID-19 para todo el sector público y privado, dispuesto por medio del Decreto Ejecutivo Nº 43249-S.

II.- Hechos probados. De importancia para la decisión de este asunto, se estiman como debidamente demostrados los siguientes hechos: a) la recurrente, ostenta una condición de regular en la clase de puesto como Profesional de Servicio Civil 1 B (G.de E.) / Equipos Interdisciplinarios / Social en el centro educativo San Felipe del Circuito 06 de la Dirección Regional de Educación San José Central (informe rendido bajo juramento); b) de acuerdo con el Decreto Ejecutivo No.43249-S de fecha 7 de octubre del 2021, publicado en el Alcance No. 206 a la Gaceta No.196 del 12 de octubre del 2021, que modifica el Reglamento a la Ley Nacional de Vacunación de Costa Rica, se estipula la obligatoriedad de la vacuna de cita, para todas las personas funcionarias del sector público (prueba aportada); c) el decreto reguló 43249-S que “será responsabilidad del patrono tomar las medidas correspondientes de acuerdo con la legislación del país y la normativa institucional, en el caso de los trabajadores que no quieran vacunarse contra el COVID-19”. así las cosas, al pertenecer la presente instancia ministerial dentro del ámbito del sector público que regula la norma de cita y además estar regido por el régimen estatutario del cual la Dirección General de Servicio Civil, se constituye como la instancia rectora de los recursos humanos en el Régimen de Servicio Civil, dicha Dirección gira instrucciones mediante Circular No. DG-015-2021 de fecha 21 de octubre del año en curso, lo que en lo conducente reza: “…se emite la siguiente directriz para aplicación por parte de las Oficinas de Recursos Humanos bajo su ámbito legal : A los (as) Jefes (as) de Recursos Humanos delegados por esta Dirección General. Se les instruye para que todo nombramiento de personal, ascensos y sus prórrogas, se aprueben en el tanto la persona funcionaria objeto del movimiento, cumpla los requisitos para ello, y además cuente con la vacunación completa contra el Covid-19 o en su defecto, esté en proceso de cumplirla, de conformidad con la programación de citas que le haya hecho la Caja Costarricense de Seguro Social por sus instancias competentes. La ORH debe asegurarse el cumplimiento de esta disposición por los medios que estime pertinentes. De encontrarse negativa de vacunación por parte de alguna persona candidata a ingreso en alguna institución del Régimen de Servicio Civil, la ORH respectiva deberá desistir del movimiento…” (informe rendido bajo juramento); d) la Dirección de Recursos Humanos del Ministerio de Educación Pública, se encuentra en el desarrollo paulatino de las medidas en torno a lo instruido por la Dirección General de Servicio Civil en cuanto a los movimientos de personal correspondiente a nombramiento de personal, ascensos y sus prórrogas, las cuales se efectuaran en el tanto la persona funcionaria que se encuentre objeto de algún movimiento referido, cumpla los requisitos para ello, y además cuente con la vacunación completa contra el Covid-19 o en su defecto, esté en proceso de cumplirla o demuestre una contraindicación médica debidamente declarada, que no le sea posible recibir la vacuna contra el Covid-19, situación que tiene un tratamiento confidencial la información brindada por el usuario a la Dirección de Recursos Humanos o a las dependencias desconcentradas, a efecto de cumplir con lo requerido por el ente rector en caso de encontrarse bajo los supuestos referidos (informe rendido bajo juramento); e) ante las medidas que como patrono se están gestando en el Ministerio de Educación Pública en torno al cumplimiento de lo regulado en el Decreto N°43249-S, las mismas están en proceso de construcción, en observancia a la legislación del país y la normativa institucional, en razón del principio de legalidad (informe rendido bajo juramento=.

III.- Hechos no probados. No se estiman demostrados los siguientes hechos de relevancia para esta resolución: Que la recurrente padezca algún padecimiento o enfermedad que les imposibilite ser vacunada.

