Mandatory COVID-19 vaccination for public employeesObligatoriedad de vacunación COVID-19 para funcionarios públicos

*210223410007CO* Res. No. 2022000374 CONSTITUTIONAL CHAMBER OF THE SUPREME COURT OF JUSTICE. San José, at nine twenty in the morning on the fifth of January two thousand twenty-two.

Action of unconstitutionality brought by Arcelio Hernández Mussio, of legal age, married, attorney, with identity card number 1-832-451, resident of San José, against "Decreto Ejecutivo 43249-S, titled 'Reform to Decreto Ejecutivo No. 42889-S of March 10, 2021, denominated reform to Decreto Ejecutivo No. 32722-S of May 20, 2005, "Reglamento a la Ley Nacional de Vacunación" 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 Regulation of the Legislative Assembly; Law No. 5395 of October 30, 1973, Ley General de Salud, Law No. 8811—'Ley Nacional de Vacunación' of July 18, 2001, Decreto Ejecutivo No. 32722—'Reglamento a la Ley Nacional de Vacunación' of May 20, 2005, Decreto Ejecutivo No. 37808—'Norma Nacional de Vacunación' of January 8, 2013, Decreto Ejecutivo No. 30965-S—'Reglamento sobre gestión de los desechos infectocontagiosos que se generan en establecimientos que prestan atención a la salud y afines' of December 17, 2002, Decreto Ejecutivo No. 41045-S of May 10, 2016 'Reglamento General de Habilitación de Servicios de Salud'; the Lineamientos Nacionales para la Vigilancia de la enfermedad COVID-19; the Lineamientos generales para el uso del Equipo de Protección Personal (EPP), para prevenir la exposición por Coronavirus (COVID19); the Manual de Procedimientos para la ejecución de vacunación contra COVID-19 en los establecimientos de salud de la Caja Costarricense de Seguro Social, version #7, June 2021, Ministerio de Salud, LS-SS-013, Lineamientos sobre la vacunación contra el virus SARS-CoV-2 para la prevención de la COVID-19 — as well as any norm or regulation issued by other public institutions that oppose the principle of prior, free, informed consent."

Resultando:

1.- By writ received in the Secretariat of the Chamber on November 4, 2021, it is requested that the following be declared unconstitutional: "Decreto Ejecutivo 43249-S, titled 'Reform to Decreto Ejecutivo No. 42889-S of March 10, 2021, denominated reform to Decreto Ejecutivo No. 32722-S of May 20, 2005, "Reglamento a la Ley Nacional de Vacunación" 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 Regulation of the Legislative Assembly; Law No. 5395 of October 30, 1973, Ley General de Salud, Law No. 8811—'Ley Nacional de Vacunación' of July 18, 2001, Decreto Ejecutivo No. 32722—'Reglamento a la Ley Nacional de Vacunación' of May 20, 2005, Decreto Ejecutivo No. 37808—'Norma Nacional de Vacunación' of January 8, 2013, Decreto Ejecutivo No. 30965-S—'Reglamento sobre gestión de los desechos infectocontagiosos que se generan en establecimientos que prestan atención a la salud y afines' of December 17, 2002, Decreto Ejecutivo No. 41045-S of May 10, 2016 'Reglamento General de Habilitación de Servicios de Salud'; the Lineamientos Nacionales para la Vigilancia de la enfermedad COVID-19; the Lineamientos generales para el uso del Equipo de Protección Personal (EPP), para prevenir la exposición por Coronavirus (COVID19); the Manual de Procedimientos para la ejecución de vacunación contra COVID-19 en los establecimientos de salud de la Caja Costarricense de Seguro Social, version #7, June 2021, Ministerio de Salud, LS-SS-013, Lineamientos sobre la vacunación contra el virus SARS-CoV-2 para la prevención de la COVID-19 — as well as any norm 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 Ley General de Salud, Article 2 of Law No. 8239, "Derechos y deberes de las personas usuarias de los servicios de salud públicos y privados", Articles 1 and 4 of the Regulation of the Caja Costarricense de Seguro Social (CCSS); the principle of equality and non-discrimination derived from Article 33 of the Political Constitution; the 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 Ley General de la Administración Pública) for 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 vaccination 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 informative 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 paragraph, 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 not previously authorized by law, and 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. Refers that the matter is the amparo appeal being processed in file 21-021972-0007-CO, in which the petitioner appears as appellant and has invoked the unconstitutionality of the regulations indicated above. Refers that, according to the concept of prior, informed, full, and free consent, as well as informative autonomy, he is not obliged to consent to vaccination, nor to have his sensitive data stored. In addition to this, points out that it is an action that concerns and interests the community. 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 agreement taken 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 Service Regulation of the Legislative Assembly. In said 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 renders nugatory 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 informative autonomy, he is not obliged to consent to vaccination, nor to have his sensitive data stored; in the referred agreement, his fundamental right to give or not give his prior informed consent freely for vaccination is not contemplated, and reference is made to Decreto Ejecutivo No. 43249-S, which contains a declaration of mandatory nature that is contrary to his fundamental rights, whereby the Legislative Assembly acts arbitrarily by giving greater rank and importance to an executive decree, which is below the law and the international conventions signed by Costa Rica. Therefore, this action is filed against decree No. 42889-S, "Reforma Reglamento a la Ley Nacional de Vacunación and numerals 2, 3, and 6 subsection a) of Law No. 8111, Ley Nacional de Vacunación", as well as the other regulations already indicated, for infringing principles of international and constitutional law, originating the subjective act of mandatory covid vaccination in a generalized manner, without prior informed consent, which must be obtained without coercion or threat, in order to be free. Refers that, said mandatory nature of vaccination indicated in decree No. 42889-S, "Reforma Reglamento a la Ley Nacional de Vacunación in accordance with numerals 2, 3, and 6 subsection a) of Law No. 8111, Ley Nacional de Vacunación", 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, informative self-determination, principle of legality, legal certainty, and right to justice; having the privilege of living in a Rule of Law State and democratic country, with strong bases in the profound respect for human and fundamental rights of every inhabitant of our national territory. Given the lack of information, his doubts about quality guarantee controls, stability, efficiency, immunity, and adverse effects of mandatory covid-19 vaccines, among many others, it is offensive to him to be forced to vaccinate against covid-19 to continue his work as an advisor, which would render nugatory his human right to freely consent to inoculation. Indicates that, to this day, there is total obscurity about the terms of the State's contract with Pfizer; it is unknown who will be responsible for eventual health damages resulting from mandatory vaccination, in violation of the principle of full informed consent, that is, with access to all relevant information for making the decision, 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 informative 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 the right to every person and worker, to "occurring to the laws, all must find reparation for the injuries or damages they have received in their person, property, or moral interests. They must be given prompt, complete justice, without denial and in strict conformity with the laws," reasons for which, written, prior, and duly informed consent, given freely, without coercion or threat, constitutes a human right for every person obliged to be vaccinated against covid, who possesses 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 public authorities, in the mandatory nature of generalized vaccination without 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. This preventive measure is a constitutional right, necessary and indispensable, to avoid serious or irreparable damages to the health of any human being, given the possibility of some adverse effect of the vaccine against covid-19, but it is not provided for in its mandatory nature. The principles of respect for human dignity, autonomy of will, prior, full, and free informed consent, and informative 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 Decreto Ejecutivo No. 42889-S, "Reforma Reglamento a la Ley Nacional de Vacunación and numerals 2, 3, and 6 subsection a) of Law No. 8111 Ley Nacional de Vacunación", by indicating the mandatory nature of covid-19 vaccination, generates a direct employer request to demand medical and health information, which is private information, under the protection of Article 24 of the Political Constitution, in accordance with internal national legislation, according to Articles 1, 2, 3, 4, 10, 19, 22, 152 and 345 subsection 3) of Law No. 5395, Ley General de Salud, Article 1, 3 subsection e) and 7 subsection 1.c) of Law No. 8968, Ley de Protección frente al Tratamiento de sus datos personales, Article 1 of Law No. 7425, Ley sobre registro, secuestro y examen de documentos privados e Intervención de las comunicaciones and Articles 6, 8, 10 and 11 of Law No. 7771, Ley General Sobre el VIH-SIDA. Constitutionally, both the decree and the challenged numerals, by pointing out the phrase "mandatory nature" of covid-19 vaccination, are unconstitutional, because they are an excess of prevention that constitutes repression, in a country that claims to be a Rule of Law State, where minimal intervention constitutes a fundamental part of our democratic system, and that for this reason, 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 sovereignty into fundamental and inalienable rights. 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. It simply started from the death alarm of the pandemic to violate this right, which is derived from the application of Articles 20 and 21 of the Political Constitution. For almost twelve months of administering the vaccination, the Caja Costarricense de Seguro Social has not provided the insured with a document containing the prior, duly informed consent. The previous violation is increased by the decree challenged here, as public officials are forced to get vaccinated under threat of losing their job if they do not do so, without a prior medical examination prevailing that prevents serious or irreparable harm to health, thus being able to guarantee the adequate and tangible exercise of the fundamental right to safeguard life and health. Refers that one of the main characteristics of informed consent is based on its prior nature, but above all free, a characteristic gathered 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 using it as a condition for subjecting oneself to other procedures or benefits, without coercion, threats, or misinformation. Points out that, since the beginning of covid-19 vaccination, 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, facing the threat of job loss (in the health and economic crisis situation we face), there is total coercion, so that, in the case of being able to issue consent, this 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, the patient must be provided with "relevant data about the intervention in question". In summary, it is said that there must be conformity between the passive subject, holder of the protected legal right—the human person—and the action deployed by the active subject, the competent research professional, that is, a "meeting of wills" between both subjects, regarding the same object. Additionally, from the legal perspective, it must be recognized that informed consent comprises both ethical aspects inherent to 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 their condition as a human being and by the simple fact of being alive. 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”. Points out that the ECHR admitted in a matter resolved in the first decade of this century, that "the acceptance or rejection of medical treatment or the choice of an alternative form of treatment is vital to the principles of self-determination and personal autonomy". Given the omission of informed consent, Articles 20, 21, and 28 of the Political Constitution are harmed, as indicated. From the conjunction of these three articles, informed consent is derived. References a judgment of this Court. Indicates that, at the normative legal level of Costa Rican domestic law, Article 22 of the Ley General de Salud provides that "no person may be subjected to medical or surgical treatment that implies serious risk to their physical integrity, their health, or their life, without their prior consent or that of the person legally called to give it if they were impeded from doing so. Emergency interventions are excepted from this requirement." Cites in turn subsections i), h) and i) of Article 2 of the Ley de Derechos y Deberes de las Personas Usuarias de los Servicios Públicos, in relation to the obligation to obtain informed consent. Points out that said regulation finds support in the Universal Declaration on Bioethics and Human Rights which, despite not being ratified by our country, contains among its principles respect for autonomy and individual responsibility, by indicating that "The autonomy of persons to make decisions, while taking responsibility for those decisions and respecting the autonomy of others, is to be respected. For persons who are not capable of exercising autonomy, special measures are to be taken to protect their rights and interests" (Article 5). Points out that the challenged decree contradicts the "Reglamento de la Caja de Seguro Social (CCSS), about informed consent. Denotes that informed consent is part of the right to information; the necessary and indispensable information is required for making prior decisions aimed at whether a person decides to receive the vaccine or not, regardless of whether or not they are a public official. References Article 4 of that same regulation of the CCSS, and argues that the due communication has not operated in this case, because, despite the fact that decree 48889-S indicates in Article 2: "When they are summoned by those in charge for such purpose and in accordance with the respective institutional planning, the persons contemplated in the previous 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…", 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. Points out that the decree challenged as unconstitutional makes a distinction without basis 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 discretion of the employer. This entails discrimination without acceptable basis. Both one group and the other are composed of human beings with equal dignity and value before the law. Considers that the mandatory nature of vaccination against covid-19 for public and private officials, without prior written and duly informed consent, is inapplicable for being contrary to fundamental values and 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 challenged provision demonstrates that the obligation to vaccinate specifically public sector workers and potentially private sector workers constitutes discrimination to the detriment of the working class, because in a lax manner it creates an inexact equivalence between the decree that forces health sector officials to vaccinate with the obligation to vaccinate all public and private sector officials, thereby contravening the constitutional and universal spirit of equality and non-discrimination. 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 condition of being vaccinated, this as a requirement to keep their job, a fact that constitutes an arbitrary action typical of anti-democratic systems. In addition to being a real threat to an employee or public official, which can even be penalized with prison, if not obeyed. It is no secret that our country has made notable progress in the principle of non-discrimination in the workplace, so new forms of discrimination must continue to be confronted. In addition to the above, Article 7 of the Ley VIH Sida guarantees confidentiality, non-discrimination, the right not to be obliged to provide 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 that, paradoxically, it is now the State itself that is the source of hateful segregationist and discriminatory practices, without having conducted substantiated scientific research to support those criteria. The mandatory nature of 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 people as part of their freedom to choose and not simply the decision of a minister or the Executive Branch. Denotes that the challenged decree does not oblige the rest of the population to be vaccinated against covid-19, only the 330,000 public officials, which he considers violates the norms and principles stated in this section. Even, by executive decree, vaccination obligation is imposed on public officials who belong to other branches, and public entities with levels of autonomy even at a constitutional level, such as local governments and certain autonomous institutions that have reinforced autonomy by constitutional provisions. According to the foregoing, the questioned executive decree does not establish fundamental criteria that allow justifying the mandatory nature of the application for the group of public workers, potentially for private sector workers, and not for the rest of the population. Indicates that the decree in question violates freedom of thought and expression (Articles 28 and 29 of the Political Constitution, 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). Our country has abundant national and international legislation and jurisprudence protecting the right to free expression. Considers 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 thinking is not considered, the doors to authoritarianism begin to open, and this is very dangerous in a democratic State like ours. It is not possible to admit health reasons as the only cause for exception to not getting vaccinated, since this absolutely curtails free expression and thought, as it delimits the manifestation of the will of people who, for various motivations, do not wish to be inoculated to a single cause. All people have the right to dissent from receiving the vaccination, because there has been no clear and truthful information about its effects on the population's health, so 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, since inoculation does not prevent contagion. Furthermore, points out that vaccinated people are not immune to contagion 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 has more deaths than last year when there were no vaccines. It is scientifically proven that the effectiveness of 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 it is measured after 45 months of having been vaccinated, it is reduced to an effectiveness of only 53% to prevent infections for the Pfizer vaccine and 67% for the AstraZeneca vaccine. After 6 months, its effectiveness against hospitalization also decreases. In Singapore, where vaccination with two doses has been administered to 78% of the 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% has received the double dose and 45% has the booster (third dose). Currently, the infection rate is among the highest in the world (235/100,000) and much higher than in 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 Costa Rica's currently, and considered by the CDC (Center for Disease Control of the USA) as a red alert (more than 25/100,000). Therefore, not even with 99.7% of its population vaccinated have they managed to control the virus (data from www.ourworldindata.org and Johns Hopkins University). Another astonishing example is the number of infections that occurred recently at Duke University, North Carolina. They mandated vaccination for students and staff, and despite the fact that 98% of the students had their full vaccination, and the staff 92%, 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 populous 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 house a treatment based on some antiviral medications, including 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 that the vaccine, whose medium- and long-term side effects are unknown and which is still in the experimental phase, without guarantee or liability on the part of the manufacturer, is not the only alternative to overcome 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. It 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 due to the application of the term vaccine. The objective pursued by vaccination with its application is to induce active immunity, a fact that 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 harmed and, therefore, the entire procedure consequent to it. It questions that 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 action 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 fulfill the essential objective that characterizes the definition of vaccine, which is to induce protective active immunity against the corresponding infectious disease. Given the nonexistence of the expected effect with the application of the COVID-19 vaccine, the principle of legality is harmed, because 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 that is not known with scientific certainty what it is, nor what effects it produces in the short, medium, and long term. To this is added that the inoculation does not fulfill the objective that defines the 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 to say, evidently, vaccinated people equally become infected and sick, something that in theory should not happen if a person is vaccinated. On the other hand, a highly significant aspect must be taken into consideration in this action, which is 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 gives a false alarm supported by the ambiguity of political discourse. Furthermore, they are forcing the population to submit to an in vivo 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 (BPC and Key Responsibility of Investigators in the Context of Clinical Trials: WHO Solidarity of Clinical Studies - WHO COVID-19). It indicates that, although the authorities, in their double discourse, reveal that they have full knowledge of this, they are still forcing the population to take a step in an experimental procedure without full knowledge, but clearly declared by the WHO. The Minister of Health himself coincides with what was previously stated, as he made known on May 31, 2021, in the appearance before the Legislative Assembly in extraordinary session #04, where he explicitly indicated to the deputies: "In this matter of how long the immunity of the vaccine lasts, there is still no clarity, studies and follow-up by the different companies continue, and we understand that it is expected that at least 9 months later there will be immunity, 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 therefore we must continue to be aware of 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 stated by the Minister of Health, because the evidence over time shows that the effects of the vaccines diminish with time, to the point that some countries are already applying a third dose and a fourth is not ruled out. The foregoing denotes 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 "vaccine", and now they approved it as "vaccine", what matters is the real-time clinical study. Furthermore, they confirm that the period of immunity is unknown; therefore, if the time of effectiveness is not known until the study is finished, nor can contraindications, interactions, and adverse reactions be known with certainty. It is clear that the results of the clinical trials are emerging over time, since these trials are being conducted "In Vivo" in the population and until they are finalized, demonstrable technical-scientific information will not be known, 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 route is not governed in accordance with the provisions of the regulations of the cited regulation itself, the General Law of Public Administration, or our Constitution. The precautionary principle provides that "when an activity represents a threat or damage to human health or the environment, precautionary measures must be taken, even when the cause-effect relationship has not been able to be scientifically demonstrated conclusively." Said principle has its foundations in 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 sectors, the promotion of decision-making based on the limitation of 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 inherent 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 Caja de Seguro Social to perform preventive medical examinations, harms said principle, because the application of 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, given the mandatory nature of COVID-19 vaccination, which guarantee protecting the life of every worker and any human being residing in the Nation, because life does not depend on life itself alone, but also on the prevention of any harm, however minimal, to health. The government has been irresponsible in properly 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 managed, because while they affirm that the "vaccines" are safe, on the other hand, they accept that studies demonstrating their effectiveness and safety are lacking. It is because of 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 aforementioned measures, 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 states 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 harmed, 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 and, as evidence, the very declarations of the World Health Organization. It points out that the principle of hierarchy of norms is violated, Article 7, 48, 129, and 140 subsection 3) of the Political Constitution and the principle of conventionality. In the field of human rights, there is no formal separation between International Law and Constitutional Law, because it is the same law. The substantive prevails over the formal. What is truly imposing 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, the conventionality control, the fundamental basis of our constitutional system in the Rule of Law, should suffice to indicate that Decreto Ejecutivo No. 42889-S is unconstitutional, because it contradicts the international legal instruments mentioned herein and related to Human Rights, which are of higher rank; therefore, the mandatory nature of 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 interference of the State, 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 juridical personality, indicating that, as a person, they have the right to have their life respected and, therefore, their health, as well as their physical, psychological, and moral integrity. It states that it is clear that the mandatory nature of the vaccine violates these fundamental human rights recognized internationally, as they violate the physical integrity of individuals, by imposing on public sector employees and extending it to private sector workers, the introduction into their body of a vaccine without prior, full, and free informed consent, without respecting their autonomy of will. Likewise, it seriously violates the right to psychological and moral integrity of individuals, by forcing said employees to be inoculated in an intimidating manner, since, if they do not do so, they are exposed to fines and administrative and criminal sanctions, and even to dismissal without employer liability or revocation of the appointment or designation, as in their case. All the rights described in the cited regulations are directly related to the right to life, health, and individual informed consent which, in turn, is associated with collective or social informed consent, which allows the application of norms and procedures that directly interest society, such as disease detection campaigns, vaccination campaigns, and research on human beings, among others. Informed consent is individual (right of man) 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 taking one or several decisions is accurately indicated, in the event they exist, with knowledge of the consequences, possible side effects, and problems that may arise. All this evidently does not occur 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 above, it points out that the decree harms 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 individuals. This country would be failing to comply with what was agreed in the cited treaties, and would be clearly regressing in these rights with the application of the accused decree. It states that the executive decree of mandatory vaccination presents a clear violation of Law No. 8239 of April 2, 2002, "Law of 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 I.V. Vs. Bolivia, informed consent must be "provided freely, voluntarily, autonomously, without pressure of any kind, without using it as a condition for undergoing other procedures or benefits, without coercion, threats, or misinformation." In such a way that the accused decree harms the right to give informed consent, as it is understood by the Inter-American Court of Human Rights and in the manner in which it is contained 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 by special law, notice must be given to 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, as the decree itself indicates, is not a health authority, so State institutions other than health authorities are not legitimized to demand said information. The obligation to be vaccinated and to reveal information regarding the medical history harms the provisions of Article 9 subsection 1) of the "Law on the Protection of the Person against 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. It 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. 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 160, 161, 162, and 170. 8) I/A Court H.R. Case of the Yakye Axa Indigenous Community 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. Case of the Sawhoyamaxa Indigenous Community Vs. Paraguay. Merits. Reparations and Costs. Judgment of March 29, 2006. Series C No. 146. Cites paragraph 177. 10) I/A Court H.R. Case of the Xákmok Kásek Indigenous Community 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. Case of the "Mapiripán Massacre" Vs. Colombia. Judgment of September 15, 2005. Series C No. 134. Cites paragraph 162. 12) I/A Court H.R. Case of Vera Vera et al. 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. Case of 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. Case of Chinchilla Sandoval et al. 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. Case of Artavia Murillo et al. (In Vitro Fertilization) 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. Case of 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. Matter of B, regarding 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. Case of Poblete Vilches et al. Vs. Chile. Merits, Reparations and Costs. Judgment of March 8, 2018. Series C No. 349. Cites paragraph 152. 19) 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 156 and 163. 20) 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. 171. Cites paragraph 68. 21) 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 paragraph 311. 22) I/A Court H.R. Case of Ximenes Lopes Vs. Brazil. 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 protection standards. Likewise, they establish transcendental jurisprudence for the internal courts of the State, which contributes to the generation of norms and precedents guided by the light of International Human Rights Law. The resolutions of the Inter-American Court significantly impact the internal legal system, so 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 condemnatory judgments issued have evidenced the deficiencies of the legal systems and, with this, international pressure has been generated to promote reforms, investigation, and prosecution of processes in order to determine and sanction those responsible for committing human rights violations, therefore, through these, the States have had to modify their internal legal system through constitutional reforms, legal reforms, and interpretation guidelines that allow the insertion of the standards established by the Inter-American Court into domestic law. It requests that the unconstitutionality of Decree No. 42889-S be declared, because not only is the right to life and health put at risk, but the entire democratic system is violated, so that the foundations of the Rule of Law are seriously affected, due to the direct, totalitarian, and arbitrary intrusion of 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 violates the right to work. It points out that the decree in question harms 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 technically or scientifically substantiated the degree of efficacy of the vaccine, in relation to preventing the spread of COVID-19 (by itself and without considering it with other measures), so it is not possible to carry out an assessment of the proportionality, necessity, and reasonableness of the measure that violates (or harms) the principle of autonomy of will. b) The sanctions for not getting vaccinated for public employees are disproportionate, because the sanctions or penalties that public employees could receive for not getting vaccinated are blank criminal or administrative-sanctioning types, which contravene the principle of criminal and administrative-sanctioning specificity, and are excessive, affecting work, which is also a fundamental right. The intention is to open administrative procedures aimed at dismissing without employer liability public employees who do not get vaccinated, or who do not provide information to the entity for which they work, on 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 Prosecutor's Office to determine whether a crime has been committed. As of the decree stipulating the mandatory declaration, instructions have been issued to the various public institutions and the private sector to sanction, including with sanctions not established in the Vaccination Law such as dismissal, all those persons who do not wish to receive the inoculation of the so-called vaccine. When summoned by those responsible 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 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 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 various media outlets. The challenged mandatory nature goes against the stated principles, since working people are coerced into submitting to mandatory inoculation, despite their well-founded fears of suffering short- or long-term harm, due to the imminent disciplinary actions, as they can be sanctioned with fines or dismissals, which has meant that, faced with the dilemma of getting vaccinated or losing their jobs, which is the means by which they support their families amidst one of the worst economic crises of the last 40 years, people are being forced, by the coercion exerted, to get vaccinated against their will. It indicates that the lack of reasonableness is evident, moreover, of the measure itself (mandatory vaccination), since 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 declining significantly, as published by several press outlets. The population has even been informed that CEACO, a hospital specialized in caring for people infected with the virus, is currently being dismantled, since, according to Health authorities, it is not required due to the significant reduction in cases. According to a publication by the Central American Population Center of the University of Costa Rica: "The manifest trend of the R rate has been downward approximately since August 21. This trend has continued. This week's rates have maintained a moderate downward trend that is expected to continue for the coming weeks." The same article indicates that the covid-19 reproduction rate in Costa Rica dropped slightly to R = 0.77, according to new diagnosis data updated to Tuesday, October 19 (Graph 1). It denotes that the report of a new diagnosis has an approximate delay of six days with respect to the moment of infection, so this estimate of R probably corresponds to Wednesday, October 13, as stated in the graph. The foregoing demonstrates that long before the publication of Executive Decree No. 43249-S, even before the Agreement of the National Vaccination and Epidemiology Commission was adopted, in extraordinary session XLV2021 of September 23, 2021, the infection rate since August 21, 2021, had been decreasing; at the beginning of September it had already fallen below 1, and is currently at 0.77, so infection has decreased without the need for mandatory vaccination. However, it cannot be affirmed that this decrease has been produced by vaccination, since it is rather due to a behavior that the virus has been presenting over time, where waves or peaks of infections with decreases occur, regardless of the people vaccinated. In Costa Rica, as of 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 argues that the sanctions established in the challenged decree clearly violate the principle of reasonableness and proportionality, by being disproportionate and unnecessary, by virtue of all the cited argumentation. On the other hand, it cannot be overlooked that every administrative act must be duly grounded. The challenged decree establishes, as a central element of its grounds, in Considerando III, that: "...health norms are of public order. In view of this, the Ministry of Health, as the competent authority, may order and take special measures to prevent the risk or damage to the health of persons, or that these spread or worsen, as well as to inhibit the continuation or recurrence of the infringement by private parties. Said legal norms, which establish the competence of the Ministry of Health in health matters, enshrine the power of authority in sanitary matters, which empowers it to dictate all technical measures that are necessary to confront and resolve states of sanitary emergency…". The concept of public order, as the basis of the decree, is vague, imprecise, and has served for the Directorate of Legal Affairs to issue the general criterion, which is also being challenged. What must be reaffirmed, then, is that the –already indeterminate in itself– concept of public order cannot be a justified basis for arbitrariness, as happens in this case. It points out that it shares the separate reasons of Magistrate Hernández López, subscribed to 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 be suspended refer to 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 that from their emergency suspension, the impossibility of recovering such rights subsequently results, or that their suspension is indefinite. The possibility of the State acting arbitrarily is also absolutely limited. 4. The Constitutional Chamber 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 that state intervention is necessary, it must be carried out by the public authority or state entity to which the law recognizes 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 Powers. d. The Administration must evaluate the various actions that can or must be carried out in the specific case, always choosing 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, "for the remainder of the affected person's life project. Particularly, 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 will obtain, and the person upon whom the limitation was imposed." e. According to the constitutional design, there are rights that can only be limited or suspended by approval of two-thirds of the votes of the Legislative Assembly. Thus, the action of the Ministry of Health and the Ministry of Labor flagrantly violates the Political Constitution, since 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 grounding itself in subsection h of Article 81 of the Labor Code, concludes that: “3. If a public official or a private sector worker, for whom the employer has made vaccination mandatory at their workplace, manifestly, 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 foundation 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 prevent covid-19. It alleges that this is a false fact that contradicts science, since, moreover, it is a public and notorious fact that vaccinated people also get sick, and, what is relevant here, they also contaminate others by transmitting the virus. The current covid-19 vaccines do not prevent those who are vaccinated from transmitting the virus. Hence, if in a workplace, public or private, all workers can contaminate each other, vaccinated or not, it is absolutely disproportionate and unconstitutional to conclude that dismissal without employer liability is justified only for those who are not vaccinated, falsely concluding that only the vaccinated prevent 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 due entitlements. It cannot be accepted that the Executive Branch, based on an emergency situation and supposedly grounded in public order, limits constitutional rights in the way it does, since dismissal without employer liability is absolutely disproportionate, exceeds the limit of the division of powers, and makes the imposed sanction cease to be temporary and renders the violated right irrecoverable, because with such decisions, the employee definitively loses their job and all labor rights attached to their employment contract, in addition to the threat of imposing a fine of one base salary and referring the case of the official who does not accept vaccination to the Public Prosecutor's Office. 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 estimates that the challenged decree also violates the principle of informational self-determination, by requesting private information referring to the medical record and given the absence of prior informed consent (consentimiento informado) 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 privacy and human dignity through effective protection of personal data contained in files, archives, records, or databases, regardless of whether they are private or public. Informational self-determination empowers every person to know who holds recorded information about them, the type of information maintained, and for what purpose. Furthermore, concurrently, it implies the possibility of rectification, blocking, and deletion of that information. It states that this Constitutional Chamber developed and protected this right through abundant and emphasized jurisprudential development. However, the need was emphasized for a law to be issued that would positivize the principles derived from the jurisprudence, while 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 for the Protection of the Person regarding the Processing of their Personal Data, a norm which in turn has due regulation (Executive Decree No. 37554-JP of October 30, 2012); both norms are based on the parameters established by the Constitutional Court. Said law protects sensitive data, including health data. The Law for the Protection of the Person regarding the Processing of their Personal Data guarantees 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 provided in Article 1. The classification as "public order" highlights the transcendence of the protected legal asset and the need for its mandatory observance by all subjects, both private and public law. Article 2 of said regulatory body establishes its scope of action, providing that it encompasses automated or manual databases, whether belonging to public or private entities, and also contemplates any subsequent use made of that information. It excepts from its application databases maintained by individuals or legal entities for exclusively internal, personal, or domestic purposes. However, if these databases are subject to commercialization, they must comply with the provisions of the law. The protection refers to data concerning a person or property. In this sense, personal data, that is, data belonging to an identified or identifiable person. The concept of personal data is broad, as it comprises any data of an identified or identifiable person. However, for purposes of its protection, the law differentiates between several categories of personal data. Data relating to health are classified as sensitive, and as such, subject to a higher degree of protection. It suffices to recall that, as a general rule, there is a prohibition on the processing of sensitive data; persons are not obliged to provide this type of information. The materialization of the right to informational self-determination, regarding the principles of informed consent (consentimiento informado) 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 owner or their representative, as well as to ensure the quality of the information (Articles 5, 6, and 7 of the Law for the Protection of the Person regarding the Processing of their Personal Data), so that, in this way, whoever requests or collects personal data about a person for processing must inexorably observe at least the following mandatory guidelines: • Inform the data subjects or their representatives in advance, in an express, precise, and unequivocal manner, of the existence of a personal database; the purposes pursued with the data collection; the recipients of the information and who may access it; • the obligation or not to provide answers to the questions asked during data collection; • 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 paragraph of the Data Protection Law). • Obtain the express consent of the data subject or their representative, consent that must be recorded in writing, in a physical or electronic document (Article 5, second paragraph 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, the database controller is imposed a duty to adopt the necessary technical and organizational measures to guarantee the security of personal data and prevent its alteration, accidental or illicit destruction, loss, unauthorized processing or access, as well as any other action contrary to the mentioned law, including at a minimum within those measures the most adequate physical and logical security mechanisms, in accordance with the technological development prevailing at the given moment. Likewise, a duty of confidentiality falls upon said controllers and those who participate in any phase of the personal data processing, whether due to their professional or functional condition (Article 11 of the Data Protection Law). Among the fundamental principles of personal data protection is that of the affected person's consent. The law may except the need for such consent, allowing the collection and delivery of data in certain cases, but in the case at hand, we are not under any of the exception assumptions 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, as it concerns medical matters, people's health, and now human resources departments request this information from their employees, without any legal legitimacy to do so, and on top of everything, harming what is established in the indicated provisions of the Protection Law regarding the Processing of their Personal Data. Likewise, it adds the absence of informed consent (consentimiento informado) (adequate and with varied options), regarding access to the medical record, and with prior information on the possible effects of vaccination, as well as the examinations prior to said inoculation. The processing of personal data, and especially sensitive data, is broadly protected by the cited law, constitutional jurisprudence, and the Political Constitution. Therefore, it is violative of the principle of self-determination; sensitive data cannot be in the hands of just anyone, without the informed consent (consentimiento informado) that should form the medical record of every person. That 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 in the health field, this consent being characterized as granted freely, voluntarily, and consciously, and not in the way the administration is acting, without even providing this right to the officials bound by the challenged decree. It adds that the mandatory nature of vaccination as provided in the challenged decree, by the mere condition of being a public official, without free and informed consent (consentimiento informado), without knowing the possible effects on the health or life of the person subjected to said inoculation, 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 considered. In correlation to the fundamental right to life protected in constitutional numeral 21, is Article 20 of the Magna Carta, which guarantees the right to freedom of every person, and their capacity to dispose of their own body. Both norms constitute the constitutional source of informed consent (consentimiento informado), since from this derives the freedom to choose which treatment is most favorable for the restoration of their health, or to be able to choose if they wish to participate in a formal research process, attending such consent as a fundamental right inherent to the person, and not as in the case at hand, where vaccination is mandated, without guaranteeing prior duly informed consent to the workers, thereby violating their right to life, to health, and to receive adequate and truthful information. It 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. It refers that, from ruling 2010-1668 of this Chamber, it follows: 1- The legal framework governing state health policy to be developed by the competent authorities is regulated by the General Health Law. 2- That the regulations of the Costa Rican Social Security Fund (Caja Costarricense de Seguro Social) related to experimentation on human beings, being regulations that by their nature as general norms do not prove to be the suitable legal mechanism to guarantee the protection of fundamental rights directly related to experimentation on human beings, including the right to life, personal freedom, physical integrity, the right to health, and other involved rights. 3- Rights that, due to their characteristic as fundamental and inherent to the human being, must be regulated and limited only 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 subject to 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 mere 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, this type of procedure, about which information on its possible effects has been omitted, cannot be regulated by a regulation, regardless of the right to human life, the right to health, privacy, and human dignity. It insists that Executive 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,” by forcing public officials to be vaccinated without the Costa Rican Social Security Fund (Caja Costarricense de Seguro Social) informing about the possible effects, even less about labor rights regarding the occupational hazards insurance policy in the event of an adverse effect caused as a result of said mandatory covid-19 vaccination, grossly violates the constitutional rights of all public officials - and potentially all private sector workers - regarding the rights to privacy, integrity, and human dignity, as highlighted by the distinguished jurisprudence of this Chamber in relation to the regulations on experimentation on human beings of the Costa Rican Social Security Fund (Caja Costarricense de Seguro Social). It alleges that what is sought with this action even implies a change of criteria in the jurisprudence of this honorable Constitutional Chamber, which is permitted by the Law of Constitutional Jurisdiction. 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 healthcare 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 end." Up to this point, there would be no conflict with the position of the Inter-American Court of Human Rights, because these ends can be achieved without mandatory nature, through educational and awareness campaigns, but the Constitutional Chamber has gone further and has said that this importance of vaccination can validly justify the mandatory nature of vaccines, which represents an interpretation contrary to human dignity and international instruments on bioethics. 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 itself. Due to the foregoing, a weighing of rights in possible conflict must not only be made, but, once and for all, it must be made clear that the human being should not be seen as a mere instrument to achieve social goals, as happens in the case of mandatory vaccination, but that, at all times and in all cases, human dignity must be the guide for decision-making at the legislative, executive, and judicial levels. Only in this way can there be certainty that situations as lamentable as those that have occurred in Costa Rica, due to having it backwards, will not be repeated. It requests that: 1. The present action of unconstitutionality be admitted, and the mandatory nature of the inoculation sustained in the challenged decree be suspended while this action is resolved on its merits. 2. Decree No. 42889-S, Reform Regulation to the National Vaccination Law and numerals 2, 3, and 6 subsection a) of Law No. 8111, National Vaccination Law, as well as all regulations that oppose prior, full, and free informed consent (consentimiento informado), regarding the mandatory nature of vaccination for all public officials and potentially all private sector workers, be declared unconstitutional and consequently annulled. 3. The Ministry of Health be warned that it may not continue to apply the mandatory nature of vaccination.

2.- By writ filed on December 22, 2021, the petitioner reiterates their 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, 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, human dignity.

It is alleged that the phrase with the exception of cases of mandatory vaccination or other measures relating to public health, in this article, violates personal liberty, specifically, 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 rule 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 routine schedule by 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 routine schedule by 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 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 rule 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 Costa Rican Social Security Fund (Caja Costarricense de Seguro Social), thereby allowing vaccination to be mandatory in Costa Rica, by excluding the possibility of refusing to receive a vaccine that has been declared mandatory by 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, either voluntarily or compulsorily, 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, it shall decide whether the vaccination is mandatory or voluntary” is unconstitutional and must be annulled. SIXTH: Article 1, subsection e) of the Regulation to the National Vaccination Law (Reglamento a la Ley Nacional de Vacunación) 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 the agreement of the National Commission for Vaccination and Epidemiology No. XLV-2021 of September 23, 2021, which takes effect as of October 15, 2021, a decree by which the mandatory nature of the Covid-19 vaccine was approved for all public sector employees, as well as for those private sector employees whose employers, within their internal labor provisions, have opted 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 of Human Rights 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 deemed amended, in order to comply with the corresponding formal requirements.

3.- By brief filed on January 3, 2022, Mariela Fallas Pacheco requests to be considered as a coadjuvant in this action, based on the same arguments as the petitioner.

4.- 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 petition brought before it that is manifestly inadmissible, or when it considers that there are sufficient grounds to reject it, or that it involves the simple reiteration or reproduction of a prior identical or similar rejected petition.

Drafted by Magistrate Castillo Víquez; and,

Considering:

I.- Preliminarily. Regarding the coadjuvancy petition. By brief filed on January 3, 2022, Mariela Fallas Pacheco requests that a coadjuvancy petition be filed in this action of unconstitutionality. Article 83 of the Law of Constitutional Jurisdiction establishes, to this effect, that within fifteen days following the first publication of the notice referred to in the second paragraph of Article 81, the parties involved in matters pending as of the date 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, as the case may be, the grounds for unconstitutionality in relation to the matter that concerns them. In this specific case, the coadjuvancy petition is inadmissible, not only because the petition lacks a signature, authentication, and the corresponding stamp of the Bar Association (Colegio de Abogados), but also because coadjuvancy involves an accessory procedural intervention and its fate follows that of the main intervention, which, for the reasons detailed *infra*, is inadmissible.

II.- Regarding the admissibility requirements for the action of unconstitutionality. The instant proceeding was instituted for the purpose of guaranteeing the supremacy of the Political Constitution over norms or other provisions of a general nature. In light of this and by express will of the legislator, it is of a high technical degree, so that for its admissibility, certain requirements established by law must be strictly met. Among the required elements are: adequate substantiation of the grounds for unconstitutionality with specific citation of the Constitutional Law 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), accreditation of standing conditions (powers of attorney and certifications), and the literal certification of the brief where the reservation of unconstitutionality was made in the prior matter (Article 79).

III.- Regarding the petitioner's standing. This Court considers that the petitioner's standing derives from the first paragraph of Article 75, insofar as the *amparo* appeal No. 21-021972-0007-CO is pending resolution and duly processed. In said proceeding, the petitioner alleged 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, by 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 of the Legislative Assembly (Reglamento Autónomo de Servicio de la Asamblea Legislativa), which requires proof of the covid-19 vaccine for regular and confidential personnel of the Legislative Assembly, as well as for those who work ad honorem; 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 29. The base matter states that the foregoing implies a threat of sanction that renders nugatory 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 be vaccinated, in accordance with 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 disputed regulation does not contemplate such a request. In accordance with the foregoing, the base matter constitutes a reasonable means to protect the petitioner's rights as an ad honorem official of a public institution, and therefore he has standing to raise his arguments regarding his condition as a public official. Consequently, he has standing to bring action before this jurisdiction in that sense.

IV.- Regarding other formalities and the admissibility of this action. As this Court has indicated in its jurisprudence, the requirement of sufficient substantiation does not amount to a mere formality, but rather constitutes an essential admissibility requirement. This was set forth in judgment No. 2013-16944 of 2:30 p.m. on December 18, 2013:

“II.- INADMISSIBILITY FOR LACK OF SUBSTANTIATION. Pursuant to Article 78 of the Law of Constitutional Jurisdiction, the brief filing the action of unconstitutionality must set forth the grounds clearly and precisely, with specific citation of the norms or principles considered infringed. Said requirement does not amount to a mere formality, but rather an essential admissibility requirement, because by virtue of the principle *pro sententia* - 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 exists 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 as to obtain the issuance of a judgment; the foregoing not only facilitates the administration of justice but also avoids the imposition of obstacles to not achieving it (see in the same sense, judgments numbers 93-5175, 3041-97, 01-06, 2874-06, 1622-08 and 2887-08). Consequently, the lack of substantiation of the action prevents the issuance of a duly reasoned and consistent judgment consistent with what is sought. Likewise, it is inadmissible for this Chamber to rule on the merits of norms challenged in an action when the petitioner does not substantiate the reasons for the challenge, since this would entail conducting an abstract constitutional review as an academic exercise, which is not compatible with the purpose of a proceeding of this nature.” (Emphasis not in the original).

In the *sub examine*, the petitioner brings the action against “Executive Decree 43249-S, entitled 'Reform to Executive Decree No. 42889-S of March 10, 2021, denominated reform to Executive Decree No. 32722-S of May 20, 2005, 'Regulation 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 Regulation 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 - 'Regulation 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- 'Regulation 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 Regulation for the Licensing of Health Services'; the National Guidelines for the Surveillance of the COVID-19 disease; the General Guidelines for the use of Personal Protective Equipment (PPE), to prevent exposure to Coronavirus (COVID19); the Procedure Manual for the execution of vaccination against COVID-19 in 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 norm or regulation issued by other public institutions that oppose the principle of prior and free informed consent”; however, in the substantiation provided in the filing brief, he 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. Regarding the rest of the challenged regulations, the action lacks substantiation, as the petitioner not only omitted to refer to the provisions and content of each challenged regulation or guideline, but also to indicate how the fundamental norms and principles are violated, individually. Although, subsequently, the petitioner provided a brief seeking to amend those deficiencies, the fact is that he limited himself to citing the norms without developing each one of them, in order to contrast them with the Constitutional Law; he only challenges the mandatory nature of the vaccine without informed consent, but without offering a true substantiation and argumentation regarding each challenged norm. Likewise, he seeks to challenge, in an open and generalized manner, “any norm or regulation issued by other public institutions that oppose the principle of prior and free informed consent”, which is entirely inadmissible, as it is the petitioner’s responsibility to determine and adequately substantiate the provisions whose annulment he seeks in this type of proceeding. Thus, the action is admissible only against Executive Decree No. 42889-S of March 10, 2021, partially reformed by Executive Decree No. 43249-S of October 7, 2021, having met all the respective formalities. As for the rest, it is considered appropriate to reject the action outright.

V.- Regarding the object of the action. Having noted the foregoing, the petitioner requests that the unconstitutionality of Executive Decree No. 42889-S of March 10, 2021, partially reformed by Executive Decree No. 43249-S of October 7, 2021, be declared, considering that it violates:

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 Regulation of the Costa Rican Social Security Fund (CCSS), and in the jurisprudence of the Inter-American Court of Human Rights. He argues that the challenged decree is unconstitutional, as it does not provide for the existence of free, prior, and informed consent, but rather, quite the contrary, provides for the mandatory nature of vaccination against covid-19 against the principle of self-determination and with serious consequences in case of non-compliance for public officials and some private sector workers, without first providing all the required information to guarantee their life.

The principle of equality and non-discrimination derived from Article 33 of the Political Constitution. He 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. He states that there is no technical justification demonstrating 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 forced to be vaccinated, harming their autonomy.

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 or contrary to people who do wish to do so, as there has been no clear and truthful information about its effects on the population's health. He indicates that, 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 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 not known, and that it is still in the experimental phase, without guarantee or responsibility on the part of the manufacturer, that it is the only alternative to overcome the SARS-CoV-2 health crisis, so 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.

The principle of legality established in Articles 11 of the Political Constitution and 11 of the General Public Administration Law (Ley General de la Administración Pública), due to the use of the term vaccine in the case of inoculation against covid-19, which does not meet the main characteristic, inducing protective active immunity against the corresponding infectious disease, according to Article 1, subsection p) of the Regulation 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 Ethics Committees and Principles of Good Clinical Practices. He 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 it was approved as a "vaccine", they confirm that the immunity period is not known; therefore, if the duration of effectiveness is not known until the study is concluded, the contraindications, interactions, and adverse reactions cannot be known with certainty either.

The precautionary principle in health matters, given the mandatory nature of vaccination without prior medical examinations. He indicates that a double discourse has been managed, because while they affirm that the "vaccines" are safe, on the other hand, they accept that studies demonstrating their effectiveness and safety are lacking. It is because of this enormous confusion, the lack of data, 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 be vaccinated, and even the World Health Organization has stated this.

The principle of hierarchy of norms, developed in Articles 7, 48, 129, and 140, subsection 3) of the Political Constitution, as 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. The mandatory nature of the vaccine violates these internationally recognized fundamental human rights, as they threaten the physical integrity of individuals, by imposing on public sector officials and extending it to private sector workers, the introduction into their body of a vaccine without prior, informed, full, and free consent, without respecting their autonomy of will. Likewise, it seriously transgresses the right to the psychic and moral integrity of individuals, by forcing said officials to be inoculated, in an intimidating manner, since, 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 in his case.

The principle of conventionality, as the country has committed to guaranteeing the right to health, as well as the impossibility of receiving arbitrary interference by governments in individuals.