IV.- Sobre el caso concreto. Sobre el marco normativo que rige esta materia. En primer término, el Código Civil dispone lo siguiente:

“Art. 46.- Toda persona puede negarse a ser sometida a un examen o tratamiento médico o quirúrgico, con excepción de los casos de vacunación obligatoria o de otras medidas relativas a la salud pública, la seguridad laboral y de los casos previstos en el artículo 98 del Código de Familia (…)” . (Lo destacado no corresponde al original).

La Ley General de Salud, en relación con las competencias del Ministro de Salud ordena lo siguiente:

“Art. 345. 3. Declarar obligatorios la vacunación contra ciertas enfermedades así como ciertos exámenes o prácticas que se estimen necesarios para prevenir o controlar enfermedades ”.

De otra parte, respecto a las obligaciones de los administrados, la referida ley señala lo siguiente:

“Art. 147.- Toda persona deberá cumplir con las disposiciones legales o reglamentarias y las prácticas destinadas a prevenir la aparición y propagación de enfermedades transmisibles.

Queda especialmente obligada a cumplir:

(…)

Las medidas preventivas que la autoridad de salud ordene cuando se presente una enfermedad”.

La vacunación es justamente una medida preventiva para evitar la propagación de una enfermedad transmisible.

El artículo 3, de la Ley Nacional de Vacunación señala:

“(…) De conformidad con la presente Ley, son obligatorias las vacunaciones contra las enfermedades cuando lo estime necesario la Comisión Nacional de Vacunación y Epidemiología, que se crea en esta Ley, en coordinación con el Ministerio de Salud y la Caja Costarricense de Seguro Social.

Las vacunas aprobadas deberán suministrarse y aplicarse a la población, sin que puedan alegarse razones económicas o falta de abastecimiento en los servicios de salud brindados por instituciones estatales.

Estas vacunas aprobadas se refieren al esquema básico oficial que se aplique a toda la población, y a las vacunas para esquemas especiales dirigidos a grupos de riesgo específicos.

La Comisión Nacional de Vacunación y Epidemiología deberá elaborar una lista oficial de vacunas, que se incluirá en el Reglamento de la presente Ley. La lista podrá ser revisada y analizada periódicamente, atendiendo los frecuentes cambios tecnológicos en este campo (…)” (el én,fasis no pertenece al original).

En consonancia con esto, el artículo 6 del mismo cuerpo normativo, en sus incisos a), b) y e), reconoce como funciones y objetivos de la Comisión de Vacunación y Epidemiología:

“(…) a) Garantizar la obligatoriedad y gratuidad de las vacunas y el acceso efectivo de toda la población a ellas (…) b) Formular los lineamientos políticos y estratégicos generales sobre vacunación, aplicables en el sector salud (…) e) Definir, conjuntamente con las autoridades del sector salud del país, los esquemas y las vacunas referidos en el artículo 3º de la presente Ley (…)”.

A la luz de lo expuesto, no es posible afirmar que el principio de reserva de Ley en la regulación de los derechos fundamentales haya sido vulnerado, toda vez que la aplicación obligatoria de la vacuna contra el coronavirus COVID-19, en los funcionarios públicos, fue definida por la Comisión Nacional de Vacunación y Epidemiologia, conforme a las potestades otorgadas por la Ley Nacional de Vacunación. Esto llevó a que se emitiera el el Decreto Ejecutivo No.43249-S de fecha 7 de octubre del 2021, publicado en el Alcance No. 206 a la Gaceta No.196 del 12 de octubre del 2021, que modifica el Reglamento a la Ley Nacional de Vacunación de Costa Rica, se estipula la obligatoriedad de la vacuna de cita, para todas las personas funcionarias del sector público. Así las cosas, la inclusión de la vacuna en contra del coronavirus COVID-19 en el esquema nacional de vacunación y su carácter obligatorio para los funcionarios públicos, debe ser entendida a la luz de lo dispuesto por la Ley Nacional de Vacunación, que define el marco general regulatorio en la materia.