Laws subsequent to the National Vaccine Law, such as Article 2, subsection c) of Law No. 8239 of April 2, 2002, “Law of rights and duties of users of public and private health services,” as 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 indicating the right of every person to maintain total privacy over their clinical history, except when, through a special law, notification must be given to 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, as the decree itself indicates, is not a health authority. He also argues that the obligation to be vaccinated and to reveal information regarding the medical history harms the provisions of Article 9, subsection 1) of the "Law on the Protection of Individuals regarding the processing of their personal data," and its transgression is sanctioned in Article 31.

The jurisprudence of the Inter-American Court of Human Rights related to the right to life and informed consent, as the challenged decree not only puts the right to life and health at risk, but also undermines the entire democratic system, so that the foundations of the Rule of Law are seriously affected, due to the direct, totalitarian, and arbitrary intrusion of the State.

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. He indicates that the authorities have in no way technically or scientifically substantiated the degree of effectiveness of the vaccine in relation to preventing the spread of covid-19, so it is not possible to carry out an assessment of proportionality, necessity, and reasonableness of the measure that threatens the principle of autonomy of will. On the other hand, the sanctions for public officials for not getting vaccinated are disproportionate; they involve blanket criminal or administrative-sanctioning types that contravene the principle of criminal and administrative-sanctioning specificity. It is intended to open administrative proceedings 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 schedule 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 whether a crime has been committed. In this way, workers are coerced into undergoing mandatory inoculation, despite their well-founded fears of suffering short or long-term harm to their health, due to imminent disciplinary actions. He questions both the term of public order on which the regulation is based and the sanctions for workers who do not get vaccinated.

The principle of informational self-determination, related to 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 paragraph, of the American Convention on Human Rights, due to the lack of protection of sensitive information, as it involves a medical matter, since it imposes the obligation to communicate this information to human resources departments without any legal authorization to do so, also violating the Law on Protection regarding the Processing of Personal Data. Likewise, he considers it is violated by the absence of free and informed consent, without prior information on the possible effects of vaccination, as well as the examinations prior to said inoculation.

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 be vaccinated is established, without people knowing beforehand whether or not they run the risk of suffering serious consequences to their body, which he considers cruel and degrading treatment, by not considering that there are people who have various ailments, given the absence of free and duly informed consent. Furthermore, the right of every person to dispose of their own body is violated.

The regulatory power established in Article 140, subsections 3) and 18) of the Political Constitution, and the principle of legal reserve, by imposing the mandatory nature of vaccination without free and duly informed consent by decree and not by law. Forcing public officials to be vaccinated without the Caja Costarricense de Seguro Social informing them about the possible effects, much less about labor rights regarding the occupational risk insurance policy in the event of an adverse effect caused as a result of said mandatory nature of the covid-19 vaccination, grossly violates the constitutional rights of all public officials, regarding the rights to privacy, integrity, and human dignity.

The Decreto Ejecutivo n.° 43249-S challenged here provides as follows:

"Article 1.- Amend Article 2 of Decreto Ejecutivo N° 42889-S of March 10, 2021, called Amendment to Decreto Ejecutivo N° 32722-S of May 20, 2005, called 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:

"Article 2.- Based on Article 3 of the Ley Nacional de Vacunación, Ley número 8111 of July 18, 2001, as well as ordinals 2 and 18 of the Reglamento a la Ley Nacional de Vacunación, Decreto Ejecutivo número 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.

When summoned by those in charge for such purpose and in accordance with the respective institutional planning, the persons covered 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 wish to be vaccinated against COVID-19." Given that this Court has already ruled on several of the aspects raised by the petitioner, some precedents are cited below, which will allow several of the arguments to be resolved, jointly or separately, as follows.

VI.- On the mandatory nature of vaccination, the principle of legal reserve, and the right to life and health.

In judgment n.° 2021-23195 of 9:15 a.m. on October 15, 2021, recently reiterated in n.° 2021-26519 of 1:10 p.m. on November 24, 2021, this Court reaffirmed its criterion, regarding the mandatory nature of vaccination against covid-19 established in the decree challenged here, stating the following:

"V.- ON THE SPECIFIC CASE. The Chamber notes that, according to the reports issued by the Minister of Health and the Medical Manager, both of the Caja Costarricense de Seguro Social, the vaccines being administered in the country against the coronavirus COVID-19 are not medicines in the experimental phase.

VI.- REGULATORY FRAMEWORK: The Civil Code provides as follows:

"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 does not correspond to the original).

The Ley General de Salud, regarding 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." Furthermore, regarding the obligations of administered persons, the aforementioned law indicates 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.

Is especially obligated to comply:

(...)

• b)The preventive measures that the health authority orders when a disease appears." Vaccination is precisely a preventive measure to avoid the spread of a communicable disease.

Additionally, Article 3 of the Ley Nacional de Vacunación states:

"(...) In accordance with this Law, vaccinations against diseases are mandatory when deemed necessary by the Comisión Nacional de Vacunación y Epidemiología, 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 administered 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 scheme applied to the entire population, and to vaccines for special schemes targeting specific risk groups.

The Comisión Nacional de Vacunación y Epidemiología must prepare an official list of vaccines, which shall be included in the Reglamento 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 accordance with this, Article 6 of the same regulatory body, in its subsections a), b), and e), recognizes as functions and objectives of the Comisión de Vacunación y Epidemiología:

"a) Guarantee the mandatory and free nature of vaccines and effective access to them for the entire population (...) b) Formulate the general political and strategic guidelines on vaccination, applicable in the health sector (...) e) Define, jointly with the authorities of the country's health sector, the schedules and vaccines referred to in Article 3 of this Law." From the foregoing, it is not possible to affirm that the principle of legal reserve in the regulation of fundamental rights has been violated, since 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 Decreto No.42889-S "Reforma Reglamento a la 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.

Likewise, in exercise of the same powers, Article 2 of Decreto 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." On the other hand, Article N° 18 of Decreto Ejecutivo N° 32722 details the official list of vaccines included in the Esquema Público Básico Universal de Costa Rica, an article amended by Article 1° of Decreto Ejecutivo N° 42889 of March 10, 2021, specifically, in point N° 15, which includes Covid-19.

For its part, it is important to note that Article N° 150 of the Ley General de Salud, Ley N° 5395 of October 30, 1973, a public order law 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 Ministry of Health.

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.

VII.- It should be noted that mandatory vaccination for cases of COVID-19 is not absolute, but rather, as indicated, 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 "Manuales de Procedimientos para la ejecución de vacunación contra COVID-19 en los establecimientos de salud de la 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:

"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 reference from a specialist doctor indicating that they can be vaccinated.

If there is an indication to vaccinate, this shall 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 in patients who have had a mild, moderate, or severe allergic reaction during the administration of the first dose of this vaccine." In 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:

"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 reference from a specialist doctor indicating that they can be vaccinated. If there is an indication to vaccinate, this administration shall be carried out at intramural vaccination sites, with access to emergency services in case anaphylaxis treatment is required. - Pregnancy -Maternal Lactation • Note: In the case of women from any of the priority groups who are in a period of maternal lactation and wish to be vaccinated for the benefit they may have with this intervention, the CNVE agreed that they must be explained that there are no studies in that population and that the risks of the application of 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 to make the decision to be vaccinated, assessing risk/benefit. They must not present lactation certificates, nor must 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 who receive 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 -Maternal Lactation Note: In the case of women from any of the priority groups who are in a period of maternal lactation and wish to be vaccinated for the benefit they may have with this intervention, the CNVE agreed that they must be explained that there are no studies in that population and that the risks of the application of 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 to make the decision to be vaccinated, assessing risk/benefit. They must not present LM certificates, nor must 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, protected persons and the doctors who examine them could determine when conditions are present that medically advise against vaccination. Moreover, although there might be some margin of doubt about 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 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.

VIII.- Likewise, this Court cannot ignore the evidence provided in other amparo appeals, for example, expedientes 21-008192-0007-CO and 21-008767-0007-CO (taken ad effectum videndi) in which it is recorded that the CCSS authorities issued circular n.°GG-1156-2021 of April 16, 2021, through which the General Management regulates the institutional application of Decreto Ejecutivo n.°42889-S on the mandatory nature of the COVID-19 vaccine.

Said circular provides for 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. Furthermore, in case of refusal, the authorities must follow a series of steps: 1) a 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 of a clinical team composed of the comprehensive care physician for the worker and the person responsible for immunizations, to finally assess the possibility of opening an administrative procedure. By virtue of the foregoing, a margin is also accredited for workers to justify before the employer instances their refusal to receive vaccination due to medical contraindications.

In 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…" The criterion set forth is fully applicable to the object of this action. This Chamber has ruled out that Decreto Ejecutivo n.° 42889-S, modified by Decree n.° 43249-S, violates the principle of legal reserve in the regulation of fundamental rights, since 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 existing regulations by including the vaccine in question in the national vaccination scheme authorized by law.

On the other hand, as indicated by the aforementioned precedent and judgment n.° 2021-26519, the personnel to be vaccinated shall be defined under the technical criterion of the Coordinación de Inmunización and Technical 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 deals with technical, medical, and scientific aspects concerning vulnerability to a virus. Nor is it a vaccine whose studies regarding effects are in the experimental phase, as this Court has held to be accredited in various amparo appeals. Thus, if the petitioner disagrees with such criterion, it is equally a technical discussion that would not be appropriate to be elucidated in this jurisdiction, but rather through the legality channel, through the various means of evidence that said channel contemplates and that allow its broad discussion and technical and scientific verification. This being the case and in accordance with the foregoing, it is not considered that the right to health of individuals is being harmed; far from it, the aim is to ensure it at the collective level, for a public interest. This is what this Court stated in the aforementioned judgments and when referring to the general legitimacy of the purpose pursued by establishing the mandatory nature of a vaccine, in judgment n.° 2020-0019433 of 09:20 a.m. on October 9, 2020, indicating the following:

"(...) 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 safeguarding public health and preventing diseases constitutes a constitutionally legitimate purpose that can validly justify the mandatory nature of vaccines (...)"

The previously cited precedent -n.° 2021-23195- also dismisses the petitioner's affirmation that the population has not been informed of the real effects that the vaccine in question can produce, nor that the risks in this regard have been warned of, stating:

"VII.- It should be noted that mandatory vaccination for cases of COVID-19 is not absolute, but rather, as indicated, 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 "Manuales de Procedimientos para la ejecución de vacunación contra COVID-19 en los establecimientos de salud de la 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:

"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 reference from a specialist doctor indicating that they can be vaccinated.

If there is an indication to vaccinate, this shall 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 in patients who have had a mild, moderate, or severe allergic reaction during the administration of the first dose of this vaccine." In 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:

"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 reference from a specialist doctor indicating that they can be vaccinated. If there is an indication to vaccinate, this administration shall be carried out at intramural vaccination sites, with access to emergency services in case anaphylaxis treatment is required. - Pregnancy -Maternal Lactation • Note: In the case of women from any of the priority groups who are in a period of maternal lactation and wish to be vaccinated for the benefit they may have with this intervention, the CNVE agreed that they must be explained that there are no studies in that population and that the risks of the application of 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 to make the decision to be vaccinated, assessing risk/benefit. They must not present lactation certificates, nor must 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 who receive 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 -Maternal Lactation Note: In the case of women from any of the priority groups who are in a period of maternal lactation and wish to be vaccinated for the benefit they may have with this intervention, the CNVE agreed that they must be explained that there are no studies in that population and that the risks of the application of 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 to make the decision to be vaccinated, assessing risk/benefit. They must not present LM certificates, nor must 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, protected persons and the doctors who examine them could determine when conditions are present that medically advise against vaccination. Moreover, although there might be some margin of doubt about 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 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." Nor is it true that people's ailments are not considered, thereby harming their right to health. The challenged decree excludes from mandatory vaccination against covid-19 those officials who, due to a duly declared medical contraindication, cannot be vaccinated, thereby safeguarding their right to health. For such purposes, the challenged Article 2 provides:

"Article 2.- Based on Article 3 of the Ley Nacional de Vacunación, Ley número 8111 of July 18, 2001, as well as ordinals 2 and 18 of the Reglamento a la Ley Nacional de Vacunación, Decreto Ejecutivo número 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.

When summoned by those in charge for such purpose and in accordance with the respective institutional planning, the persons covered 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 wish to be vaccinated against COVID-19." Similarly, in judgment n.° 2021-19469 of 9:20 a.m. on August 31, 2021, this Chamber indicated: "That is, protected persons and the doctors who examine them could determine when conditions are present that medically advise against vaccination. Moreover, although there might be some margin of doubt about 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 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." As a corollary of the foregoing, the alleged violations of the right to life, health, the principle of legal reserve, and self-determination against the mandatory nature of vaccination against covid-19 are dismissed.

VII.- On informed consent and the protection of sensitive information. In judgment n.° 2021-24027 of 10:10 a.m. on October 26, 2021, this Court ruled on this argument, in relation to the decree challenged here, reiterating its precedents in the following sense:

"IX.- The appellant insisted that mandatory vaccination not be applied without informed consent in which patients are told 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 worth noting that the recognition of the need to grant informed consent stems from the recognition of patients' rights to autonomy and information. That is, based on the information provided by their treating physician, a patient chooses to accept or reject a medical service. In the specific case, as has been examined, there are sufficient provisions legitimizing the mandatory nature of the vaccine, so 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 Ley General de Salud, and vaccination regulations cited above). This does not prevent emphasizing that in all cases the right to information of all persons subjected to this mandatory vaccination must be respected.

On this matter, it is appropriate to cite again the Manual de Procedimientos para la ejecución de vacunación contra COVID-19 en los establecimientos de salud de la Caja Costarricense de Seguro Social, which precisely requires ensuring the right to information of users and provides the following:

"8.6 Information to the user:

User education must be mandatory before, during, and after vaccination:

- 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, vaccination must be intramural.

- It is of utmost importance to explain to the user which vaccine was administered (whether Pfizer/BioNTech or AstraZeneca) and to indicate that the second dose to be administered must be the same one.

Furthermore, the patient must be reminded of the importance of complying with the date for the administration of the second dose as indicated." - Record in the vaccination card the type of vaccine and the date of administration of the first and second doses.

- Provide information to the user about the benefits of receiving the vaccine and about the main side effects and the importance of consulting health services if, during the 3 weeks following vaccination, they experience difficulty breathing, chest pain, blurred or double vision, single or multiple bruises, reddish or purplish spots, swelling or pain in a leg, persistent abdominal pain, severe headache or one that worsens more than 3 days after vaccination).

- Information about reported side effects and those that could occur when it begins to be applied massively in the population. And the manner in which they must be reported should any of them occur after vaccination.

- In the case of the AstraZeneca vaccine, the vaccinated person must be informed of the importance of reporting any adverse effect, as with the Pfizer vaccine, through the already known channels.” From the foregoing, it is concluded that the authorities are instructed on the obligation to respect patients' right to information, and there is no evidence that they have omitted what is necessary for it to have been exercised. Consequently, this aspect of the appeal is dismissed.” Based on the foregoing, the position of this Court, 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 purposes of previously safeguarding their life and health, adopting the measures they deem pertinent. However, as this Court and the petitioner himself have indicated therein, there are other provisions that complement the decree challenged herein regarding the duty to provide sufficient and adequate information prior to vaccination; just as there is special legislation that orders the safeguarding of individuals' private data, which must be guaranteed by public or private bodies (Article 2 of the Law for the Protection of Individuals Regarding the Processing of their Personal Data). Thus, the fact that this provision does not expressly contemplate it does not imply its unconstitutionality, since at the time of its application, public officials are not exempt from the obligations established in the rest of the legal system, under the terms indicated herein; and equally, there are legally responsible bodies to verify 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 alleged violations are dismissed.

VIII.- Regarding the alleged violation of the principle of equality. The petitioner argues that the challenged regulation violates this principle, since it 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 is left to the employer's discretion. He states that there is no technical justification demonstrating the need to oblige all public officials to get vaccinated. He questions that, by executive decree, officials of other branches of government and municipalities are forced to vaccinate, harming their autonomy. However, the petitioner omits to substantiate his argument by applying the due reasonableness test to the questioned regulation. This Chamber, on repeated occasions, has stated the following:

“To undertake a reasonableness test of a norm, the Constitutional Court requires that the party provide evidence or at least elements of judgment on which to base its argument, and the same procedural burden falls on whoever refutes the arguments of the action; failure to meet these requirements makes the allegations of unconstitutionality unacceptable. The foregoing is because it is not possible to conduct an analysis of 'reasonableness' without the existence of a coherent line of argument that is evidentially supported. That is, of course, when it does not involve cases whose 'unreasonableness' is evident and manifest” (Judgment No. 1999-5236 of 2:00 p.m. on July 7, 1999, reiterated in judgments 2016-14392 of 9:05 a.m. on October 5, 2016, 2019-6935 of 11:20 a.m. on April 24, 2019, and 2021-11995 of 4:31 p.m. on May 26, 2021).

Without carrying out the respective test, the petitioner's line of argument lacks foundation, as the simple assertion by the petitioner denotes two relationships that are not comparable, since he seeks to compare a public employment relationship with a private one, despite them being two regimes with completely different regulations. On repeated occasions, this Court has ruled on the statutory regime and its difference from the private sector in this sense:

“III.- Regarding the statutory regime. Our original constituents recorded in the Political Constitution of 1949, that there should be an administrative labor regime that would regulate relations between public servants and the State, in order to protect the former from arbitrary dismissals (employment stability) and to professionalize the public function (pursuit of efficiency in the service and suitability of the official). The purpose of such an undertaking was to ensure that the Public Administration had organizational factors allowing it to satisfy the right of citizens to the proper functioning of public services. For this, the procedure for selecting and appointing a servant in the Public Administration must comply with the fundamental principles provided for in constitutional Articles 191 and 192, thereby seeking suitable personnel to occupy a public position, with the purpose of guaranteeing efficiency and effectiveness in the public function. The civil service regime is not established, then, as a corporate privilege, but as a guarantee of institutional impartiality. For this, the regulatory framework governing the public function must guarantee the selection of personnel based on criteria of merit and capacity, as well as a fair balance between rights and responsibilities of public employees. Also, said legislation must provide instruments that facilitate the different administrations in the planning, organization, 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 norms of public law, such as the regime of incompatibilities, that guarantee objectivity and impartiality in the provision of public service… Having stated the above, it is clear and evident that, from the year 1949 onwards, 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, in this regard, judgment No. 1995-3125 of 4:24 p.m. on June 14, 1995). This regime necessarily implies - as indicated in the aforementioned precedent - that this relationship, by its very nature, is based on its own general principles, not only different from those of (private) labor law, but often even contrary to them…

Even less so, when such labor provisions could be imposed on the State in its capacity as employer, by organs external to it in which alien interests converge, and sometimes interests contrary to the aims of the public administration. In accordance with what was stated by the Chamber in judgment No. 2003-10615, the wording finally given to Article 191, together with the process of profound decentralization that the Costa Rican State experienced starting in 1949, led to the current situation where the existence of various statutory relationships within the Administration is valid, considering the functional independence and administrative autonomy that the legal system ensures for various public institutions. However, 'what is not legitimate –as was stated- is for the relations between each Administration-employer and its officials to be governed by rules agreed upon (contractual) between both parties, as validly occurs in private employment relations.' The Chamber has recognized that there are two broad categories of employees who render their services to the State: those who have the status of 'public official,' 'public servant,' or 'public employee,' and those who work for economic companies or services of the State, charged with activities subject to common law. The former have been defined as those who, in the performance of their duties, carry out the public administration of the State, to whom, consequently, the public employment regime is applicable, with all the principles and characteristics deriving from the provisions of numerals 191 and 192 of the Political Constitution; while the latter are those laborers, workers, and employees who, although they work for the State, do not have the status of officials or public servants because they do not participate in the public administration of the State, given that they are hired by public companies or economic services of the State charged with activities subject to common law in accordance with the exercise of their capacity under private law, 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).

As a corollary to the foregoing, the public employment relationship applicable to public servants is a special relationship of public law or statutory, which, due to such legal nature, has limitations regarding the application of common labor law. Likewise, its regulation is subject to ordinals 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).

In addition to the foregoing, regarding the claim that by executive decree it is mandated to vaccinate officials of other branches of government and municipalities, harming their autonomy, the petitioner must be advised that this Chamber has stated on repeated occasions, that the defense of the autonomy of public institutions is only invocable by their own organs 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 that sense, the petitioner lacks standing to raise such an objection. Consequently, the allegations regarding the principle of equality are inadmissible.

IX.- Regarding the alleged violation of freedom of expression and thought. The petitioner argues that people who do not get vaccinated have the right to think differently or contrary to people who do wish to do so, since there has been no clear and truthful information regarding the effects on the population's health of what they call the covid-19 vaccine. He indicates that, 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 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, that it is the only alternative to overcome the health crisis caused by SARS-CoV-2, therefore, people who do not wish to get 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 placed above a supposed interest of science or even of society. The reasons why the petitioner claims freedom of thought and expression are violated have been dismissed in the preceding 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 been pointed out, moreover, that the mandatory vaccination ordered in the challenged decree derives from a public interest in safeguarding the health of the collective, which is legally justified in Article 46 of the Civil Code, in Article 147, subsection 3 of ordinal 345 of the General Health Law, and in 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, people effectively have the right to obtain beforehand the necessary information to safeguard their health.

In relation to these rights, this Court, in judgment No. 2018-17048 of 9:15 a.m. on October 12, 2018, has stated the following:

“Regarding freedom of thought and expression, the American Convention on Human Rights prescribes the following in ordinal 13:

“Article 13. Freedom of Thought and Expression.

1. 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.

2. 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:

• a)respect for the rights or reputations of others; or b) the protection of national security, public order, or public health or morals.

3. The right of expression may not be restricted by indirect methods or means (…)” (emphasis added).

In this line, the Inter-American Court has been consistent in pointing out that, in light of ordinals 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 set forth in a law in the formal sense, and be necessary and useful for pursuing said 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 said liability must satisfy four requirements for it to be valid under Article 13(2): 1) the grounds for establishing liability must be predetermined; 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 being 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).” Now, the decree in question does not prevent people from thinking otherwise and expressing their disagreement in that regard. And although it mandates that, despite what they think, they must submit to mandatory vaccination, it is due to a public order limitation, which is why the exercise of fundamental rights can indeed be limited. Precisely, the Chamber, when evacuating 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:

“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 individual autonomy, will be transcribed. The articles read as follows:

"Article 2.- GRATUITY AND EFFECTIVE ACCESS The mandatory nature and gratuity of vaccines are guaranteed to the entire population, as well as effective access to vaccination, especially for children, immigrants, and the sectors located below the poverty line." "Article 3.- MANDATORY NATURE In accordance with this Law, vaccinations against diseases are mandatory when deemed necessary by the National Vaccination and Epidemiology Commission, which is created in this Law, in coordination with the Ministry of Health and the Costa Rican Social Security Fund..." "Article 6.- FUNCTIONS The Commission shall have the following basic functions and objectives:

Guarantee the mandatory nature and gratuity of vaccines and the effective access of the entire population to them..." "Article 11.- TARGET POPULATION, CONDITIONS, AND AUTHORIZATION The Commission, together with the authorities of the Ministry of Health and the Costa Rican Social Security Fund, shall determine the sectors of the population that must be vaccinated; in addition, it shall decide if the vaccination is mandatory or optional, or shall set forth the conditions under which the vaccines must be supplied, according to the programs established for this purpose..." Taking into account the provisions of the transcribed norms, as well as the statement of motives of the consulted bill, this Chamber does not consider that the consultants are correct in saying that establishing the mandatory nature of vaccines violates the right of individual autonomy. 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, whose recognition must be coupled with the imposition of the duty to care for one's own health and that of others. Thus, within a comprehensive social policy aimed at solving the effects of social deficiencies, the observance of the principle of coherence of purposes determines that actions regarding working conditions, social security, education, housing, nutrition, and population be harmonized with those of health, due to the interconnectedness and interdependence of each. In this way, the statement in the consulted bill of the provision of free and mandatory medical care for the entire population in no way violates the principle of individual autonomy, yet it does guarantee essential health care in safeguarding the inescapable responsibility of the State to watch over the health of each and every citizen.” Likewise, 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:

“As for the first topic, it must be indicated that, indeed, Constitutional Law expressly recognizes the right of every person to freedom of thought, conscience, and religion. Even in the specific case of children, Article 14 of the aforementioned Convention on the Rights of the Child expressly establishes:

"Article 14 1. States Parties shall respect the right of the child to freedom of thought, conscience, and religion.