V.- Debe destacarse que la vacunación obligatoria para los supuestos de COVID-19 no es absoluta, sino que, como se señaló, el propio decreto contempla la posibilidad de que la persona presente una contraindicación médica. Debe agregarse que es público y notorio que las autoridades de la CCSS han publicitado los “Manuales de Procedimientos para la ejecución de vacunación contra COVID-19 en los establecimientos de salud de la Caja Costarricense de Seguro Social”, en los cuales se han explicado justamente cuáles son las contraindicaciones médicas para la vacunación. En la primera versión de dicho manual se consignaron las siguientes contraindicaciones:

“ No administre la vacuna Pfizer-BioNTech COVID-19:

-A personas con antecedentes de una reacción alérgica moderada o grave a cualquiera de los componentes de la vacuna Pfizer-BioNTech COVID-19.

-A personas con antecedentes de reacción alérgica moderada o grave documentada a alimentos, medicamentos o vacunas; a menos de que cuente con referencia de médico especialista que indique que se puede vacunar.

En caso de haya indicación de vacunar, esta se realizará en sitios de vacunación intramuros, con acceso a servicio de emergencias en caso de requerir tratamiento de anafilaxia.

-No se administre en Embarazo ni en Lactancia.

-No se administre la segunda dosis en pacientes que hayan hecho una reacción alérgica leve, moderada o severa durante la aplicación de la primera dosis de esta vacuna.” En el Manual (Código GM-DDSS-ASC-SAVE-18122020, versión 07) de junio de 2021, con la actualización de las vacunas autorizadas en nuestro país, se dispuso lo siguiente :

“Contraindicaciones: No administre la vacuna Pfizer-BioNTech COVID-19: -A personas con antecedentes de una reacción alérgica a cualquiera de los componentes de la vacuna Pfizer-BioNTech COVID-19.A personas con antecedentes de reacción alérgica moderada o grave documentada a alimentos, medicamentos o vacunas; a menos que cuente con referencia de médico especialista que indique que se puede vacunar. En caso de haya indicación de vacunar, esta aplicación se realizará en sitios de vacunación intramuros, con acceso a servicio de emergencias en caso de requerir tratamiento de anafilaxia. - Embarazo -Lactancia Materna • Nota: En el caso de mujeres de cualquiera de los grupos de priorización que se encuentren en periodo de lactancia materna y deseen vacunarse por el beneficio que pueden tener con esta intervención, la CNVE acordó que se les debe explicar que no existen estudios en esa población y que se desconocen por lo tanto los riesgos de la aplicación de la vacuna y que para proceder a la vacunación debe firmarse el documento correspondiente que evidencie que ha recibido la información necesaria por parte del personal de salud para la toma de decisión de vacunarse, valorando riesgo/beneficio. No debe de presentar certificados de lactancia, ni debe de dejar de dejar de dar lactancia a su hijo o hija. Se les puede aplicar vacuna AstraZeneca o vacuna de Pfizer según disponibilidad en el vacunatorio respectivo.

(…)

Las personas que reciben la primera dosis de la vacuna para COVID-19 de AstraZeneca deben completar el esquema con la vacuna de AstraZeneca. • Contraindicación: -Hipersensibilidad a la sustancia activa o a cualquiera de los componentes de la vacuna. - Embarazo -Lactancia Materna Nota: En el caso de mujeres de cualquiera de los grupos de priorización que se encuentren en periodo de lactancia materna y deseen vacunarse por el beneficio que pueden tener con esta intervención, la CNVE acordó que se les debe explicar que no existen estudios en esa población y que se desconocen por lo tanto los riesgos de la aplicación de la vacuna y que para proceder a la vacunación debe firmarse el documento correspondiente que evidencie que ha recibido la información necesaria por parte del personal de salud para la toma de decisión de vacunarse, valorando riesgo/beneficio. No debe de presentar certificados de LM, ni debe de dejar de dejar de dar lactancia a su hijo o hija. Se les puede aplicar vacuna AstraZeneca o vacuna de Pfizer según disponibilidad en el vacunatorio respectivo.” Es decir los funcionarios, funcionarias y los médicos que les examinen podrían determinar cuándo se está ante la presencia de condiciones que desaconsejen médicamente la vacunación. Por lo demás, si bien podría existir algún margen de duda sobre la duración de la eficacia de la vacuna o el periodo de protección que ofrece, ello no resulta un motivo legítimo para rechazar la inmunización. Lo significativo es que, a partir de lo anterior, se acreditan elementos para hacer operativa la posibilidad de que las personas aleguen contraindicaciones médicas para rechazar la vacuna en cuestión y, de este modo, proteger su derecho a la salud. Pero en el caso concreto, no consta que la recurrente haya manifestado alguna condición clínica específica que justifique la excepción.