2. 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.

3. 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 underline is not from the original).

With which it is confirmed that said numeral recognizes the possibility of imposing reasonable limits on the exercise of the referenced 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 referenced vaccines aims 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 -, 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 be remembered that this Chamber has highlighted:

“(…) The preponderance of life and health, as supreme values of individuals, is present and indicated as requiring obligatory protection by the State, not only in the Political Constitution but also in various international instruments subscribed to 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 petitioner seeks protection must be clear, as well as the degree of commitment 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) In the sub examine, it has been proven that both freedoms - thought and expression -, like any fundamental right, are not absolute. In any case, the challenged decree does not, in any way, impede the freedom to seek, receive, and impart information and ideas of all kinds, even those contrary to vaccination against covid-19. And although the manifestation of these cannot be exercised by opposing vaccination, the truth is that this is a reasonable limitation in the face of the State's need to protect the fundamental right to health of all persons and to prevent diseases, which, as in this case, has had publicly verifiable devastating worldwide 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 provision that protects the officials themselves, contributes to achieving a prompt reactivation not only of health services but in general, reducing the inherent costs of the situation that this pandemic has caused. Furthermore, it helps prevent any workplace from being a source of contagion, and there is currently no other alternative or tool with equal or greater efficacy to protect the health of the entire population. The petitioner must take into consideration that the benefits of the provision under study transcend to society as a whole –regarding the right to life, to health, and the improvement of economic and social conditions, as is inferred from the justification given in the very regulation in question–, aspects that, as has already been pointed out, are greater than the affectation a single worker could receive. Consequently, this extreme point is rejected on the merits.

X.- Regarding the alleged violation of the principle of legality and of laws subsequent to the Vaccine Law. The petitioner claims that the principle of legality is violated, since, in his view, the use of the term vaccine in the case of the inoculation against covid-19 does not meet the main characteristic, which is to induce active protective immunity against the corresponding infectious disease, according to Article 1, subsection p) of the Regulation to the National Vaccine Law. 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 Ethics Committees and Principles of Good Clinical Practices. He states that it is a vaccine profile without conclusive clinical studies, and that, 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.

In this regard, it is necessary to reiterate that this Chamber has ruled out that Executive Decree No. 42889-S, amended by Decree No. 43249-S, violates the principle of legal reserve in the regulation of fundamental rights, since the mandatory application of the coronavirus COVID-19 vaccine was defined by the National Vaccination and Epidemiology Commission, in accordance with the powers granted by the National Vaccination Law, which defines the general regulatory framework in the matter. In that sense, the decree challenged herein is consistent with existing regulations by including the vaccine in question in the national vaccination schedule authorized by law, so neither does it violate the principle of legality. It is also reiterated that the personnel to be vaccinated will be defined under the technical criterion of the Immunization Coordination and Technical Secretary of the National Vaccination and Epidemiology Commission of the Health Surveillance Directorate, whose basis is not subject to review in this jurisdiction, as it deals with technical, medical, and scientific aspects concerning vulnerability to a virus; and that neither is it a vaccine whose studies, regarding effects, are in an experimental phase. Consequently, the allegation raised in that sense is dismissed, and it is reiterated to the petitioner that, if he disagrees with the criterion of the public authorities regarding such aspects, even in calling it a “vaccine,” it is likewise a technical discussion that would not be appropriate to be resolved in this jurisdiction but rather in the legality channel, through the different means of proof that this channel contemplates and that allow for its broad discussion and technical and scientific verification.

On the other hand, this Court has warned, on repeated occasions - see judgment 2021-11972 of 9:30 a.m. on May 26, 2021 -, that an apparent confrontation between a legal norm and a decree constitutes a conflict of legality, whose discussion does not fall within this jurisdiction.

Therefore, the extreme raised by the claimant regarding the violation of other norms of lower rank than the Political Constitution must also be rejected.

XI.- On the alleged violation of the principles of conventionality, hierarchy of norms, and the case law of the Inter-American Court of Human Rights related to the right to life and informed consent.

The petitioner states that the challenged 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, because establishing the mandatory nature of the covid-19 vaccine for workers, without prior, full, and free informed consent, and without respecting their autonomy of will, violates the physical integrity of persons. The international instruments in question provide the following:

From the International Covenant on Economic, Social and Cultural Rights:

“Article 2 1. 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.

2. 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.

3. 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.” “Article 5 1. 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.

2. 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.” “Article 6 1. 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.

2. 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.” “Article 7 The 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:

(a) Remuneration which provides all workers, as a minimum, with:

(i) 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; (ii) A decent living for themselves and their families in accordance with the provisions of the present Covenant; (b) Safe and healthy working conditions; (c) 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; (d) Rest, leisure and reasonable limitation of working hours and periodic holidays with pay, as well as remuneration for public holidays.” From the Universal Declaration of Human Rights:

“Article 12 No 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.” From the American Convention on Human Rights:

“Article 1 Obligation to Respect Rights 1. 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, color, sex, language, religion, political or other opinion, national or social origin, economic status, birth, or any other social condition.

2. For the purposes of this Convention, "person" means every human being.” “Article 3 Right to Juridical Personality Every person has the right to recognition as a person before the law.” “Article 4 Right to Life 1. 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.

2. 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.

3. The death penalty shall not be reestablished in states that have abolished it.

4. In no case shall capital punishment be inflicted for political offenses or related common crimes.

5. 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.

6. Every person condemned to death has 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.” “Article 5 Right to Humane Treatment 1. Every person has the right to have his physical, mental, and moral integrity respected.” Having reviewed the provisions of the instruments invoked by the claimant cited supra herein, this Tribunal considers it necessary to reiterate what was previously stated, in the sense that the decree challenged herein does not harm the right to life and health of individuals; 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. Therefore, precisely, in weighing fundamental rights, the mandatory nature of vaccines to secure the right to public health is neither unconstitutional nor harmful to the international instruments invoked. What was indicated by this Tribunal, in relation to the General Vaccination Law in that regard, is reiterated:

“…Thus confirming 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 bears reiterating that this Chamber has already recognized 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. Note that, in this case, the application of the referred vaccines aims 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-, 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, given that the preservation and protection of public health is at stake. Therefore, it should be recalled that this Chamber has emphasized:

“(…) The preponderance of life and health, as supreme values of persons, is present and indicated as requiring mandatory protection from the State, not only in the Political Constitution, but also in various international instruments subscribed to 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 unquestionably and unconditionally. (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) In the same vein, as set forth, regarding the right to prior informed consent, “there are sufficient provisions that legitimize the mandatory nature of the vaccine, whereby autonomy, in such cases, is diminished in order to protect the general interest and well-being, namely, public health…” (Judgment No. 2021-24027 of 10:10 a.m. on October 26, 2021). And it was equally 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 Procedural Manual for the execution of vaccination against COVID-19 in the health facilities of the Caja Costarricense de Seguro Social, which precisely requires ensuring the right to information of users and exempting those workers who present any medical contraindication from vaccination. Certainly, the case law of the Inter-American Court of Human Rights provided by the claimant refers to the need for informed consent before performing 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 to 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, whose effects transcend beyond one person or one family, but rather cross borders and has produced burdensome consequences worldwide due to the high death toll and the conditions required to provide adequate medical care in times of high or very high demand. Note that the provision in question aims to protect 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, since it does not contravene the provisions of international conventions, but rather applies their provisions in an integral and harmonious manner, seeking their exercise without detriment to that upon which the exercise of all other human rights depends, life. Consequently, the claimant's arguments must be rejected on the merits.

XII.- On the accused violation of the principle of reasonableness and proportionality in the sanction for not being vaccinated.

It is accused that establishing sanctions such as dismissal without employer liability and/or a fine of approximately 500,000 colones, for failure to get vaccinated against covid-19, violates the right to work and the principle of reasonableness and proportionality. 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, making it impossible 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 public officials for not getting vaccinated are disproportionate, constituting blank criminal or administrative-sanctioning offenses, which contravene the principle of criminal and administrative-sanctioning typicity. It indicates that the aim is to open administrative proceedings aimed at dismissing public officials who do not get vaccinated without employer liability, 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 schedule or not. 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 Prosecutor's Office to determine if a crime has been committed. In this way, it asserts that workers are coerced into undergoing a 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 public order term on which the regulation is based and the sanctions for workers who do not get vaccinated.

Notwithstanding the foregoing, the claimant does not specify in which regulatory provisions the sanctions whose proportionality he questions are established, which prevents this Tribunal from ruling on the matter. Note that Executive Decree No. 43249-S, challenged herein and whose unconstitutionality was invoked in the underlying matter, only reformed Article 2 of Executive Decree No. 42889-S of March 10, 2021, and the sanctions challenged by the petitioner do not stem from its text.

Executive Decree No. 43249-S, regarding which this action concerns, provides the following:

“Article 1.- Reform Article 2 of Executive Decree No. 42889-S of March 10, 2021, denominated Reform to Executive Decree No. 32722-S of May 20, 2005, denominated Regulation to the National Vaccination Law and Establishment of the Obligatoriness of the COVID-19 Vaccine, so that henceforth the following is stated:

"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 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 Vaccination and Epidemiology Commission, in the 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 shall be under the terms set by the National Vaccination and Epidemiology Commission for the public sector and the private sector.

When summoned by those in charge for such purpose 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 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 want to be vaccinated against COVID-19."" By virtue of the foregoing, the claimant's lack of precision leads to a material impossibility for this Tribunal to rule, and regarding such extreme, the action must be rejected outright.

XIII.- As a corollary to the foregoing, the action must be 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 of the right to life and health. In all other respects, the action is rejected outright.

XIV.- SEPARATE NOTE BY MAGISTRATE CASTILLO VÍQUEZ. I concur with my colleagues in the arguments they put forth to reject the action outright, given that there is no evident and manifest contradiction between the law and the challenged decree. The Tribunal's position, to the effect that when a regulatory norm violates or exceeds the provisions of a law, it is a matter of legality, the discussion of which does not correspond to this jurisdiction, is, in general terms, legally correct. There is no doubt that it is the ordinary Judge who is competent to determine the scope of interpretation and application of the Law and, consequently, he is the one called upon to establish whether a regulatory norm violates or does not violate the legal norm. However, there is an important nuance in this matter, and that is that, from my point of view, when there is manifest evidence, which is obvious, that the regulatory norm exceeds, suppresses, or contradicts the text of the Law, there is no doubt that the principle of the force, authority, or efficacy of the Law is grossly violated; a principle that has constitutional coverage and must be protected by this Tribunal.

As is well known, the principle of the force, authority, or efficacy of law refers to the potency (active force), the resistance (passive force), and the regime for challenging 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 on grounds of unconstitutionality and, therefore, can only be annulled by means of a resolution of the Constitutional Chamber.

XV.- DISSENTING VOTE OF MAGISTRATE RUEDA LEAL. I separate myself from the opinion of the majority of this Tribunal and save my vote in this matter, considering that the decision to reject this unconstitutionality action 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 unconstitutionality action is a process, "established with the purpose of guaranteeing the supremacy of the Political Constitution against norms or other provisions of a general nature and that for that same reason a set of formalities must be fulfilled so that the Chamber can validly hear the merits of the challenge" as has been pointed out in the ample case law of this Chamber. However, it is precisely the law itself that orders the treatment that the different formalities and their eventual non-compliance must receive, as extracted from the text of Article 80 of the Law of Constitutional Jurisdiction which states:

“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 requirements have been omitted and shall order them to be fulfilled within three days (…)” In this matter, among other requirements, an adequate and sufficient substantiation is lacking, as required by Article 79 of the Law of Constitutional Jurisdiction, therefore, the application of the prevention to the claimant to remedy the detected omission is unquestionable. Likewise, it is by no means unnecessary to state for the record that – in my opinion – the interpretation of Articles 78 and 79 as well as that of Article 80 itself of the Law governing this jurisdiction must be broad to the benefit of those who come to this Chamber, so that access to constitutional justice is not unnecessarily limited. Thus, for reasons of form and without referring to the merits of the matter, I save my vote and order the cited prevention to be made.

XVI.- Documentation provided to the case file. The parties are warned that if they have provided any paper document, as well as objects or evidence contained in any additional electronic, computer, magnetic, optical, telematic device or one 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 "Regulation on the Electronic Case File before the Judicial Branch", approved by the Plenary Court in session No. 27-11 of August 22, 2011, Article XXVI, and published in Judicial Bulletin number 19 of January 26, 2012, as well as in the agreement approved by the Superior Council of the Judicial Branch, in session No. 43-12 held on May 3, 2012, Article LXXXI.

Therefore:

The 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 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 note. For reasons of form and without referring to the merits, Magistrate Rueda Leal dissents and orders the prevention of Article 80 of the Law of Constitutional Jurisdiction to be made.

Fernando Castillo V. President Paul Rueda L.

Jorge Araya G.

Ana María Picado B.

Ileana Sánchez N.

Aracelly Pacheco S.

Jorge Isaac Solano A.

Document Signed Digitally -- Verification Code -- *NSNPGHME6F861* **Considering:** 1.- By document received in the Secretariat of the Chamber on November 4, 2021, it is requested that the following be declared unconstitutional: *"Executive Decree 43249-S, titled 'Amendment to Executive Decree No. 42889-S of March 10, 2021, called amendment to Executive Decree No. 32722-S of May 20, 2005, "Reglamento a la Ley Nacional de Vacunación" 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 Reglamento Autónomo de Servicio de la Asamblea Legislativa; Law No. 5395 of October 30, 1973, Ley General de Salud, Law No. 8811- 'Ley Nacional de Vacunación' of July 18, 2001, Executive Decree No. 32722- 'Reglamento a la Ley Nacional de Vacunación' of May 20, 2005, Executive Decree No. 37808- 'Norma Nacional de Vacunación' of January 8, 2013, Executive Decree No. 30965-S- 'Reglamento sobre gestión de los desechos infectocontagiosos que se generan en establecimientos que prestan atención a la salud y afines' of December 17, 2002', Executive Decree No. 41045-S of May 10, 2016 'Reglamento General de Habilitación de Servicios de Salud'; the Lineamientos Nacionales para la Vigilancia de la enfermedad COVID-19; the Lineamientos generales para el uso del Equipo de Protección Personal (EPP), para prevenir la exposición por Coronavirus (COVID19); the Manual de Procedimientos para la ejecución de vacunación contra COVID-19 en los establecimientos de salud de la Caja Costarricense de Seguro Social, version #7, June 2021, Ministerio de Salud, LS-SS-013, Lineamientos sobre la vacunación contra el virus SARS-CoV-2 para la prevención de la COVID-19 -- as well as any norm or regulation issued by other public institutions that oppose the principle of prior, free, and informed consent"*, because it is deemed that they violate the principle of free and informed consent developed in Articles 20, 21, and 28 of the Constitución Política, Article 22 of the Ley General de Salud, Article 2 of Law No. 8239, "Derechos y deberes de las personas usuarias de los servicios de salud públicos y privados", Articles 1 and 4 of the Reglamento de la Caja Costarricense de Seguro Social (CCSS); the principle of equality and non-discrimination derived from Article 33 of the Constitución Política; freedom of thought and expression developed by Articles 28 and 29 of the Constitución Política, and Articles 19 of the Universal Declaration of Human Rights, 19 of the International Covenant on Civil and Political Rights, 4 of the Convención Americana de Derechos Humanos, and 13 of the Pact of San José; the principle of legality (Articles 11 of the Constitución Política and 11 of the Ley General de la Administración Pública) for 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 Constitución Política; 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 Constitución Política, related to the private information contained in the medical record; the right to life and health, according to Articles 21, 40, 46, 50, and 73 of the Constitución Política and Article 5, first subsection, of the Convención Americana sobre Derechos Humanos, 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 not previously authorized by law; and the limits of regulatory power established in Article 140, subsections 3) and 18) of the Constitución Política, as well as the principle of legal reserve. The petitioner states that the matter is the recurso de amparo being processed in file 21-021972-0007-CO, in which they appear as the petitioner and have invoked the unconstitutionality of the aforementioned regulations. They state that, according to the concept of prior, informed, full, and free consent, as well as informational autonomy, they are not obliged to consent to vaccination, nor to have their sensitive data stored. In addition to this, they point out that it is an action that concerns and is of interest to the community. The petitioner alleges having received a communication in which their appointment as an honorary advisor (asesor ad honorem) in the Asamblea Legislativa is put at risk if they do not get vaccinated against covid-19. This is because, through an agreement taken 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 Reglamento Autónomo de Servicio de la Asamblea Legislativa. In said document, vaccination against covid-19 is imposed as mandatory, under penalty of a possible revocation of their appointment as an honorary advisor, which implies, from the outset, a threat of sanction that nullifies their right to give or not give their prior, informed, full, and free consent. According to the concept of prior, informed, and free consent, as well as informational autonomy, they are not obliged to consent to vaccination, nor to have their sensitive data stored. In the aforementioned agreement, their fundamental right to freely give or not give their prior informed consent 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 their fundamental rights, meaning the Asamblea Legislativa acts arbitrarily by granting greater rank and importance to an executive decree, which is below the law and the international agreements signed by Costa Rica. Therefore, this legal action (acción) is filed against Decree No. 42889-S, "Reforma Reglamento a la Ley Nacional de Vacunación and numerals 2, 3, and 6 subsection a) of Law No. 8111, Ley Nacional de Vacunación", 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. They state that said mandatory nature of vaccination indicated in Decree No. 42889-S, "Reforma Reglamento a la Ley Nacional de Vacunación in accordance with numerals 2, 3, and 6 subsection a) of Law No. 8111, Ley Nacional de Vacunación", 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 (Estado de Derecho) and a democratic country, with strong foundations in the profound respect for the human and fundamental rights of every inhabitant of our national territory. Given the lack of information, their doubts about the quality assurance controls, stability, efficiency, immunity, and adverse effects of the mandatory covid-19 vaccines, among many others, they find it offensive to be forced to get vaccinated against covid-19 in order to continue their work as an advisor, which would nullify their human right to freely consent to the inoculation. They indicate that, to date, there is total obscurity about the terms of the State's contract with Pfizer, it is unknown who will be responsible for eventual damages to health resulting from mandatory vaccination, in violation of the principle of full informed consent, that is, with access to all relevant information for the decision-making that 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 the right to every person and worker that *"ocurriendo a las leyes, todos han de encontrar reparación para las injurias o daños que hayan recibido en su persona, propiedad o intereses morales. Debe hacérseles justicia pronta, cumplida, sin denegación y en estricta conformidad con las leyes"*, reasons for which written, prior, and duly informed consent, given freely, without coercion or threat, constitutes a human right for every person obliged to be vaccinated against covid, who possesses a document with which they can exercise said constitutional right and, in turn, safeguard their life, their health, and well-being, in accordance with Articles 21 and 50 of the Constitución Política. The inertia, omission, and abstention of public authorities, in the mandatory nature of generalized vaccination without prior, duly informed, full, and free consent of the person to be inoculated, undoubtedly violates the right to life, to health, and to receive adequate and truthful information, according to numerals 21, 27, 46 final paragraph, and 50 of our Constitución Política. This preventive measure is a constitutional right, necessary and essential, to avoid serious or irreparable harm to the health of the person and that of any human being, given the possibility of some adverse effect of the vaccine against covid-19, but it is not provided for in its mandatory nature. The principles of respect for human dignity, autonomy of will, prior, full, and free informed consent, and informational self-determination, are protected by constitutional principles such as the principle of legality, legal certainty, and the right of access to justice, constitutional rights amply protected in Articles 1, 7, 11, 20, 21, 27, 30, 33, 40, 41, 46 final paragraph, 50, and 148 of the Constitución Política, 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 Convención Americana sobre Derechos Humanos, 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, "Reforma Reglamento a la Ley Nacional de Vacunación and numerals 2, 3, and 6 subsection a) of Law No. 8111 Ley Nacional de Vacunación", by indicating the mandatory nature of covid-19 vaccination, generates a direct employer request to demand medical and health information, which is information of a private nature, under the protection of Article 24 of the Constitución Política, in accordance with internal national legislation, according to Articles 1, 2, 3, 4, 10, 19, 22, 152, and 345 subsection 3) of Law No. 5395, Ley General de Salud, Article 1, 3 subsection e), and 7 subsection 1.c) of Law No. 8968, Ley de Protección frente al Tratamiento de sus datos personales, Article 1 of Law No. 7425, Ley sobre registro, secuestro y examen de documentos privados e Intervención de las comunicaciones, and Articles 6, 8, 10, and 11 of Law No. 7771, Ley General Sobre el VIH-SIDA. Constitutionally, both the decree and the challenged numerals, by using the phrase "mandatory nature" for covid-19 vaccination, are unconstitutional because they are an excess of prevention that constitutes repression, in a country that claims to be a Rule of Law State, where minimal intervention constitutes 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 results in a strong, arbitrary, and gross intrusion of the state's sovereign power (potestad de imperio) into fundamental and inalienable rights. They point out that the application of the vaccine against covid-19 began in late December 2020, and from that moment, informed consent was not complied with. They simply started from the alarm of death due to the pandemic to violate this right, which is derived from the application of Articles 20 and 21 of the Constitución Política. During almost twelve months of vaccination being applied, the Caja Costarricense de Seguro Social has not provided insured persons with a document containing prior, duly informed consent. The previous violation is increased by the decree challenged here, as public officials are forced to get vaccinated under threat of losing their job if they do not, this without a prior medical examination prevailing to prevent serious or irreparable harm to health, thus being able to guarantee the adequate and tangible exercise of the fundamental right to safeguard life and health. They state that one of the main characteristics of informed consent is based on its prior nature, but above all free, a characteristic enshrined in 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 Constitución Política), that is, consent must be given freely, voluntarily, autonomously, without pressure of any kind, without using it as a condition for subjection to other procedures or benefits, without coercion, threats, or misinformation. They point 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, given the threat of job loss (in the health and economic crisis situation we face), there is total coercion, so that, in the event of being able to give consent, this would not be free or voluntary. Another issue of great importance is the significant misinformation that exists around vaccination, as 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, the patient must be provided with "the relevant data of the intervention in question." In summary, it is said that there must be conformity between the passive subject holding the protected legal interest -the human person- and the action deployed by the active subject, the competent research professional, that is, a "meeting of the minds" between both subjects, regarding the same object. Additionally, from a legal perspective, it must be recognized that informed consent includes both ethical aspects typical of the scientific knowledge involved, and bioethics, and is derived from the unavoidable respect for Human Rights enshrined in the international and national legal system, 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 due to their condition as a human being and for the simple fact of being alive. They reference 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, apdo. 136"*. They indicate 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." Given the omission of informed consent, Articles 20, 21, and 28 of the Constitución Política are harmed, as indicated. Informed consent is derived from the conjunction of these three articles. They reference a judgment of this Court. They indicate that, regarding the legal normative level of Costa Rican domestic law, Article 22 of the Ley General de Salud provides that "*ninguna persona podrá ser sometida a tratamiento médico o quirúrgico que implique grave riesgo para su integridad física, su salud o su vida, sin su consentimiento previo o el de la persona llamada a darlo legalmente si estuviere impedido para hacerlo. Se exceptúa de este requisito las intervenciones de urgencia.*" They also cite subsections i), h) and i) of Article 2 of the Ley de Derechos y Deberes de las Personas Usuarias de los Servicios Públicos, in relation to the obligation to obtain informed consent. They note that said regulation finds support in the Universal Declaration on Bioethics and Human Rights which, despite not being ratified by our country, includes among its principles respect for autonomy and individual responsibility, by indicating that *"se habrá de respetar la autonomía de la persona en lo que se refiere a la facultad de adoptar decisiones, asumiendo la responsabilidad de éstas y respetando la autonomía de los demás. Para las personas que carecen de la capacidad de ejercer su autonomía, se habrán de tomar medidas especiales para proteger sus derechos e intereses"* (Article 5). They point out that the challenged decree contradicts the very "Reglamento de la Caja de Seguro Social (CCSS)," regarding informed consent. They denote that informed consent is part of the right to information; the necessary and essential information is required for making prior decisions directed at whether a person decides or not to get the vaccine, regardless of whether or not they are a public official. They reference Article 4 of that same CCSS regulation, and argue that due communication has not occurred in this case, because, despite Decree 48889-S indicating in Article 2: *"Para cuando sean citados por los encargados para tal efecto y de acuerdo con la planificación institucional respectiva, las personas contempladas en el párrafo anterior deberán vacunarse, con excepción de aquellos funcionarios que, por contraindicación médica debidamente declarada, no les sea posible recibir la vacuna contra el Covid-19…"*, there has not been full information about contraindications, adverse reactions, and drug interactions with other pharmaceutical products, and the meaning of freely given consent is emptied of content. They point out that the decree challenged as unconstitutional makes a distinction without foundation 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 discretion of the employer. This entails discrimination without a justifiable basis. Both groups are composed of human beings with equal dignity and value before the law. They consider that the mandatory nature of vaccination against covid-19 for public and private officials, without prior, written, and duly informed consent, is inapplicable because it is contrary to fundamental values and 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 Convención Americana sobre Derechos Humanos, "Pact of San José." The simple comparison of the transcribed norms with the questioned provision shows that the obligation to be vaccinated specifically for public sector workers and potentially for private sector workers constitutes discrimination to the detriment of the working class, since it loosely creates an inexact equivalence between the decree that obliges 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. They point out that the decree in question constitutes a gross injury to the principle of equality enshrined in Article 33, given that there is no technical justification demonstrating the need to force all public officials to get vaccinated, that is, the government starts from the condition of being a public official to establish the conditioning of being vaccinated, this as a requirement to keep one's job, an act 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 be penalized even with imprisonment, if not obeyed. It is no secret to anyone that our country has been advancing notably in the principle of non-discrimination in employment, so new forms of discrimination must continue to be faced. In addition to the above, Article 7 of the Ley VIH Sida guarantees confidentiality, non-discrimination, 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 avoid forms of discrimination by employers against workers and which paradoxically, it is now the State itself that emanates odious segregationist and discriminatory practices, without having conducted substantiated scientific investigations that support these criteria. The mandatory nature of 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 persons as part of their freedom to choose and not simply the decision of a minister or the Executive Branch. They denote that the challenged decree does not force the rest of the population to get vaccinated against covid-19, only the 330,000 public officials, which they estimate violates the norms and principles stated in this section. Even more, the mandatory nature of vaccination is imposed, by executive decree, on public officials who belong to other branches of government, and to public entities with levels of autonomy even at the constitutional level, such as local governments and certain autonomous institutions that have reinforced autonomy by constitutional provisions. According to the foregoing, the questioned executive decree does not establish fundamental criteria that allow justifying the mandatory nature of the application for the group of public workers, potentially for private sector workers, and not for the rest of the population. They indicate that the decree in question violates freedom of thought and expression, (Articles 28 and 29 of the Constitución Política, Articles 19 of the Universal Declaration of Human Rights, 19 of the International Covenant on Civil and Political Rights, 4 of the Convención Americana de Derechos Humanos, and 13 of the Pact of San José). Our country has abundant national and international legislation and jurisprudence protecting the right to free expression. They consider it necessary that people who do not get vaccinated 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 to admit health reasons as the sole cause of exception for not being vaccinated, since this absolutely curtails free expression and thought, as it limits the manifestation of the will of persons who, for various motivations, do not wish to be inoculated to a single cause.