VI.- Asimismo, este Tribunal no puede obviar la prueba aportada en otros recursos de amparo, que son aplicables al caso concreto, por ejemplo, los expedientes 21-008192-0007-CO y 21-008767-0007-CO (tenidos ad effectum videndi ) en los que consta que las autoridades de la CCSS dictaron la circular n.°GG-1156-2021 de 16 de abril de 2021, mediante la cual la Gerencia General regula la aplicación institucional del decreto ejecutivo N°42889-S sobre la obligatoriedad de la vacuna del COVID-19 para el personal de salud.

Dicha circular dispone de varias etapas. Por ejemplo, se reitera que las personas trabajadoras deberán vacunarse, con excepción de aquellos funcionarios que, por contraindicación médica debidamente declarada, no les sea posible recibir la vacuna. Además, en caso de negativa, las autoridades deben seguir una serie de pasos: 1) la prevención al funcionario; 2) el análisis de las condiciones de salud ocupacionales de cada uno de los trabajadores y 3) la determinación de responsabilidades. En dicha fase se examinan las justificaciones por parte del trabajador, el informe de un equipo clínico conformado por el médico de atención integral al trabajador y el responsable de inmunizaciones, para finalmente, valorar la posibilidad de abrir un procedimiento administrativo. En virtud de lo anterior, se acredita también un margen para que los trabajadores justifiquen ante las instancias patronales la negativa a recibir la vacunación en virtud de contraindicaciones médicas.

En conclusión, queda claro que el marco normativo es suficiente y razonable, y su respeto busca garantizar la salud de las personas singulares y la salud pública.

VII.- Por otro lado, se constata que la decisión de vacunar a los funcionarios y funcionarias públicos así como al resto de la población tiene su fundamento en un criterio técnico de la Coordinación de Inmunización y secretario Técnico de la Comisión Nacional de Vacunación y Epidemiología de la Dirección de Vigilancia de la Salud, lo cual le fue comunicado al Ministerio de Educación. Así, ese criterio no puede ser cuestionado por esta Sala Constitucional, pues excede sus competencias. Nótese que, mediante Sentencia N° 2021-000871 de las 09:15 horas del 15 de enero de 2021, esta Cámara Constitucional estableció lo siguiente: “no corresponde a esta Sala determinar la procedencia o no de la aplicación del esquema de vacunación en relación con el Covid-19, por referirse a aspectos técnicos, médicos y científicos que versan sobre la vulnerabilidad a un virus (…)”. De esta forma, este Tribunal reitera que no le corresponde determinar la procedencia o no de la aplicación del esquema de vacunación en relación con el Covid-19, por referirse a aspectos técnicos, médicos y científicos que versan sobre la vulnerabilidad a un virus.

VIII.- SOBRE LA CONFIDENCIALIDAD DE LOS DATOS RELACIONADOS CON LA VACUNACIÓN CONTRA COVID 19.- Ahora, en el caso bajo estudio, la recurrente también cuestiona que como funcionaria del Ministerio recurrido, debe entregar información sobre la vacunación contra la Covid-19, sin embargo considera que el procedimiento establecido resulta violatorio de su derecho a la intimidad, a la privacidad, por tratarse en su criterio de datos sensibles". Como punto de partida, es necesario indicar que mediante decreto ejecutivo n.°42889-S, el Estado dispuso sobre la obligatoriedad de la contra la COVID-19, siendo que en la Sentencia n°2020-0019433, de las 09:20 horas de 9 de octubre de 2020, claramente la Sala se refirió a legitimidad en general del fin que persigue el establecer el carácter obligatorio de una vacuna, e indicó que:

“(…) esta Sala ha reconocido, en primer lugar, la importancia de la vacunación como parte de la asistencia sanitaria esencial que debe garantizar el Estado costarricense en aras de proteger el derecho fundamental a la salud de todas las personas, y, en segundo lugar, que el resguardo de la salud pública y la prevención de las enfermedades constituye un fin constitucionalmente legítimo que puede justificar válidamente la obligatoriedad de las vacunas (…)” (el énfasis no pertenece al original).

En virtud de ello, y en cumplimiento, con lo instruido en la Ley de Vacunación N°8111, del 18 de julio de 2002 y el decreto ejecutivo N°43249-S publicado en la Gaceta N°206 del 12 de octubre del 2021, se establece la obligatoriedad de vacuna contra el COVID 19, a todos los funcionarios públicos. Además, el artículo 152, de la Ley General de Salud indica que es obligatorio para toda persona presentar los certificados de vacunación cuando la autoridad así lo determine. De modo, en cuanto este extremo, la parte recurrida actuó de conformidad al principio de legalidad o de la juridicidad que consagra el artículo 11, de la Constitución Política, que significa que los actos y comportamientos de la Administración deben de estar regulados por norma escrita, lo que implica desde luego, el sometimiento a la Constitución a la ley, y en general a todas las normas del ordenamiento jurídico. Por tal razón, las instituciones públicas solo pueden actuar en la medida en la que se encuentre apoderadas para hacerlo por el mismo ordenamiento y normalmente a texto expreso, en consecuencia solo le es permitido lo que esté constitucionalmente y legalmente autorizado en forma expresa y todo lo que no les esté autorizado, les está vedado. En ese sentido, la autoridad recurrida en condición de patrono se encuentra legitimada a solicitar un comprobante del esquema de vacunación contra la Covid-19 efectuado al recurrente y demás empleados de la Institución, al respecto las autoridades del Ministerio de Educación Pública informan bajo juramento que como patrono estan gestando las formas de verificación en torno al cumplimiento de lo regulado en el Decreto No. 43249-F, las cuales están en proceso construcción. De modo, que en cuanto este extremo la autoridad recurrida no ha lesionado derecho fundamental alguno al recurrente, y lo procedente es declarar sin lugar este extremo del recurso.

IX.NATURALEZA JURÍDICA DE LA INFORMACIÓN CONTENIDA EN EL CARNET DE VACUNAS CONTRA LA COVID-19. Adicionalmente, se tiene que el reclamo planteado por la recurrente radica al acceso de datos personales de la recurrente y el tratamiento y mecanismo de registro que la Administración recurrida utiliza para alcanzar esa obligación. Efectivamente, la información relativa a la historia clínica de las enfermedades que padece una persona así como el dictamen médico o epicrisis han sido calificados como datos sensibles de acceso restringido. Nótese, que la Ley de Protección de la persona frente al tratamiento de sus datos personales n° 8968, en su artículo 3, inciso e), establece:

“ Para los efectos de la presente ley se define lo siguiente: (…)

• e)Datos sensibles: información relativa al fuero íntimo de la persona, como por ejemplo los que revelen origen racial, opiniones políticas, convicciones religiosas o espirituales, condición socioeconómica, información biomédica o genética, vida y orientación sexual, entre otros” .

A su vez, el artículo 9, en lo conducente indica :

“Artículo 9.- Categorías particulares de los datos.

Además de las reglas generales establecidas en esta ley, para el tratamiento de los datos personales, las categorías particulares de los datos que se mencionarán, se regirán por las siguientes disposiciones:

1.- Datos sensibles. Ninguna persona estará obligada a suministrar datos sensibles. Se prohíbe el tratamiento de datos de carácter personal que revelen el origen racial o étnico, opiniones políticas, convicciones religiosas, espirituales o filosóficas, así como los relativos a la salud, la vida y la orientación sexual, entre otros.