All persons have the right to dissent from receiving vaccination, since there has been no clear and truthful information regarding its effects on the health of the population. Therefore, if a person lacks clarity about the effects it will cause to their health, they have the right to feel safe by not being vaccinated, as inoculation does not prevent infection. Furthermore, it points out that vaccinated persons are not immune to infection and can become infected. The vaccine, moreover, will not provide indefinite protection, so vaccinated persons 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 complete vaccination (2 doses), and 86% has one dose. (https://www.ocss.sa.cr/web/coronavirus/vacunacion). Despite this, hospitals are saturated, and persons with 2 doses of vaccination are infected and some are hospitalized in intensive care units. How is this possible, if 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 vaccines depends greatly on the moment at which it is measured. Two weeks after receiving the second vaccine, as is the case in the French study, it is at its moment of maximum effectiveness. If measured after 45 months of having been vaccinated, effectiveness is reduced to only 53% for preventing 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 carried out in 78% of the 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, the infection rate is among the highest in the world (235/100,000) and much higher than that of Costa Rica (24/100,000). It indicates that some will opine that this 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 complete vaccination rate of 99.7%. In addition, it is very strict in the requirements to enter the country. They demand double vaccination or a negative PCR test, along with 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). Therefore, 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 that occurred recently at Duke University, North Carolina. They mandated vaccination for students and staff, and despite 98% of students having complete vaccination, and staff at 92%, they had a resurgence of 364 positive cases in one week (end of August), of which only 8 corresponded to unvaccinated persons. 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 persons with a positive result and those living in the same house a treatment based on certain antiviral medications, including Ivermectin, vitamin D3, Zinc supplements, among others, both prophylactically and therapeutically. Today, it has a very low infection and mortality rate from COVID-19. It has 34 of the 75 districts free of COVID-19. It points out that the vaccine, whose medium and long-term side effects are not known and which is still in the experimental phase, without guarantee or responsibility from the manufacturer, does not seem to be the only alternative to overcome the health crisis caused by SARS-CoV-2. Consequently, persons 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. It alleges a 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 due to the application of the term vaccine. The objective pursued by vaccination with its application is to induce active immunity, a fact that is not what is happening with the mass inoculation that this government is imposing on public and private officials. The acts of the public administration must fall within the framework of legality; if there is a defect, the validity of the decree in question is harmed, and, therefore, the entire procedure resulting from it. It questions whether mass inoculation can be mandated under a term that does not exist, according to current regulations that clearly define what a vaccine is. The State must comply, in issuing its acts, with the requirements of legality, necessity, and proportionality. All actions or conduct of the public administration (administrative acts, material actions, and public services) must be authorized, expressly, by the legal system. The principle of legality is characterized by delimiting the action 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 because 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. Faced with a lack of certainty, a pro-health principle is imposed, for the benefit of persons who do not wish to introduce a substance that is not known with scientific certainty what it is, nor what effects it produces in the short, medium, and long term. Added to this is that the inoculation does not fulfill the objective that defines a vaccine. For example, in Costa Rica, 52% of the population has complete vaccination (2 doses), and 86% has one dose. Despite this, hospitals are saturated, and persons with 2 doses of vaccination are infected, and some are hospitalized in intensive care units. That is, evidently, vaccinated persons still become infected and get sick, something that theoretically should not happen if a person is vaccinated. On the other hand, a highly significant aspect must be taken into consideration in this action, which is the general population's lack of knowledge of technical topics, which contributes to the generalization of the denomination "vaccine" to this medication in ongoing clinical trials. This raises 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 (BPC and Key Responsibility of Researchers in the Context of Clinical Trials: Solidarity of the WHO Clinical Studies-WHO COVID-19). It indicates that, even though the authorities in their double discourse reveal that they are fully aware of this, they are still forcing the population to take a step in an experimental procedure without full knowledge, but clearly declared by the WHO. The Minister of Health himself coincides with the foregoing, as he made known on May 31, 2021, during his appearance before the Legislative Assembly in extraordinary session #04, where he explicitly indicated to the deputies: "Regarding how long the immunity of the vaccine lasts, there is still no clarity, studies and follow-up by the different companies are continuing, and we understand that it is expected that there will be immunity for at least 9 months later, there are some more recent studies, we will still have much to learn about this talk of a possibility of immunity of up to many more years, and therefore we must continue to follow 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 stated by the Minister of Health, as evidence over time shows that the effects of 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, 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", what matters is the real-time clinical study. Furthermore, they confirm that the period of immunity is not known; therefore, if neither the period of effectiveness is known until the study is finished, the contraindications, interactions, and adverse reactions cannot be known with certainty either. It is clear that the results of the clinical trials are unfolding over time, since these trials are being carried out "In Vivo" on the population, and the demonstrable technical-scientific information will not be known until completion, by early 2023, according to the start date of the clinical studies. Based on what has been expressed, it considers that the decree challenged through this avenue is not governed in accordance with what is established in the regulations of the cited regulation itself, 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 has not been scientifically demonstrated conclusively." This principle has its foundations in 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 virtue 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, combined with the refusal of the Caja de Seguro Social to perform preventive medical examinations, violates said principle, as the application of 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 in the face of the real and tangible absence of the necessary preventive measures, given the mandatory nature of COVID-19 vaccination, which would guarantee the protection of the life of every worker and any human being residing in the Nation, for life depends not only on life itself, but also on the prevention of any harm, however 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 demonstrating their effectiveness and safety are lacking. It is due to this enormous confusion, lack of data, and studies on the effectiveness and safety of the vaccines in the short and long term that the population must be safeguarded, and under no circumstances should people be forced to vaccinate, as even the World Health Organization has stated. Moreover, 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 widespread last year to curb infections, such as the use of masks, frequent hand washing, home ventilation, physical distance, or avoiding crowded places. The WHO spokesperson insisted on the need 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 states that it is not possible for a group of public and private officials to be forced to vaccinate, 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 scientifically demonstrated conclusively and, as proof, the very statements of the World Health Organization. It points out that the principle of hierarchy of norms is violated, Articles 7, 48, 129, and 140 subsection 3) of the Political Constitution, and the principle of conventionality. In matters of human rights, there is no formal separation between International Law and Constitutional Law, as it concerns the same law. The substantive prevails over the formal. What is truly important is the greater protection, regardless of whether that protection is recognized in an international instrument, the Political Constitution, or a law of the Republic. Because of this, conventionality control, a fundamental basis of our constitutional system in the Rule of Law, should suffice to indicate that Executive Decree No. 42889-S is unconstitutional, as it contravenes the international legal instruments mentioned herein and relating to Human Rights, which are of a higher rank; therefore, the mandatory nature of vaccination against COVID-19, within our labor sphere and as human beings, violates these international legal tools, affecting the right to life, to health, and to human dignity, given the interference of the State, 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 juridical personality, indicating that, as a person, they have the right to have their life respected and, therefore, their health, as well as their physical, psychological, and moral integrity. It states that it is clear that the mandatory nature of the vaccine violates these internationally recognized fundamental human rights, as they threaten the physical integrity of persons, by imposing on officials of the public sector, extending it to workers of the private sector, the introduction into their body of a vaccine without prior, full, and free informed consent, without respecting their autonomy of will. Likewise, it seriously transgresses the right to the psychological and moral integrity of persons, by forcing said officials to inoculate themselves in an intimidating manner, since, if they do not do so, they are exposed to fines and administrative and criminal sanctions, and even dismissal without employer liability or revocation of appointment or designation, as in their case. 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 interest society, such as disease detection campaigns, vaccination campaigns, and research in human beings, among others. Informed consent is individual (a right of man) 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 more decisions is accurately indicated, if they exist, with knowledge of the consequences, possible side effects, and problems that may arise. All of this evidently does not occur with the mandatory nature imposed in the decree in question, thus violating 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, as 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 clearly regressing from these rights with the application of the accused decree. It states that the executive decree of mandatory vaccination presents a clear violation of Law No. 8239 of April 2, 2002, "Law of Rights and Duties of Users of Public and Private Health Services," specifically in relation to what is established in 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 I.V. Vs. Bolivia, informed consent must be "provided in a free, voluntary, autonomous manner, without pressures of any kind, without using it as a condition for submission to other procedures or benefits, without coercion, threats, or disinformation." Thus, the accused decree violates the right to give informed consent, as understood by the Inter-American Court of Human Rights and in the manner it is set forth 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 obligates the worker to reveal private information concerning their clinical history to someone who, according to the decree itself, is not a health authority, so State institutions other than the health authorities are not legitimized to demand such information. The obligation to vaccinate and to reveal information regarding medical history violates the provisions of Article 9, subsection 1) of the "Law for the Protection of the Person Regarding the Processing of their Personal Data," and its transgression is sanctioned in Article 31. Thus, no person is obligated to provide data about their health to anyone who is not a health area official, so the challenged decree constitutes a clear transgression of that law. It 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. Quotes 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. Quotes 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. Quotes 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. Quotes 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. Quotes 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. Quotes paragraphs 160, 161, 166, 167, 175, 176, 181, 182, 184, 189, 191, and 192. 7) 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. Quotes excerpts from paragraphs 160, 161, 162, and 170. 8) I/A Court H.R. Case of the Yakye Axa Indigenous Community Vs. Paraguay. Merits, Reparations, and Costs. Judgment of June 17, 2005. Series C No. 125. Quotes an excerpt from paragraph 162. 9) I/A Court H.R. Case of the Sawhoyamaxa Indigenous Community Vs. Paraguay. Merits. Reparations and Costs. Judgment of March 29, 2006. Series C No. 146. Quotes paragraph 177. 10) I/A Court H.R. Case of the Xákmok Kásek Indigenous Community Vs. Paraguay. Merits. Reparations and Costs. Judgment of August 24, 2010. Series C No. 214. Quotes paragraphs 186 and 187. 11) I/A Court H.R. Case of the "Mapiripán Massacre" Vs. Colombia. Judgment of September 15, 2005. Series C No. 134. Quotes paragraph 162. 12) I/A Court H.R. Case of Vera Vera et al. Vs. Ecuador. Preliminary Objection, Merits, Reparations, and Costs. Judgment of May 19, 2011. Series C No. 226. Quotes paragraph 43. 13) I/A Court H.R. Case of Suárez Peralta Vs. Ecuador. Preliminary Objections. Merits, Reparations, and Costs. Judgment of May 21, 2013. Series C No. 261. Quotes paragraph 130. 14) I/A Court H.R. Case of Chinchilla Sandoval et al. Vs. Guatemala. Preliminary Objection, Merits, Reparations, and Costs. Judgment of February 29, 2016. Series C No. 312. Quotes paragraph 170. 15) I/A Court H.R. Case of Artavia Murillo et al. (In Vitro Fertilization) Vs. Costa Rica. Preliminary Objections, Merits, Reparations, and Costs. Judgment of November 28, 2012. Series C No. 257. Quotes paragraph 147. 16) 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. Quotes paragraphs 155 and 270. 17) I/A Court H.R. Matter of B, regarding El Salvador. Provisional Measures. Resolution of the Inter-American Court of Human Rights of May 29, 2013. Quotes paragraph 15. 18) 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. Quotes paragraph 152. 19) 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. Quotes paragraphs 156 and 163. 20) 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. 171. Quotes paragraph 68. 21) 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. Quotes paragraph 311. 22) I/A Court H.R. Case of Ximenes Lopes Vs. Brazil. Judgment of July 4, 2006. Series C No. 149. Quotes paragraphs 103, 125, 126, and 147.

It indicates that the cases resolved by the Inter-American Court are emblematic for 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 by the light of International Human Rights Law. The resolutions of the Inter-American Court significantly impact the internal legal system, leading 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 condemnatory judgments issued have evidenced the deficiencies of legal systems and, with this, international pressure has been generated to promote reforms, investigation, and the pursuit of processes in order to determine and sanction those responsible for committing human rights violations. Therefore, through these, States have had to modify their internal legal system through constitutional reforms, legal reforms, and interpretation guidelines that allow the insertion of the standards established by the Inter-American Court into domestic law.

It requests that the unconstitutionality of decree 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 are seriously affected, due to the direct, totalitarian, and arbitrary intrusion of 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 technically or scientifically substantiated 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 proportionality, necessity, and reasonableness of the measure that attacks (or injures) the principle of autonomy of will. b) The sanctions for not getting vaccinated for public officials are disproportionate, since the sanctions or penalties that public officials could receive for not getting vaccinated are blank criminal or administrative-sanctioning types, which contravene the principle of criminal and administrative-sanctioning legality, and are excessive, affecting work, which is also a fundamental right. The intention is to open administrative procedures aimed at dismissing without employer liability those public officials 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 schedule 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. Based on the decree stipulating the declaration of mandatory vaccination, instructions have been issued to different public institutions and the private sector to sanction, even with sanctions not established in the Vaccination Law such as dismissal, all those persons who do not want to receive the inoculation of the so-called vaccine. When summoned by those in charge for such purposes and, in accordance with the respective institutional planning, the persons contemplated in the previous paragraph must get vaccinated, with the exception of those officials for whom, due to a duly declared medical contraindication, it is not possible to receive the Covid-19 vaccine. It 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 want to be vaccinated against covid-19. The foregoing has generated immense media pressure, to the degree of coercing people who do not want to get vaccinated with the threat of dismissal, as has been published in different media outlets. The accused mandatory vaccination goes against the stated principles, since working persons are coerced into submitting to mandatory inoculation, despite their well-founded fears of suffering short or long-term harm, due to the imminent disciplinary actions, since they can 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 exerted coercion to get vaccinated against their will.

It indicates that the lack of reasonableness is also evidenced in the measure itself (mandatory vaccination), since 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 CEACO, a specialized hospital for the care of people infected with the virus, is being dismantled at this moment, 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 of the University of Costa Rica: <i>"The manifest trend of the R rate has been downward since approximately August 21. This trend has been maintained. This week's rates have maintained a moderate downward trend that is expected to continue for the coming weeks"</i>. The same article indicates that the reproduction rate of covid-19 in Costa Rica dropped slightly to R = 0.77, according to the data of new diagnoses updated to Tuesday, October 19 (Graph 1). It denotes that the report of a new diagnosis has an approximate delay of six days with respect to 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 Executive Decree No. 43249-S, even before the Agreement of the National Vaccination and Epidemiology Commission was adopted, in the extraordinary session XLV2021 of September 23, 2021, the infection rate had already been declining since August 21, 2021, at the beginning of September it had already fallen below 1, and currently it is at 0.77, so the contagion has decreased without the need for mandatory vaccination. Moreover, it also cannot be affirmed that this decrease has been produced by vaccination, since it is rather due to a behavior that the virus has been presenting over the course of time, where waves or peaks of infections occur with decreases, independently of vaccinated persons. In Costa Rica, as of September 20, 2021, when one of the highest levels of infection 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 states that the sanctions established in the accused decree clearly violate the principle of reasonableness and proportionality, being disproportionate and unnecessary, by virtue of all the cited arguments. On the other hand, it cannot be overlooked that every administrative act must be duly substantiated. The contested decree establishes, as a central element of its substantiation, in Considering III, that: <i>"...health norms are of public order. In view of this, the Ministry of Health as the competent authority may order and take special measures to prevent risk or harm to people's health, or to prevent these from spreading or worsening, as well as to inhibit the continuation or recurrence of the infraction by private individuals. Said legal norms, which establish the competence of the Ministry of Health in health matters, enshrine the power of authority in sanitary matters, which empowers it to dictate all the technical measures that are necessary to confront and resolve states of sanitary emergency…"</i>. The concept of public order, as the foundation of the decree, is vague, imprecise, and has served for the Directorate of Legal Affairs to issue the general criterion, which is also challenged. What must be reaffirmed, then, is that the—already indeterminate in itself—concept of public order cannot be a justified foundation for arbitrariness, as happens in this case. It points out that it shares the separate reasons of Judge 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 be suspended refer to 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 emergency cases. 3. Even in cases of those guarantees susceptible to suspension, their annulment is not possible, nor that their emergency suspension subsequently results in the impossibility of recovering such rights, or that their suspension is indefinite. The possibility of the State acting arbitrarily is likewise absolutely limited. 4. This Constitutional Chamber itself has established the "reasonableness test" to determine whether a constitutional right has been violated. That 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 if a state intervention is necessary, it must be carried out by the public authority or state entity to which the law recognizes competence. c. That, in such cases, the 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 Powers. 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, such that the necessary intervention respects the temporality of the action and the guarantee of the restoration of the constitutional right, <i>"in what remains of the person's life project. Particularly, 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 will obtain, and the person upon whom the limitation was imposed."</i> 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, since 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 based on subsection h of Article 81 of the Labor Code, concludes that: <i>"3. If a public official or private sector worker, for whom the employer has arranged vaccination as mandatory in their workplace, refuses in a manifest, reiterated, and unjustified manner to get 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"</i>. It indicates that, without any foundation supporting the legal criterion, the Ministry of Labor establishes, supported by the decree, that anyone who refuses to get 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, furthermore, it is a public and notorious fact that vaccinated people also get sick, and in what is relevant here, they also contaminate others by transmitting the virus. The current vaccines against covid-19 do not prevent those who get vaccinated from transmitting the virus. Hence, if in a workplace, public or private, all workers can contaminate each other, vaccinated or not, 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 prevent the disease. Every employer, including the State, is in absolute freedom to dismiss their workers, provided they respect 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, they must do so with employer liability, paying all due amounts. It cannot be accepted that the Executive Branch, based on an emergency situation and supposedly grounded in public order, limits constitutional rights in the manner it does, since dismissal without employer liability is absolutely disproportionate, exceeds the limit of the division of competences, and causes the imposed sanction to cease being temporary and renders the violated right irrecoverable, because with such decisions, the employee definitively loses their job and all labor rights attached to their employment contract, in addition to the threat of imposing a fine of one base salary 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 estimates that the challenged decree also violates the principle of informational self-determination, by requesting private information referring to the medical file and in the absence of informed consent prior to the inoculation. The right of informational self-determination is one of the fundamental rights derived from Article 24 of the Political Constitution, which ensures respect for privacy and human dignity through effective protection of personal data contained in files, archives, records, or databases, regardless of whether these are of a private or public nature. Informational self-determination empowers every person to know who holds registered information about them, the type of information maintained, and for what purpose. Additionally, concurrently, it implies the possibility of rectifying, blocking, and deleting that information. It refers that this Constitutional Chamber developed and protected that right through an abundant and noted jurisprudential development. However, emphasis was placed on the need for a law to be issued that would positivize 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 which in turn has the corresponding regulation (Executive Decree No. 37554-JP of October 30, 2012); both norms are based on the parameters established by the Constitutional Tribunal. 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 concerning their person or property, as provided in Article 1. The classification as "of public order" highlights the importance of the protected legal interest and the need for its mandatory compliance by all subjects, both under 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 entities, and also contemplates any subsequent use made of that information. It exempts from its application databases maintained by natural or legal persons for exclusively internal, personal, or domestic purposes. However, if these databases are subject to commercialization, they must be subject to the provisions of the law. The protection refers to data concerning a person or property. In this sense, personal data, that is, data belonging to an identified or identifiable person. The concept of personal data is broad, as it encompasses any data of an identified or identifiable person. However, for purposes of its protection, the law differentiates between several categories of personal data. Data relating to health are classified as sensitive, and as such, subject to a higher degree of protection. Suffice it to recall that, as a general rule, there is a prohibition on the processing of sensitive data; persons are not obliged to provide this type of information. The materialization of the right of informational self-determination, around the principles of informed consent and quality of information, imposed as basic requirements for the collection of data, 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, in this way, whoever 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 the collection of data, the recipients of the information, and who may access it; • The mandatory or non-mandatory nature of providing answers to the questions asked during data collection; • 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 paragraph, of the Data Protection Law (Ley de Protección de Datos)). • 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 paragraph, of the same law). • Ensure the quality of the information, that is, verify that the data are current, truthful, accurate, and that they are adequate for determined, explicit, and legitimate purposes. In addition to the foregoing, the database controller is imposed a duty to adopt the necessary technical and organizational measures to guarantee the security of personal data and prevent its alteration, accidental or illicit destruction, loss, unauthorized processing or access, as well as any other action contrary to the law in question, contemplating within those measures, at a minimum, the most adequate physical and logical security mechanisms, in accordance with the technological development prevailing at any given time. Likewise, upon said controllers and those who participate in any phase of the personal data processing process, there falls, in correspondence with that information, a duty of confidentiality, whether due to their professional or functional condition (Article 11 of the Data Protection Law (Ley de Protección de Datos)). Among the fundamental principles of personal data protection is that of the consent of the affected person. The law may exempt the need for that consent, allowing the collection and delivery of data in certain cases, but in the case at hand, we are not under any of the exception assumptions 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, as it relates to a medical matter, people's health, and now human resources departments request this information from their employees, without any legal legitimacy 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 (Ley de Protección frente al Tratamiento de sus datos personales). It also adds the absence of informed consent (adequate and with varied options), regarding access to the medical file, 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 protected by the cited law, constitutional jurisprudence, and the Political Constitution. Therefore, it is a violation of the principle of self-determination; sensitive data cannot be in the hands of just any person, without the informed consent that should form part of every person's medical file. That 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 in the health field, characterizing this consent as being granted freely, voluntarily, and consciously, and not in the way the administration is acting, without even providing this right to the officials obliged by the challenged decree. It adds that the mandatory nature of vaccination as ordered in the challenged decree, merely due to the condition 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 said inoculation are, 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 who have various ailments is not weighed. In a manner correlative to the fundamental right to life protected in constitutional numeral 21, there is Article 20 of the Magna Carta, which guarantees every person's right to freedom and their capacity to dispose of their own body. Both norms constitute the constitutional source of informed consent, since from this derives the freedom to choose which treatment is most favorable for the restoration of their health, or to be able to choose whether they wish to participate in a formal research process, considering such consent as a fundamental right inherent to the person, and not as in the case at hand, where vaccination is mandated, without guaranteeing prior, duly informed consent to the workers, thereby violating their right to life, to health, and to receive adequate and truthful information.

It 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 reserve. It states that, from judgment 2010-1668 of this Chamber, the following can be deduced: 1- The legal framework governing state policy on health matters that the competent authorities must develop is regulated by the General Health Law (Ley General de Salud). 2- That the regulations of the Caja de Seguro, related to experimentation on human beings, being regulations that, due to their character as a general norm, do not prove to be the ideal legal mechanism to guarantee the protection of fundamental rights directly related to experimentation on human beings, 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 only through 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 reserved for law. Scientific interest can never violate or take precedence over the right to life, health, physical or mental integrity, dignity, and any other fundamental right or freedom inherent to the person, by their very 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 individuals; hence, this type of procedure, regarding which information on its possible effects has been omitted, cannot be regulated by an executive decree, outside the bounds of the right to human life, the right to health, privacy, and human dignity. He insists that Executive 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," by forcing public officials to be vaccinated without the Costa Rican Social Security Fund informing them about the possible effects, much less about labor rights regarding the workplace risk insurance policy in the face of an adverse effect caused as a result of this mandatory covid-19 vaccination, grossly violates the constitutional rights of all public officials —and potentially all private sector workers— regarding the rights to privacy, integrity, and human dignity, just as the distinguished jurisprudence of this Chamber has shown in relation to the regulations on experimentation on human beings of the Costa Rican Social Security Fund. He argues that what is sought with this action even implies a change of criteria in the jurisprudence of this honorable Constitutional Chamber, which is permitted by the Law of Constitutional Jurisdiction. 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 assistance 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 disease prevention constitutes a constitutionally legitimate purpose." So far, there would be no conflict with the stance of the Inter-American Court of Human Rights, because those purposes can be achieved without mandatory application, 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 itself. Due to the foregoing, a weighing of rights in possible conflict must not only be made, but, once and for all, it must be made clear that the human being should 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 lamentable as those that have occurred in Costa Rica, due to having it the other way around, will not be repeated. He requests that: 1. The present unconstitutionality action be admitted, and the mandatory nature of the inoculation based on the challenged decree be suspended while this action is decided 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 warned that it may not continue applying the mandatory nature of vaccination.

2.- By brief filed on December 22, 2021, the petitioner reiterates his allegations of unconstitutionality and details each of the rules 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 claimed that the phrase with the exception of cases of mandatory vaccination or other measures relating to public health, from this article, is violative of personal liberty, specifically, 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 by the health authorities. By excluding vaccination from that possibility, the obligation of the Costa Rican State 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 by the health authorities. By excluding vaccination from that possibility, the obligation of the Costa Rican State 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 obligation of the Costa Rican State 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 to establish the mandatory nature of vaccines "when it deems it necessary" in coordination with the Ministry of Health and the Costa Rican Social Security Fund, thus 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 obligation of the Costa Rican State 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 where 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 and the resolutions of the Inter-American Commission, is violated. Therefore, the phrase "furthermore, it shall decide whether 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 application, 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, specifically the judgment of November 30, 2016, I.V. v. Bolivia case, and resolutions 4/2020 and 1/2021 of the Inter-American Commission, among others. SEVENTH: Executive Decree No. 43249-S signed by the Executive Branch on October 7, 2021, formalized the agreement of the National Commission for Vaccination and Epidemiology No. XLV-2021 of September 23, 2021, effective as of October 15, 2021, a decree by which the mandatory nature of the Covid-19 vaccine was approved for all public sector employees, 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, specifically the judgment of November 30, 2016, I.V. v. Bolivia case, 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 unconstitutionality action be accepted as amended, in order to comply with the corresponding formal requirements.

3.- By brief filed on January 3, 2022, Mariela Fallas Pacheco requests to be considered as a joiner in this action, based on the same arguments as the petitioner.

4.- Article 9 of the Law of Constitutional Jurisdiction empowers the Chamber to reject outright or on the merits, at any time, even from its presentation, any motion brought before it that is manifestly unfounded, or when it considers that there are sufficient elements of judgment to reject it, or that it is a simple reiteration or reproduction of a previous, identical or similar rejected motion.

Drafted by Judge Castillo Víquez; and,

Considering:

I.- Preliminary. Regarding the motion to join. By brief filed on January 3, 2022, Mariela Fallas Pacheco requests a motion to join in this unconstitutionality action. Article 83 of the Law of Constitutional Jurisdiction establishes, to that effect, that within fifteen days following the first publication of the notice referred to in the second paragraph of Article 81, the parties appearing in the matters pending at the date of the filing of the action, or those with a legitimate interest, may appear within it to join in the allegations that could justify its appropriateness or inappropriateness, or to expand, where appropriate, the grounds for unconstitutionality in relation to the matter that concerns them. In this specific case, the request to join is unfounded, not only because the motion lacks a signature, authentication, and the corresponding Bar Association stamp, but also because joining supposes an accessory procedural intervention and its fate follows that of the main intervention, which, for the reasons detailed below, is inadmissible.

II.- On the admissibility requirements of the unconstitutionality action. The process at hand was established for the purpose of guaranteeing the supremacy of the Political Constitution, against norms or other provisions of a general nature. In accordance with this and by express will of the legislator, it is of a highly technical nature, so for its admissibility, certain requirements provided by law must be strictly met. Among the required elements are: the adequate substantiation of the grounds for unconstitutionality with a specific citation of the Constitutional Law that is considered infringed (Article 78), the signature of the person filing the action duly authenticated by a legal professional with due payment of legal taxes (Article 78), the accreditation of standing conditions (powers of attorney and certifications), and the literal certification of the brief where the reservation of unconstitutionality was made in the prior matter (Article 79).

III.- On the standing of the petitioner. This Tribunal considers that the standing of the petitioner derives from the first paragraph of Article 75, insofar as the amparo appeal No. 21-021972-0007-CO is pending resolution and duly processed. In that 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 of the Legislative Assembly, which requires proof of the covid-19 vaccine from the regular and confidential personnel of the Legislative Assembly, as well as from those who work ad honorem; 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 29 last. 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, which 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 be vaccinated, pursuant to 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 file; however, the disputed regulation does not contemplate such a request. In accordance with the foregoing, the base matter constitutes a reasonable means to protect the rights of the petitioner as an ad honorem official of a public institution, and he is therefore legitimized to raise his arguments regarding his condition as a public official. Thus, he has standing to bring action before this jurisdiction in that sense.

IV.- On other formalities and the admissibility of this action. As this Tribunal has indicated in its jurisprudence, the requirement of sufficient substantiation does not translate into a mere formality, but rather constitutes an essential admissibility requirement. This was established in judgment No. 2013-16944 of 2:30 p.m. on December 18, 2013:

"II.- INADMISSIBILITY FOR LACK OF SUBSTANTIATION. In accordance with Article 78 of the Law of Constitutional Jurisdiction, the brief filing the unconstitutionality action must set forth the grounds clearly and precisely, with a specific citation of the norms or principles that are considered infringed. Said requirement does not translate into a mere formality, but into an essential admissibility requirement, since by virtue of the pro sententia principle —developed on other occasions by this Chamber— according to which the admissibility requirements must be interpreted in a sense 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 the 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 handed down; the foregoing not only facilitates the administration of justice but also avoids the imposition of obstacles to not achieve it (see in the same sense, judgments numbers 93-5175, 3041-97. 01-06. 2874-06. 1622-08 and 2887-08). Consequently, the lack of substantiation of the action prevents the handing down of a duly reasoned and congruent judgment with what was sought. Likewise, it is unfounded for this Chamber to rule on the merits of norms challenged in an action, when the person filing the action does not substantiate the reasons for which they challenge, as this would imply carrying out an abstract constitutional control by way of an academic exercise, which is not compatible with the purpose of a process of this nature." (Emphasis is not from the original).

In the sub examine, the petitioner files the action against "Executive Decree 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, "Regulation 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 Regulation 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 – "Regulation 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 – "Regulation 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 Regulation for the Authorization of Health Services"; the National Guidelines for the Surveillance of the 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 norm or regulation issued by other public institutions that oppose the principle of prior and free informed consent"; however, in the substantiation provided in the brief of filing, he 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. Regarding the other challenged regulations, the action lacks substantiation, as the petitioner not only omitted to refer to the provisions and content of each challenged regulation or guideline, but also failed to indicate how the fundamental norms and principles are violated, on an individualized basis.

Although the petitioner subsequently submitted a brief attempting to remedy these deficiencies, the fact is that he limited himself to citing the norms without developing each one of them, in order to contrast them with the Constitution. He solely claims the mandatory nature of the vaccine without informed consent, but without offering a true foundation and argumentation regarding each challenged norm. Likewise, he attempts to challenge, in an open and generalized manner, <i>_{"any norm or regulation issued by other public institutions that oppose the principle of prior, free, and informed consent"}</i>, which is entirely improper, as it is the petitioner's responsibility to adequately determine and substantiate the provisions whose nullity he seeks in this type of proceeding. Thus, the action is admissible only against Executive Decree No. 42889-S of March 10, 2021, partially amended by Executive Decree No. 43249-S of October 7, 2021, having complied with all respective formalities. For the rest, it is considered that the appropriate course is to reject the action outright.

**V.- On the object of the action.** Having stated the above, it is understood that the petitioner requests that the unconstitutionality of Executive Decree No. 42889-S of March 10, 2021, partially amended by Executive Decree No. 43249-S of October 7, 2021, be declared, because he considers it violates:

1. The principle of informed consent developed in Articles 20, 21, and 28 of the Political Constitution, Article 22 of the General Health Law (Ley General de Salud), Article 2 of Law No. 8239, "Rights and Duties of Users of Public and Private Health Services" (Derechos y deberes de las personas usuarias de los servicios de salud públicos y privados), Articles 1 and 4 of the Regulation of the Costa Rican Social Security Fund (Caja Costarricense de Seguro Social, CCSS), and the jurisprudence of the Inter-American Court of Human Rights. He argues that the challenged decree is unconstitutional because it does not provide for the existence of free, prior, and informed consent, but rather, on the contrary, mandates the compulsory nature of COVID-19 vaccination against the principle of self-determination and with serious consequences for non-compliance for public officials and some private sector workers, without first providing all the required information that guarantees their life.

2. The principle of equality and non-discrimination derived from Article 33 of the Political Constitution. He points out 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 employer's discretion. He states that there is no technical justification demonstrating the need to force all public officials to be vaccinated. He questions that, by executive decree, officials of other branches of government and municipalities are forced to be vaccinated, harming their autonomy.

3. 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 or contrary to people who do wish to do so, because there has been no clear and truthful information about its effects on the population's health. He indicates that 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 the inoculation does not prevent contagion. Furthermore, vaccinated people are not immune to contagion and can become infected, because 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 an experimental phase, without a guarantee or responsibility from the manufacturer that it is 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 be above a supposed interest of science or even of society.

4. The principle of legality established in Articles 11 of the Political Constitution and 11 of the General Law of Public Administration (Ley General de la Administración Pública), due to the use of the term vaccine in the case of the inoculation against COVID-19, which does not meet the main characteristic of inducing active protective immunity against the corresponding infectious disease, according to Article 1, subsection p) of the Regulation to the National Vaccination Law (Reglamento a la Ley Nacional de Vacunas). They are forcing the population to undergo a live clinical trial 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. He states that it is a vaccine profile without conclusive clinical studies, as stated by Minister Salas himself, so it must be considered that, although it was prematurely classified as a "vaccine," and now they have approved it as a "vaccine," they confirm that the immunity period is unknown. Therefore, if the time of effectiveness is unknown until the study is completed, the contraindications, interactions, and adverse reactions cannot be known with certainty either.

5. The precautionary principle in health matters, given the mandatory nature of vaccination without prior medical examinations. He points out that a double discourse has been managed, because while they affirm that the "vaccines" are safe, on the other hand, they accept that studies demonstrating their effectiveness and safety are lacking. It is due to 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 be vaccinated, and even the World Health Organization has stated this.

6. 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 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. The mandatory nature of the vaccine violates these internationally recognized fundamental human rights, since they threaten the physical integrity of individuals by imposing on officials of the public sector, and extending to workers in the private sector, the introduction into their body of a vaccine without prior, full, and free informed consent, without respecting their autonomy of will. Likewise, it seriously transgresses the right to the psychological and moral integrity of individuals, by forcing said officials to be inoculated in an intimidating manner, since, if they do not do so, they expose themselves to fines, administrative and criminal sanctions, and even dismissal without employer liability or revocation of the appointment or designation, as applicable.

7. The principle of conventionality, since the country has committed to guaranteeing the right to health, as well as the impossibility of receiving arbitrary interference by governments in individuals.

8. Laws subsequent to the National Vaccination Law (Ley Nacional de Vacunas), 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" (Ley de derechos y deberes de las personas usuarias de los servicios de salud públicos y privados), 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, 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 forces the worker to reveal private information concerning their clinical history to someone who, as the decree itself indicates, is not a health authority. He 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 Individuals Regarding the Processing of their Personal Data" (Ley Protección de la Persona frente al tratamiento de sus datos personales), and its transgression is sanctioned in Article 31.

9. 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, so that the foundations of the Rule of Law are seriously affected, due to the direct, totalitarian, and arbitrary intrusion of the State.

10. The principle of reasonableness and proportionality in the sanction 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 threatens the right to work. He points out that the authorities have in no way technically or scientifically substantiated the degree of effectiveness of the vaccine in relation to preventing the spread of COVID-19, so it is not possible to make an assessment of the proportionality, necessity, and reasonableness of the measure that threatens the principle of autonomy of will. On the other hand, the sanctions for public officials for not getting vaccinated are disproportionate; they constitute blank criminal or administrative-sanctioning types, which contravene the principle of criminal and administrative-sanctioning legality. The aim is to open administrative procedures aimed at dismissing without employer liability those public officials 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 schedule or not. 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 if a crime has been committed. In this way, working people are coerced into undergoing mandatory inoculation, despite their well-founded fears of suffering short- or long-term damage to their health, due to the imminent disciplinary actions. He questions both the term of public order on which the regulation is based, and the sanctions for workers who do not get vaccinated.

11. The principle of informational self-determination, related to the private information contained in the medical file, the right to life and health, according to Articles 21, 24, 40, 46, 50, 73 of the Political Constitution and Article 5, first paragraph, 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 legitimacy to do so, also violating the Law on Protection Regarding the Processing of Personal Data. Likewise, he considers it is violated by the absence of free and informed consent, without prior information on the possible effects of vaccination, as well as the examinations prior to said inoculation.

12. 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 be vaccinated is established, without individuals knowing beforehand whether or not they run the risk of suffering serious consequences to their bodies, which he considers cruel and degrading treatment, by failing to consider that there are people who have various ailments, given the absence of free and duly informed consent. Furthermore, the right of every person to dispose of their own body is violated.

13. The regulatory power established in Article 140, subsections 3) and 18) of the Political Constitution, and the principle of legislative reserve, for imposing the mandatory nature of vaccination without free and duly informed consent by decree and not by law. Forcing public officials to get vaccinated without the Costa Rican Social Security Fund (Caja Costarricense de Seguro Social) informing them about the possible effects, even less about labor rights regarding the occupational hazard insurance policy in the event of an adverse effect caused by this mandatory COVID-19 vaccination, grossly violates the constitutional rights of all public officials regarding the rights to privacy, integrity, and human dignity.

The Executive Decree No. 43249-S challenged here, provides the following:

"*Article 1.- Amend Article 2 of Executive Decree No. 42889-S of March 10, 2021, denominated Amendment to Executive Decree No. 32722-S of May 20, 2005, denominated Regulation to the National Vaccination Law and Establishment of the Mandatory Nature of the COVID-19 Vaccine, so that henceforth the following is recorded:* "*Article 2.- Based on Article 3 of the National Vaccination Law, Law No. 8111 of July 18, 2001, as well as Article 2 and 18 of the Regulation to the National Vaccination Law, Executive Decree No. 32722 of May 20, 2005, the COVID-19 vaccine shall be mandatory for personnel established by the National Commission for 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 shall be under the terms set by the National Commission for Vaccination and Epidemiology for the public sector and the private sector.*" "*When they are summoned by those in charge for that purpose and according to the respective institutional planning, the persons contemplated in the previous paragraph must be vaccinated, with the exception of those officials for whom, due to duly declared medical contraindication, it is not possible to 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 be vaccinated against COVID-19.*" Given that this Court has already ruled on several of the aspects indicated by the petitioner, we proceed to cite some precedents that will allow several of the arguments to be resolved, jointly or separately, below.

**VI.- On the mandatory nature of vaccination, the principle of legislative reserve, and the right to life and health.** In ruling 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 Court reaffirmed its criterion, regarding the mandatory nature of COVID-19 vaccination established in the decree challenged here, stating the following:

"*V.- REGARDING THE SPECIFIC CASE. The Chamber highlights that, according to the reports issued by the Minister of Health and the Medical Manager, both of the Costa Rican Social Security Fund (Caja Costarricense de Seguro Social), the vaccines applied in the country against the COVID-19 coronavirus are not medications in an experimental phase.* *VI.- REGULATORY FRAMEWORK: 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 from the original).* *The General Health Law (Ley General de Salud), in relation to the competencies of the Minister of Health, orders the following:* *"Art. 345. 3.* Declare vaccination against certain diseases mandatory, as well as certain examinations or practices deemed necessary to prevent or control diseases." On the other hand, regarding the obligations of the administered parties, the aforementioned law states the following:

"Art. 147.- Every person must comply with the legal or regulatory provisions and practices designed to prevent the emergence and spread of communicable diseases.

They are especially obligated to comply:

(...)

• b)With the preventive measures that the health authority orders when a disease appears." Vaccination is precisely a preventive measure to avoid the spread of a communicable disease.

Furthermore, Article 3 of the National Vaccination Law (Ley Nacional de Vacunación) states:

"(...) In accordance with this Law, vaccinations against diseases are mandatory when deemed necessary by the National Vaccination and Epidemiology Commission (Comisión Nacional de Vacunación y Epidemiología), created in this Law, in coordination with the Ministry of Health (Ministerio de Salud) and the Costa Rican Social Security Fund (Caja Costarricense de Seguro Social).

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

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 Vaccination and Epidemiology Commission (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 periodically reviewed and analyzed, taking into account the frequent technological changes in this field (...)" (emphasis not in 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 Vaccination and Epidemiology Commission (Comisión de Vacunación y Epidemiología):

"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 schemes and vaccines referred to in Article 3 of this Law." From the foregoing, it is not possible to affirm that the principle of legal reservation (reserva de Ley) in the regulation of fundamental rights has been violated, since the mandatory application of the vaccine against the coronavirus COVID-19 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). This led to the issuance of Decree No. 42889-S "Reform Regulation to the National Vaccination Law" (Executive Decree No. 32722-S of May 20, 2005) in order to include the vaccine in question in the national vaccination scheme.

Likewise, 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 National Vaccination Commission (Comisión Nacional de Vacunación), in extraordinary sessions number VII-2021 of February 16, 2021, and VIII of February 23, 2021." On the other hand, Article No. 18 of Executive Decree No. 32722 details the official list of vaccines included in the Universal Basic Public Scheme of Costa Rica (Esquema Público Básico Universal de Costa Rica), an article amended by Article 1 of Executive Decree No. 42889 of March 10, 2021, specifically including Covid-19 in point No. 15.