(…)

2.- Datos personales de acceso restringido. Datos personales de acceso restringido son los que, aun formando parte de registros de acceso al público, no son de acceso irrestricto por ser de interés solo para su titular o para la Administración Pública. Su tratamiento será permitido únicamente para fines públicos o si se cuenta con el consentimiento expreso del titular (…)” .

Resulta indudable que los datos referidos al estado de salud de una persona son considerados, en principio, íntimos, reservado frente a la acción y el conocimiento de los demás, que es lo que preserva el derecho a la intimidad contenido en el 24, de la Constitución Política. Lo anterior por cuanto, la información relativa a la salud física o psíquica de una persona constituyen un elemento importante de su vida privada, lo que le atribuye a su titular el poder de resguardar ese ámbito reservado para sí, de una publicidad no querida. En principio, no se le puede obligar, sin justificación alguna o mandato legal a difundir datos que afecten, en sentido amplio, a su salud. Sin embargo, este derecho subjetivo, como todos y sin excepción, puede ser limitado cuando sea preciso preservar otros derechos y bienes constitucionales, tales como la presencia de otros intereses generales como los estudios epidemiológicos, las situaciones de riesgo grave para la salud de la colectividad, entre otros. En todo caso, las posibles limitaciones del derecho fundamental a la intimidad personal deberán estar fundadas en una previsión legal que tenga justificación constitucional, sea proporcionada y que exprese con precisión todos y cada uno de los presupuestos materiales de la medida limitadora. En ese sentido y en lo que nos interesa para el caso bajo estudio, la Sala ha reconocido, en primer lugar, la importancia de la vacunación como parte de la asistencia sanitaria esencial que debe garantizar el Estado costarricense en aras de proteger el derecho fundamental a la salud de todos los habitantes; en segundo lugar, que el resguardo de la salud pública y la prevención de las enfermedades constituye un fin constitucionalmente legítimo que puede justificar válidamente la obligatoriedad de las vacunas; y tercero, es obligatorio para toda persona presentar los certificados de vacunación cuando la autoridad así lo determine. Bajo esa línea, no lleva razón la recurrente al indicar que el declarar información relacionada con la vacunación contra la covid 19, emitido por la Caja Costarricense de Seguro Social contenga datos sensibles, pues la información requerida por la autoridad recurrida, constituye una los datos del esquema de vacunación obligatoria realizado por el amparado, avalado en el artículo 150, de la Ley General de Salud, que establece la obligación de la vacunación y revacunación contra enfermedades transmisibles; y el artículo 152, del mismo cuerpo normativo, que dispone el deber para toda persona presentar los certificados de vacunación cuando la autoridad así lo determine. Así las cosas, la medida tomada por la autoridad recurrida es necesaria y proporcional al fin establecido por el ordenamiento jurídico y no afecta la esfera jurídica del amparado, ya que toda persona sujeta a una vacunación obligatoria está obligada a mostrar la prueba que la llevó a cabo. En consecuencia, los carnés de vacunación contra la covid-19, que emite la Caja Costarricense de Seguro Social constituyen un mecanismo de información que la persona recibió una cantidad de dosis de la vacuna contra el Covid 19, siendo que ello no entra dentro de la conceptualización de información biomédica o genética o sobre la salud, por lo que no califica como un dato sensible, sino que es un dato personal de acceso restringido por ser de interés solo para su titular o para la Administración Pública. Así las cosas, al haber sido declarada la vacuna como obligatoria es deber de la amparada, y de todos los ciudadanos demostrar a la administración pública cuando así lo requiera, que ha cumplido con lo instruido por el ordenamiento jurídico y ello no constituye una violación al derecho a la intimidad. En ese contexto, la parte recurrida no ha lesionado derecho fundamental alguno al recurrente.

X.- Conclusión. En mérito de lo expuesto, se impone declarar sin lugar el recurso. (…)”