For its part, it is important to point out that Article No. 150 of the General Health Law (Ley General de Salud), Law No. 5395 of October 30, 1973, of public order that must be complied with by every person who inhabits our country, also mentions the mandatory nature of vaccination and revaccination against communicable diseases determined by the Ministry of Health (Ministerio de Salud).

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 National Vaccination Law (Ley Nacional de Vacunación), which defines the general regulatory framework on the matter.

VII.- It should be highlighted that mandatory vaccination for COVID-19 cases is not absolute, but, as noted, the decree itself contemplates the possibility that a person presents a medical contraindication. It should be added that it is public and notorious that the authorities of the CCSS have publicized the "Procedure Manuals for the execution of vaccination against COVID-19 in the health establishments of the Costa Rican Social Security Fund (Caja Costarricense de Seguro Social)," in which the medical contraindications for vaccination have been precisely explained. In the first version of said manual, the following contraindications were recorded:

"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 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 had a mild, moderate, or severe allergic reaction during the application of the first dose of this vaccine." 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, provided the following:

"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 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 priority groups who are in a period of breastfeeding and wish to be vaccinated for the benefit they may obtain 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 to make the decision to be vaccinated, assessing risk/benefit. They must not present breastfeeding certificates, nor must they 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.

(...)

Persons 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 priority groups who are in a period of breastfeeding and wish to be vaccinated for the benefit they may obtain 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 to make the decision to be vaccinated, assessing risk/benefit. They must not present LM certificates, nor must they 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." That is, the covered persons and the doctors who examine them could determine when conditions are present that medically advise against vaccination. Moreover, although there might be some margin of doubt about 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 foregoing, elements are accredited to operationalize the possibility for persons to allege medical contraindications to reject the vaccine in question and, in this way, protect their right to health.

VIII.- Likewise, this Court cannot ignore the evidence provided in other amparo (amparo) appeals, 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.

Said circular provides for 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. 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 this phase, the justifications by the worker are examined, along with the report of a clinical team composed of the comprehensive worker care physician and the immunization coordinator, to finally assess the possibility of opening an administrative procedure. By virtue of the above, a margin is also accredited for workers to justify to the employer instances their refusal to receive the vaccination based on 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..." The criteria set forth is fully applicable to the object of this action. This Chamber has dismissed that Executive Decree No. 42889-S, amended by Decree No. 43249-S, violates the principle of legal reservation (reserva de ley) in the regulation of fundamental rights, since the mandatory application of the vaccine against the coronavirus COVID-19 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. 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.

On the other hand, as indicated by the precedent cited supra and judgment No. 2021-26519, the personnel to be vaccinated will be defined under the technical criterion of the Immunization Coordination (Coordinación de Inmunización) and Technical Secretary of the National Vaccination and Epidemiology Commission (Comisión Nacional de Vacunación y Epidemiología) of the Health Surveillance Directorate (Dirección de Vigilancia de la Salud), whose basis is not subject to review in this jurisdiction, as it deals with technical, medical, and scientific aspects related to vulnerability to a virus. Nor is it a vaccine whose studies, regarding its effects, are in an experimental phase, as this Court has held as accredited in various amparo (amparo) appeals. Therefore, if the plaintiff disagrees with such a criterion, this is equally a technical discussion that should not be elucidated in this jurisdiction, but rather in the legality channel, through the different means of proof that said channel contemplates and that allow its broad technical and scientific discussion and verification. That being the case and as set forth, it is not considered that the right to health of persons is being harmed; far from it, it is intended to ensure it at a collective level, for a public interest. This Court so indicated in the judgments cited supra, and when referring to the general legitimacy of the purpose pursued by establishing the mandatory nature of a vaccine, in judgment No. 2020-0019433 of 09:20 hours on October 9, 2020, by stating the following:

"(...) 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 the safeguarding of public health and the prevention of diseases constitutes a constitutionally legitimate purpose that can validly justify the mandatory nature of vaccines (...)"

The precedent cited previously - No. 2021-23195 - also dismisses the plaintiff's claim that the population has not been informed of the real effects that the vaccine in question can produce, nor that the risks in this regard have been warned, by stating:

"VII.- It should be highlighted that mandatory vaccination for COVID-19 cases is not absolute, but, as noted, the decree itself contemplates the possibility that a person presents a medical contraindication. It should be added that it is public and notorious that the authorities of the CCSS have publicized the "Procedure Manuals for the execution of vaccination against COVID-19 in the health establishments of the Costa Rican Social Security Fund (Caja Costarricense de Seguro Social)," in which the medical contraindications for vaccination have been precisely explained. In the first version of said manual, the following contraindications were recorded:

"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 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 to patients who have had a mild, moderate, or severe allergic reaction during the application of the first dose of this vaccine." In 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:

"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 physician indicating that they can be vaccinated. In the event that vaccination is indicated, 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 in a period of 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 health personnel to make the decision to be vaccinated, assessing risk/benefit. They should not present breastfeeding certificates, nor should they stop breastfeeding their child. They may be administered the AstraZeneca vaccine or the Pfizer vaccine according to availability at the respective vaccination site.

(...)

Persons who receive 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 in a period of 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 health personnel to make the decision to be vaccinated, assessing risk/benefit. They should not present breastfeeding certificates, nor should they stop breastfeeding their child. They may be administered the AstraZeneca vaccine or the Pfizer vaccine according to availability at the respective vaccination site." That is to say, the protected persons and the doctors examining them could determine when conditions exist that medically advise against vaccination. For the rest, although there might be some margin of doubt about the duration of the vaccine's efficacy or the period of protection it offers, this does not constitute a legitimate reason to refuse immunization.

What is significant is that, based on the foregoing, elements are accredited to make operational the possibility for persons to allege medical contraindications to refuse the vaccine in question and, in this way, protect their right to health." Nor is it true that the ailments of persons are not weighed, injuring their right to health. The contested decree excludes from mandatory vaccination against covid-19, those officials who, due to a duly declared medical contraindication, are unable to be vaccinated, safeguarding their right to health. For such effects, the contested Article 2 provides:

"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 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 shall be in the terms set by the National Commission for Vaccination and Epidemiology for the public sector and the private sector.

When they are summoned by those in charge for such purpose 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 unable to 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." Likewise, in judgment No. 2021-19469 of 9:20 a.m. on August 31, 2021, this Chamber, stated: "That is to say, the protected persons and the doctors examining them could determine when conditions exist that medically advise against vaccination. For the rest, although there might be some margin of doubt about the duration of the vaccine's efficacy or the period of protection it offers, this does not constitute a legitimate reason to refuse immunization. What is significant is that, based on the foregoing, elements are accredited to make operational the possibility for persons to allege medical contraindications to refuse the vaccine in question and, in this way, protect their right to health." Corollary of the foregoing, the alleged violations of the right to life, health, the principle of legal reserve, and self-determination against the mandatory nature of vaccination against covid-19 are dismissed.

VII.- On informed consent and the protection of sensitive information. In judgment No. 2021-24027 of 10:10 a.m. on October 26, 2021, this Court ruled on this allegation, in relation to the decree contested here, reiterating its precedents in the following sense:

"IX.- The appellant party insisted that mandatory vaccination not be applied without an informed consent in which patients are told that it is an experimental medication. In this regard, it is necessary to point out that the competent health authorities in the matter have rejected that it is an experimental medication, as noted supra. Secondly, it would be worth highlighting that the recognition of the need for informed consent to be granted stems from the recognition of the rights of autonomy and information of patients. That is to say, based on the information provided by their treating physician, a patient chooses to accept or reject a medical service. In the specific case, as has been examined, there are sufficient provisions that legitimize the mandatory nature of the vaccine, so 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 vaccination regulations cited above). This does not prevent emphasizing that in all cases the right to information of all persons subjected to this mandatory vaccination must be respected. On this matter, it is pertinent to cite again the Procedures 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 users and provides the following:

"8.6 Information to the user:

User education must be mandatory before, during, and after vaccination:

- Before vaccinating, counseling must be provided and the person to be vaccinated must be educated; it 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 event of any of these conditions, vaccination must be intramural.

-It is of utmost importance to explain to the user which vaccine was applied (If Pfizer/BioNTech or AstraZeneca) and to tell them that the second dose to be applied must be the same.

In addition, the patient must be reminded of the importance of complying with the application date of the second dose as indicated.

-Record in the vaccination card the type of vaccine and the application date of the first and second doses.

-Provide information to the user about the benefits of receiving the vaccine and about the main side effects and the importance of consulting health services in the event that during the 3 weeks after vaccination they present difficulty breathing, chest pain, blurred or double vision, single or multiple bruises, reddish or purple spots, swelling or pain in a leg, persistent abdominal pain, intense headache or one that worsens more than 3 days after vaccination).

-Information on reported side effects and on those that could appear when it begins to be applied massively in the population. And the way in which they must be notified in the event that any of them appear after being vaccinated.

-In the case of the AstraZeneca vaccine, the vaccinated person must be told the importance of notifying, just as with the Pfizer vaccine, any adverse effect through the already known channels." From the foregoing, it is concluded that the authorities are instructed on the obligation to respect the right to information of patients, and it is not recorded that they have omitted what is necessary for it to have been exercised. Consequently, this aspect of the appeal is dismissed." Based on the foregoing, the stance of this Court, 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, in order to previously safeguard their life and health, adopting the measures they deem pertinent. However, as this Court and the plaintiff himself have pointed out, 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 is special regulation that orders the safeguarding of individuals' private data, and that must be guaranteed by public or private bodies (Article 2 of the Law on the Protection of the Person against 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, 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 referred law establishes as an effective guarantee: "Any 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 dismissed.

VIII.- On the alleged violation of the principle of equality. The plaintiff points out that the contested regulation injures that principle, since it 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. He states that there is no technical justification that demonstrates the need to oblige all public officials to be vaccinated. He questions that, by executive decree, officials of other powers and municipalities are obliged to be vaccinated, injuring their autonomy. However, the plaintiff omits to substantiate his argument, applying the due reasonableness test to the questioned regulation. This Chamber, on repeated occasions, has indicated the following:

"To undertake a reasonableness examination of a regulation, the Constitutional Court requires that the party provide proof or at least elements of judgment on which to base its argumentation, and an equal procedural burden corresponds to whoever refutes the arguments of the action, and failure to comply with these requirements makes the allegations of unconstitutionality unacceptable. The foregoing, because it is not possible to carry out an analysis of "reasonableness" without the existence of a coherent argumentative line that is evidentially supported. This of course, when it is not a case whose "unreasonableness" is evident and manifest" (Judgment No. 1999-5236 of 2:00 p.m. on July 7, 1999, reiterated in judgments 2016-14392 of 9:05 a.m. on October 5, 2016, 2019-6935 of 11:20 a.m. on April 24, 2019, and 2021-11995 of 4:31 p.m. on May 26, 2021).

Without carrying out the respective test, the plaintiff's argumentative line lacks foundation, since from the simple affirmation of the petitioner two relationships are denoted that are not comparable, as he intends to compare a public employment relationship with a private one, despite being two regimes with totally different regulations. On repeated occasions, this Court has ruled on the statutory regime and its difference with the private sector in this sense:

"III.- On the statutory regime. Our original constituents enshrined in the Political Constitution of 1949, that there must be an administrative labor regime that regulates the relations between public servants and the State, in order to protect the former from arbitrary dismissals (stability in employment) and to professionalize the public function (search for efficiency in service and suitability of the official). The object of such purpose was to ensure that the Public Administration had organizational factors that would allow it to satisfy the right of citizens to the proper functioning of public services. For this, the procedure to select and appoint a servant in the Public Administration must comply with the fundamental principles provided for in constitutional Articles 191 and 192, thereby seeking suitable personnel to occupy a public post, with the purpose of guaranteeing efficiency and effectiveness in the public function. The civil service regime is not erected then as a corporate privilege, but as a guarantee of institutional impartiality. For this, the regulatory 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 merit and capacity in access, and also to certain norms of public law, such as the system of incompatibilities, that guarantee objectivity and impartiality in the provision of public service... Expounding the foregoing, it is clear and evident that, from the year 1949, the legal system that regulates the employment relationship between the public administration and its servants in our country is governed by public law, a principle that is 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 implies, necessarily - as indicated in the precedent cited above - that this relationship, by its very nature, is based on its own general principles, not only distinct from those of labor (private) law, but even often opposed to them... Even less so, when such labor provisions could be imposed on the State in its condition as employer, by external bodies in which foreign interests converge, and sometimes contrary to the purposes of the public administration. In accordance with what was indicated by the Chamber in judgment No. 2003-10615, the wording finally given to Article 191, together with the process of profound decentralization that the Costa Rican State experienced starting in 1949, led to the fact that currently the existence of various statutory relationships in the Administration is valid, in consideration of the functional independence and administrative autonomy that the legal system assures to several public institutions.

However, "what is not legitimate—as has been stated—is for the relations between each Administration-employer and its officials to be governed by rules agreed upon (contractual) between both parties, as validly occurs in private employment relations." The Chamber has recognized that there are two broad categories of employees who provide services to the State: those who have the status of "public official" (funcionario público), "public servant" (servidor público), or "public employee" (empleado público), and those who work for State enterprises or economic services, engaged in activities subject to common law. The former have been defined as those who, in the performance of their duties, carry out the public administration of the State, to whom —consequently— the public employment regime is applicable, with all the principles and characteristics derived from the provisions of Articles 191 and 192 of the Political Constitution; while the latter are those laborers, workers, and employees who, although they work for the State, do not have the status of public officials or public servants because they do not participate in the public administration of the administration, since they are hired by public enterprises or State economic services engaged in activities subject to common law pursuant to the exercise of their private law capacity, by virtue of which their employment regime is governed by the rules of common law, that is, ordinary labor legislation (see judgment No. 2006-14416).

As a corollary to the foregoing, the public employment relationship that applies to public servants is a special relationship of public or statutory law, 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). (Emphasis not in original).

In addition to the above, regarding the argument that an Executive Decree compels the vaccination of officials from other branches of government and municipalities, thereby infringing their autonomy, the petitioner must be advised that this Chamber has repeatedly stated that the defense of the autonomy of public institutions may only be invoked 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 that sense, the petitioner lacks standing to raise such a complaint. Consequently, the arguments regarding the principle of equality are inadmissible.

**IX.- Regarding the alleged violation of freedom of expression and freedom of thought.** The petitioner argues that persons who do not get vaccinated have the right to think in a manner different from or contrary to persons who do wish to do so, because there has been no clear and truthful information regarding the effects on the health of the population of what is called the covid-19 vaccine. He 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, since the inoculation does not prevent contagion. Furthermore, vaccinated persons are not immune to contagion and can become infected, because the vaccine does not provide indefinite protection, meaning that vaccinated persons 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 responsibility on the part of the manufacturer, that it is the only alternative for exiting the health crisis caused by SARS-CoV-2, meaning that persons 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 placed above a supposed interest of science or even of society. The reasons for which the petitioner claims that freedom of thought and expression have been harmed have been dismissed in the preceding recitals (considerandos), in which it has been established that information regarding vaccination and its effects has indeed been disseminated, and that it is not in the experimental phase. It has also been noted that the mandatory vaccination provided for in the challenged decree arises from a public interest in safeguarding the health of the collective, which is legally justified in Article 46 of the Civil Code, in Article 147, subsection 3 of Article 345 of the General Health Law (Ley General de Salud), and in Article 3 of the National Vaccination Law (Ley Nacional de Vacunación). The cases in which it is contraindicated have been disseminated, and it has been established that, despite the mandatory nature of vaccination, persons indeed have the right to obtain the necessary information beforehand to protect their health.

Regarding these rights, this Tribunal, in judgment No. 2018-17048 of 9:15 a.m. on October 12, 2018, has stated the following:

"Regarding freedom of thought and expression, the American Convention on Human Rights stipulates in Article 13 the following:

'Article 13. Freedom of Thought and Expression.

1. 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.

2. 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:

• a)respect for the rights or reputations of others; or b) the protection of national security, public order, or public health or morals.

3. The right of expression may not be restricted by indirect methods or means (…)' (emphasis added).

Along these lines, the Inter-American Court has consistently stated 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 for pursuing those purposes. Thus, it has been indicated that 'the only legitimate restrictions on the right to freedom of expression are imposed 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 defined; 2) these grounds must be expressly and precisely stated 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 Laws on Contempt and the American Convention on Human Rights, IACHR, http://www.cidh.oas.org/annualrep/94span/cap.V.htm)." Now then, the decree in question does not prevent people from thinking otherwise and expressing their disagreement in this regard. And although it provides that, despite what they think, they must be subjected 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, pronounced in the following manner:

"**V.- Mandatory nature of vaccination, Articles 2, 3, 6, and 11 of the bill.** Before analyzing the claim raised by the consulting legislators, the rules that, in the opinion of the consultants, could be unconstitutional for being contrary to the principle of freedom of choice (autonomía de la voluntad) will be transcribed. The articles read as follows:

'**Article 2.- FREE PROVISION AND EFFECTIVE ACCESS** The **mandatory** nature (obligatoriedad) and free provision of vaccines, as well as effective access to vaccination, are guaranteed to the entire population, especially for children, immigrants, and sectors located below the poverty line.' '**Article 3.- MANDATORY NATURE** 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 in this Law, in coordination with the Ministry of Health and the Costa Rican Social Security Fund (Caja Costarricense de Seguro Social)...' 'Article 6.- FUNCTIONS The Commission shall have the following basic functions and objectives:

• a)Guarantee the mandatory nature and free provision of vaccines and the effective access of the entire population to them...' 'Article 11.- TARGET POPULATION, CONDITIONS, AND AUTHORIZATION The Commission, together with the authorities of the Ministry of Health and the Costa Rican Social Security Fund, shall determine the sectors of the population that must be vaccinated; furthermore, it shall decide whether vaccination is **mandatory** or voluntary or shall establish the conditions under which vaccines are to be administered, in accordance with the programs established for this purpose...' Taking into account the provisions of the rules transcribed above, as well as the statement of purpose of the bill under consultation, this Chamber does not consider the consultants to be correct in stating that establishing the mandatory nature of vaccines is harmful to the right of freedom of choice. Health as a means and as an end for the personal and social fulfillment of mankind constitutes a human and social right whose recognition is beyond dispute. It is one of the rights of man that emanates from his dignity as a human being. From this right arises a responsibility regarding health for the individual, for organized community, and for the State itself. In international instruments and constitutional declarations of social rights, the right to health is included, the recognition of which must be coupled with the imposition of the duty to care for one's own health and that of others. It is thus that, within a comprehensive social policy aimed at resolving the effects of social deficiencies, the observance of the principle of coherence of ends determines that actions regarding working conditions, social security, education, housing, nutrition, and population be harmonized with those of health, due to the interconnectedness and interdependence of each. 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 harms the principle of freedom of choice, but rather guarantees the essential health assistance in safeguarding the unavoidable responsibility of the State to watch over the health of each and every citizen." Likewise, and in particular regarding the limitations that apply to other fundamental rights in the face of the right to life and health, this Tribunal has established the following:

"Regarding the first topic, it must be indicated that, **indeed, Constitutional Law expressly recognizes the right of every person to freedom of thought, conscience, and religion.** Even in the specific case of children, Article 14 of the aforementioned Convention on the Rights of the Child expressly establishes:

'Article 14 1. States Parties shall respect the right of the child to freedom of thought, conscience and religion.

2. 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.

3. 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.' (Underlining not in the original).

**By 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 the other members of the community** -including, especially, other children-, to the extent that this 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, meaning that 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 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. Not only the relevance of the values for which the plaintiff claims protection must be clear, 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) In the case at hand (sub examine), it has been established that both freedoms—thought and expression—like all fundamental rights, are not absolute. In any case, the challenged decree in no way prevents the freedom to seek, receive, and impart information and ideas of all kinds, even when they are contrary to vaccination against covid-19. And while the manifestation of these cannot be exercised by opposing vaccination, the truth is that this is a reasonable limitation in the face of the State's need to protect the fundamental right to health of all people 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 Tribunal reiterated that vaccination against covid-19 is a suitable provision that protects the officials themselves, contributes to achieving 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 to prevent any workplace from being a source of contagion, and to date, no other alternative or tool exists with equal or greater efficacy to protect the health of the entire population. The petitioner must consider that the benefits of the provision under study transcend to society as a whole—regarding the right to life, to health, and the improvement of economic and social conditions, as is evident from the reasoning provided in the very regulation in question—, aspects that, as has already been noted, are greater than the harm that a single worker could suffer. Consequently, the claim in question is rejected on the merits.

**X.- Regarding the alleged violation of the principle of legality and of laws subsequent to the Vaccination Law.** The petitioner claims a violation of the principle of legality, because, in his opinion, the use of the term vaccine in the case of inoculation against covid-19 does not comply with the main characteristic, which is to induce active protective immunity against the corresponding infectious disease, according to Article 1, subsection p) of the Regulation to the National Vaccination 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 Ethics Committees and Good Clinical Practice Principles.

It refers to a vaccine profile without conclusive clinical studies, and that, if the duration of effectiveness is unknown until the study is completed, the contraindications, interactions, and adverse reactions cannot be known with certainty either.

In this regard, it is necessary to reiterate that this Chamber has dismissed the claim that Executive Decree No. 42889-S, amended by Decree No. 43249-S, violates the principle of legal reserve in the regulation of fundamental rights, since the mandatory application of the vaccine against the COVID-19 coronavirus was defined by the National Commission for Vaccination and Epidemiology (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 conformity with existing regulations by including the vaccine in question in the national vaccination schedule authorized by law, and therefore 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 and Technical Secretary of the National Commission for Vaccination and Epidemiology of the Health Surveillance Directorate, whose basis is not subject to review in this jurisdiction, as it addresses technical, medical, and scientific aspects regarding vulnerability to a virus; and that it is also not a vaccine whose studies, regarding its effects, are in an experimental phase. Consequently, the argument raised in this regard is dismissed, and the claimant is reminded that if he disagrees with the public authorities' criteria concerning such aspects, including calling it a "vaccine," this is also a technical discussion that should not be elucidated in this jurisdiction, but rather through the legality pathway, via the various means of proof that this pathway contemplates and that allows for its broad discussion and technical and scientific verification.

On 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 confrontation between a legal norm and a decree implies a conflict of legality, the discussion of which does not correspond to this jurisdiction. Hence, the point raised by the claimant regarding the violation of other norms of a lower rank than the Political Constitution must also be rejected.

XI.- On the alleged violation of the principles of conventionality, the hierarchy of norms, and the jurisprudence of the Inter-American Court of Human Rights related to the right to life and informed consent.

The applicant states that the questioned decree contradicts international legal instruments related 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, and without respecting their autonomy of will, violates the physical integrity of individuals. The international instruments in question provide the following:

From the International Covenant on Economic, Social and Cultural Rights:

"Article 2 1. 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.

2. 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.

3. 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." "Article 5 1. 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.

2. 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." "Article 6 1. 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.

2. 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." "Article 7 The 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:

• a)Remuneration which provides all workers, as a minimum, with:
• i)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; ii) A decent living for themselves and their families in accordance with the provisions of the present Covenant; b) Safe and healthy working conditions; c) 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; d) Rest, leisure and reasonable limitation of working hours and periodic holidays with pay, as well as remuneration for public holidays." From the Universal Declaration of Human Rights:

"Article 12 No 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." From the American Convention on Human Rights:

"Article 1 Obligation to Respect Rights 1. 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, color, sex, language, religion, political or other opinion, national or social origin, economic status, birth, or any other social condition.

2. For the purposes of this Convention, "person" means every human being." "Article 3 Right to Juridical Personality Every person has the right to recognition as a person before the law." "Article 4 Right to Life 1. 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.

2. In countries that have not abolished the death penalty, it may be imposed only for the most serious crimes, 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.

3. The death penalty shall not be re-established in states that have abolished it.

4. In no case shall capital punishment be inflicted for political offenses or related common crimes.

5. Capital punishment shall not be imposed upon persons who, at the time the crime was committed, were under eighteen years of age or over seventy years of age; nor shall it be applied to pregnant women.

6. Every person condemned to death has 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." "Article 5 Right to Humane Treatment 1. Every person has the right to have his physical, mental, and moral integrity respected." Having reviewed the provisions of the instruments invoked by the claimant cited supra, this Court considers it necessary to reiterate what was previously stated, in the sense that the decree challenged here does not violate the right to life and health of individuals; far from it, it seeks the greatest well-being of the population in general. It was also clearly established that this is not a solution in an experimental phase. Thus, precisely, upon weighing fundamental rights, the mandatory nature of vaccines to procure the right to public health is neither unconstitutional nor injurious to the international instruments invoked. What was indicated by this Court, in relation to the General Vaccination Law in that sense, is reiterated:

"...With which it is confirmed that said provision recognizes the possibility of imposing reasonable limits on the exercise of the aforementioned rights to protect public health. In which case, it is fitting to reiterate 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, with the application of the aforementioned vaccines, the aim is 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. Therefore, it must be remembered that this Chamber has emphasized:

"(...) The preponderance of life and health, as supreme values of individuals, is present and designated as a mandatory protection for 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 actor claims 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)" (Sentencia n.° 2020-19433 of 9:20 a.m. on October 9, 2020) In 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…" (Sentencia n.° 2021-24027 of 10:10 a.m. on October 26, 2021). And it was also added: "This does not prevent 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 Procedures Manual for the execution of vaccination against COVID-19 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 performing any medical act; however, the petitioner must note the context of such pronouncements, since they are based on ordinary situations and not on a pandemic as is currently the case, which implies a different assessment. The foregoing is not intended to harm the fundamental rights of workers, much less to 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, whose effects transcend beyond one person or one family, but rather cross borders and have produced grave consequences worldwide due to the high death tolls and the conditions required to provide them with proper medical care in times of high or extremely high demand. It should be noted that the provision in question aims to protect collective health and the rights of others, among which are included those who cannot be vaccinated for medical reasons. In this sense, the decree in question does not harm the principle of hierarchy of norms, since it does not contravene the provisions of international conventions, but rather applies their provisions in a comprehensive and harmonious manner, seeking their exercise without detriment to the right upon which the exercise of all other human rights depends, life. Consequently, the petitioner's allegations must be rejected on their merits.

XII.- Regarding the alleged violation of the principle of reasonableness and proportionality in the sanction for not getting vaccinated. It is alleged that establishing sanctions such as dismissal without employer liability and/or a fine of approximately 500,000 colones, for failure to get vaccinated against covid-19, violates the right to work and the principle of reasonableness and proportionality. 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 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 public officials who do not get vaccinated are disproportionate, constituting blank criminal or administrative-sanctioning types, which contravene the principle of criminal and administrative-sanctioning legality. It indicates that the intention is to open administrative proceedings 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 schedule or not. 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 if a crime has been committed. Thus, it asserts that workers are coerced into undergoing 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 public order basis on which the regulation is founded and the sanctions for workers who do not get vaccinated. However, the petitioner does not specify which regulatory provisions establish the sanctions whose proportionality is being questioned, which prevents this Tribunal from ruling on the matter. It should be noted that executive decree n.° 43249-S, challenged here and whose unconstitutionality was invoked in the underlying case, only amended article 2 of executive decree n.° 42889-S of March 10, 2021, and the sanctions challenged by the petitioner do not arise from the text thereof.

Executive decree n.° 43249-S, regarding which this action is brought, provides as follows:

"Article 1.- Amend article 2 of Executive Decree N° 42889-S of March 10, 2021, called Reform to Executive Decree N° 32722-S of May 20, 2005, called Regulation to the National Vaccination Law and Establishment of the Mandatory Nature of the COVID-19 Vaccine, so that the following is stated henceforth:

"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 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.

When summoned by those in charge for such purpose and in accordance with 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 be vaccinated against COVID-19." By virtue of the foregoing, the petitioner's lack of precision entails a material impossibility for this Tribunal to rule, and regarding such aspect, the action must be flatly rejected.

XIII.- As a corollary of the foregoing, the action must be rejected on its merits regarding the alleged violation of the principles of informed consent, hierarchy of norms, conventionality, legal reserve, and informational self-determination; and of the rights to life and health. For the rest, the action is flatly rejected.

XIV.- SEPARATE NOTE OF MAGISTRATE CASTILLO VÍQUEZ. I agree with my colleagues on the arguments they put forward to flatly reject the action, since there is no evident and manifest contradiction between the law and the decree being challenged. The Tribunal's position, that when a regulatory norm violates or exceeds what is provided in a law, it is a matter of legality, whose discussion does not correspond to this jurisdiction, is, in general terms, 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 he who is called to establish whether a regulatory norm violates the legal norm or not. However, there is an important nuance in this matter, which is that, from my point of view, when there is manifest evidence, obvious at a glance, that the regulatory norm exceeds, suppresses, or contradicts the text of the Law, there is no doubt that, in a gross manner, the principle of force, authority, or efficacy of the Law is violated; a principle that has constitutional coverage and must be protected by this Tribunal. As is well known, the principle of force, authority, or efficacy of law refers us to the potency (active force), the resistance (passive force), and the system for challenging 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.

XV.DISSENTING VOTE OF MAGISTRATE RUEDA LEAL. I dissent from the majority criterion of this Tribunal and cast a dissenting vote in this matter, considering that the decision to flatly reject this action of unconstitutionality is premature. As I have expressed on multiple occasions (votes n.os 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 same reason, a set of formalities must be fulfilled, so that the Chamber may validly hear the merits of the challenge," as stated in the extensive jurisprudence of this Chamber. However, it is precisely the law itself that orders the treatment that must be given to the different formalities and their eventual non-compliance, as extracted from the text of article 80 of the Law of Constitutional Jurisdiction, which states:

"Article 80.- If the formalities referred to in the two preceding articles are not fulfilled, the President of the Chamber shall indicate by resolution which are the omitted requirements and shall order them to be fulfilled within three days (…)" In this matter, among other requirements, an adequate and sufficient substantiation is lacking, as required by article 79 of the Law of Constitutional Jurisdiction, so the application of a warning to the petitioner to remedy the detected omission is unquestionable. Likewise, it is absolutely not superfluous to state that – in my opinion – the interpretation of articles 78 and 79, as well as article 80 itself, of the Law governing this jurisdiction, must be broad for the 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 cast a dissenting vote and order that the cited warning be made.

XVI.- 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 that is not withdrawn within this period will be destroyed, according to the provisions of the "Regulation on the Electronic Case File before the Judiciary," approved by the Full Court in session N° 27-11 of August 22, 2011, article XXVI and published in the Judicial Bulletin number 19 of January 26, 2012, as well as in the agreement approved by the Superior Council of the Judiciary, in session N° 43-12 held on May 3, 2012, article LXXXI.

Por tanto: The 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 of the rights to life and health. For the rest, the action is flatly rejected. The joinder motion is rejected. Magistrate Castillo Víquez records a note.

On formal grounds and without addressing the merits, Magistrate Rueda Leal dissents (salva el voto) and orders that the warning (prevención) of Article 80 of the Ley de la Jurisdicción Constitucional be made.

Documento Firmado Digitalmente -- Código verificador -- *NSNPGHME6F861* MATTERS OF CONSTITUTIONALITY CONTROL", "resultado": "Rechazo", "despachoOrden": "8", "despacho": "Sala Constitucional", "esResolucionEstructural": "0", "esResolucionOral": "0", "esResolucionRelevante": "1", "fecha": "2022-01-05", "tipoDocumento": "EXT", "esCriterioUnificador": "0", "tipoContenido": "Voto de mayoría", "sourceName": "Documentos", "formatoDocumento": "ESCRITO", "tipoResolucion": "De Fondo", "tipoInformacion": "Resolución Judicial", "html": "<p class=\"MsoNormal\"><b><span style=\"font-size:10.0pt;line-height:107%;\ncolor:black\">000374-22.</span></b><span style=\"font-size:10.0pt;line-height:\n107%;color:black\"> <b>HEALTH. MANDATORY COVID-19 VACCINATION. </b>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. <br>\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.<o:p></o:p></span></p>\n\n<p class=\"MsoNormal\">ISSUES ANALYZED<o:p></o:p></p>\n\n<p class=\"MsoNormal\"><b>_{<span style=\"font-size: 14pt; line-height: 107%; font-family: Arial, sans-serif; color: black; background-image: initial; background-position: initial; background-size: initial; background-repeat: initial; background-attachment: initial; background-origin: initial; background-clip: initial;\">On the\nmandatory nature of vaccination, the principle of legal reserve, and the right\nto life and health.</span>}</b><o:p></o:p></p>\n\n<p class=\"MsoNormal\"><b>_{<span style=\"font-size: 14pt; line-height: 107%; font-family: Arial, sans-serif; color: black; background-image: initial; background-position: initial; background-size: initial; background-repeat: initial; background-attachment: initial; background-origin: initial; background-clip: initial;\">On informed\nconsent (consentimiento informado) and the protection of sensitive information.<o:p></o:p></span>}</b></p>\n\n<p class=\"MsoNormal\"><b>_{<span style=\"font-size: 14pt; line-height: 107%; font-family: Arial, sans-serif; color: black; background-image: initial; background-position: initial; background-size: initial; background-repeat: initial; background-attachment: initial; background-origin: initial; background-clip: initial;\">On the alleged\nviolation of the principle of equality.&nbsp;<o:p></o:p></span>}</b></p>\n\n<p class=\"MsoNormal\"><b>_{<span style=\"font-size: 14pt; line-height: 107%; font-family: Arial, sans-serif; color: black; background-image: initial; background-position: initial; background-size: initial; background-repeat: initial; background-attachment: initial; background-origin: initial; background-clip: initial;\">On the alleged\nviolation of freedom of expression and thought.<o:p></o:p></span>}</b></p>\n\n<p class=\"MsoNormal\"><b>_{<span style=\"font-size: 14pt; line-height: 107%; font-family: Arial, sans-serif; color: black; background-image: initial; background-position: initial; background-size: initial; background-repeat: initial; background-attachment: initial; background-origin: initial; background-clip: initial;\">On the alleged\ninfringement of the principle of legality and of laws enacted after the Ley de Vacunas.</span>}</b>_{<span style=\"font-size: 14pt; line-height: 107%; font-family: Arial, sans-serif; color: black; background-image: initial; background-position: initial; background-size: initial; background-repeat: initial; background-attachment: initial; background-origin: initial; background-clip: initial;\">&nbsp;<b><o:p></o:p></b></span>}</p>\n\n<p class=\"MsoNormal\"><b>_{<span style=\"font-size: 14pt; line-height: 107%; font-family: Arial, sans-serif; color: black; background-image: initial; background-position: initial; background-size: initial; background-repeat: initial; background-attachment: initial; background-origin: initial; background-clip: initial;\">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).<o:p></o:p></span>}</b></p>\n\n<p class=\"MsoNormal\"><b>_{<span style=\"font-size: 14pt; line-height: 107%; font-family: Arial, sans-serif; color: black; background-image: initial; background-position: initial; background-size: initial; background-repeat: initial; background-attachment: initial; background-origin: initial; background-clip: initial;\">On the alleged\nviolation of the principles of reasonableness and proportionality in the penalty for\nnot being vaccinated.<o:p></o:p></span>}</b></p>\n\n<p class=\"MsoNormal\"><o:p>&nbsp;</o:p></p>\n\n<span style=\"font-size:11.0pt;line-height:107%;font-family:&quot;Calibri&quot;,sans-serif;\nmso-ascii-theme-font:minor-latin;mso-fareast-font-family:Calibri;mso-fareast-theme-font:\nminor-latin;mso-hansi-theme-font:minor-latin;mso-bidi-font-family:&quot;Times New Roman&quot;;\nmso-bidi-theme-font:minor-bidi;mso-ansi-language:ES-CR;mso-fareast-language:\nEN-US;mso-bidi-language:AR-SA\">CO01/22</span>\r\n" }, "previousdocs": [], "nextdocs": [] }, { "doc": { "redactor": "Fernando Castillo Víquez", "numeroDocumentoPadre": "sen-1-0007-1063030", "anno": "2022", "expediente": "210223410007CO", "hora": "09:20", "notaSeparada": "Fernando Castillo Víquez", "esProtegida": "1", "esCambioCriterio": "0", "TemasYSubtemas": [ { "id": 1, "nombre": "JURISDICCIÓN CONSTITUCIONAL", "Subtemas": [ { "id": 1, "nombre": "NO APLICA" } ] } ], "controlCons": "Rechazo de fondo", "esNotaSeparada": "1", "esVotoSalvado": "0", "modified": "2026-05-16 20:01:47.33", "id": "ext-1-0007-307764", "numeroDocumento": "00374", "esResolucionClave": "0", "restrictores": "NO APLICA", "claseAsunto": "Acción de inconstitucionalidad", "tipoTexto": "1", "enteSistematizador": "SALA CONSTITUCIONAL", "descriptores": "JURISDICCIÓN CONSTITUCIONAL", "rutaTesauro": [ "TEMAS SALA CONSTITUCIONAL", "TEMAS SALA CONSTITUCIONAL||3. ASUNTOS DE CONTROL DE CONSTITUCIONALIDAD", "TEMAS SALA CONSTITUCIONAL||3. ASUNTOS DE CONTROL DE CONSTITUCIONALIDAD||JURISDICCIÓN CONSTITUCIONAL" ], "subNumeroDocumento": "1", "contenidosInteresOrden": "3", "ramaDerecho": "3. ASUNTOS DE CONTROL DE CONSTITUCIONALIDAD", "resultado": "Rechazo", "despachoOrden": "8", "despacho": "Sala Constitucional", "esResolucionEstructural": "0", "esResolucionOral": "0", "fecha": "2022-01-05", "tipoDocumento": "EXT", "esCriterioUnificador": "0", "tipoContenido": "Nota separada", "sourceName": "Documentos", "formatoDocumento": "ESCRITO", "tipoResolucion": "De Fondo", "tipoInformacion": "Resolución Judicial", "html": "<p class=\"MsoNormal\" style=\"text-align: justify; text-indent: 34pt; line-height: normal; background-image: initial; background-position: initial; background-size: initial; background-repeat: initial; background-attachment: initial; background-origin: initial; background-clip: initial;\"><b>_{<span style=\"font-size:12.0pt;color:black\">XIV.-\nSEPARATE NOTE (NOTA SEPARADA) OF MAGISTRATE CASTILLO VÍQUEZ.&nbsp;</span>}</b>_{<span style=\"font-size:12.0pt;color:black\">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.</span>}<span style=\"font-size:12.0pt;font-family:&quot;Arial&quot;,sans-serif;\ncolor:black\"><o:p></o:p></span></p>\n\n<p class=\"MsoNormal\" style=\"text-align: justify; text-indent: 34pt; background-image: initial; background-position: initial; background-size: initial; background-repeat: initial; background-attachment: initial; background-origin: initial; background-clip: initial;\">_{<span style=\"font-size:12.0pt;line-height:107%;color:black\">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).</span><span style=\"color:black\"><o:p></o:p></span>}</p>\n\n<p class=\"MsoNormal\">CO01/22<o:p></o:p></p>\r\n" }, "previousdocs": [], "nextdocs": [] }, { "doc": { "redactor": "Fernando Castillo Víquez", "numeroDocumentoPadre": "sen-1-0007-1063030", "anno": "2022", "expediente": "210223410007CO", "hora": "09:20", "esProtegida": "1", "esCambioCriterio": "0", "TemasYSubtemas": [ { "id": 1, "nombre": "JURISDICCIÓN CONSTITUCIONAL", "Subtemas": [ { "id": 1, "nombre": "NO APLICA" } ] } ], "controlCons": "Rechazo de fondo", "esNotaSeparada": "0", "esVotoSalvado": "1", "modified": "2026-05-16 20:01:47.33", "id": "ext-1-0007-307766", "numeroDocumento": "00374", "esResolucionClave": "0", "restrictores": "NO APLICA", "claseAsunto": "Acción de inconstitucionalidad", "tipoTexto": "1", "enteSistematizador": "SALA CONSTITUCIONAL", "descriptores": "JURISDICCIÓN CONSTITUCIONAL", "rutaTesauro": [ "TEMAS SALA CONSTITUCIONAL", "TEMAS SALA CONSTITUCIONAL||3. ASUNTOS DE CONTROL DE CONSTITUCIONALIDAD", "TEMAS SALA CONSTITUCIONAL||3. ASUNTOS DE CONTROL DE CONSTITUCIONALIDAD||JURISDICCIÓN CONSTITUCIONAL" ], "subNumeroDocumento": "1", "contenidosInteresOrden": "3", "ramaDerecho": "3. ASUNTOS DE CONTROL DE CONSTITUCIONALIDAD", "resultado": "Rechazo", "despachoOrden": "8", "despacho": "Sala Constitucional", "esResolucionEstructural": "0", "esResolucionOral": "0", "fecha": "2022-01-05", "tipoDocumento": "EXT", "esCriterioUnificador": "0", "tipoContenido": "Voto salvado", "sourceName": "Documentos", "formatoDocumento": "ESCRITO", "tipoResolucion": "De Fondo", "votoSalvado": "Paul Rueda Leal", "tipoInformacion": "Resolución Judicial", "html": "<p class=\"MsoNormal\" style=\"text-align: justify; text-indent: 34pt; line-height: normal; background-image: initial; background-position: initial; background-size: initial; background-repeat: initial; background-attachment: initial; background-origin: initial; background-clip: initial;\"><b>_{<span style=\"font-size:12.0pt;color:black\">XV</span>}</b><sub><span style=\"font-size:12.0pt;color:black\">.-<b>DISSENTING VOTE (VOTO SALVADO) OF MAGISTRATE RUEDA\nLEAL</b>. 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, “<i>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</i>&nbsp;<i>” 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:</span></span><span style=\"font-size:12.0pt;font-family:&quot;Arial&quot;,sans-serif;color:black\"><o:p></o:p></span></p>\n\n<p class=\"MsoNormal\" style=\"text-align: justify; text-indent: 34pt; line-height: normal; background-image: initial; background-position: initial; background-size: initial; background-repeat: initial; background-attachment: initial; background-origin: initial; background-clip: initial;\"><sub><span style=\"font-size:12.0pt;color:black\">“<i>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</i>&nbsp;(…)”</span></span><span style=\"font-size:12.0pt;font-family:&quot;Arial&quot;,sans-serif;color:black\"><o:p></o:p></span></p>\n\n<p class=\"MsoNormal\" style=\"text-align: justify; text-indent: 34pt; background-image: initial; background-position: initial; background-size: initial; background-repeat: initial; background-attachment: initial; background-origin: initial; background-clip: initial;\">_{<span style=\"font-size:12.0pt;line-height:107%;color:black\">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.</span><span style=\"color:black\"><o:p></o:p></span>}</p>\n\n<p class=\"MsoNormal\">CO01/22<o:p></o:p></p>\r\n" }, "previousdocs": [], "nextdocs": [] }, { "doc": { "redactor": "Fernando Castillo Víquez", "numeroDocumentoPadre": "sen-1-0007-1063030", "anno": "2022", "expediente": "210223410007CO", "hora": "09:20", "esProtegida": "1", "esCambioCriterio": "0", "TemasYSubtemas": [ { "id": 1, "nombre": "ACCIÓN DE INCONSTITUCIONALIDAD", "Subtemas": [ { "id": 1, "nombre": "NO APLICA" } ] } ], "controlCons": "Rechazo de fondo", "esNotaSeparada": "0", "esVotoSalvado": "0", "modified": "2026-05-16 20:01:47.33", "id": "ext-1-0007-318104", "numeroDocumento": "00374", "esResolucionClave": "0", "restrictores": "NO APLICA", "claseAsunto": "Acción de inconstitucionalidad", "tipoTexto": "1", "enteSistematizador": "SALA CONSTITUCIONAL", "descriptores": "ACCIÓN DE INCONSTITUCIONALIDAD", "rutaTesauro": [ "TEMAS SALA CONSTITUCIONAL", "TEMAS SALA CONSTITUCIONAL||3. ASUNTOS DE CONTROL DE CONSTITUCIONALIDAD", "TEMAS SALA CONSTITUCIONAL||3. ASUNTOS DE CONTROL DE CONSTITUCIONALIDAD||ACCIÓN DE INCONSTITUCIONALIDAD" ], "subNumeroDocumento": "1", "contenidosInteresOrden": "3", "ramaDerecho": "3. ASUNTOS DE CONTROL DE CONSTITUCIONALIDAD", "resultado": "Rechazo", "despachoOrden": "8", "despacho": "Sala Constitucional", "esResolucionEstructural": "0", "esResolucionOral": "0", "fecha": "2022-01-05", "tipoDocumento": "EXT", "esCriterioUnificador": "0", "tipoContenido": "Voto de mayoría", "sourceName": "Documentos", "formatoDocumento": "ESCRITO", "tipoResolucion": "De Fondo", "tipoInformacion": "Resolución Judicial", "html": "<div>Descriptor: SALUD. VACUNACIÓN OBLIGATORIA</div><div>Expediente: 21-022341-0007-CO</div><div>Sentencia: 000374-22 de 05 de enero de 2022</div><div>Tipo de asunto: Acción de inconstitucionalidad</div><div>Norma impugnada: Decreto Ejecutivo No. 43249-S de 07-10-2021, titulado 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, artículo 46 del Código Civil, Acuerdo Legislativo del 27-10-2021.&nbsp;</div><div>Parte dispositiva: Se rechaza por el fondo la acción respecto de la alegada violación a los principios del consentimiento informado, de jerarquía de las normas, de convencionalidad, de reserva de ley, de autodeterminación informativa; y del derecho a la vida y la salud. En lo demás, se rechaza de plano la acción. Se rechaza la gestión de coadyuvancia. El magistrado Castillo Víquez consigna nota. Por motivos de forma y sin referirse al fondo, el magistrado Rueda Leal salva el voto y ordena hacer la prevención del artículo 80 de la Ley de la Jurisdicción Constitucional.</div><div><br></div><div>CO08/22</div>\r\n" }, "previousdocs": [], "nextdocs": [] }, { "doc": { "redactor": "Fernando Castillo Víquez", "numeroDocumentoPadre": "sen-1-0007-1063030", "anno": "2022", "expediente": "210223410007CO", "hora": "09:20", "esProtegida": "1", "esCambioCriterio": "0", "TemasYSubtemas": [ { "id": 1, "nombre": "SENTENCIAS SALA CONSTITUCIONAL - CORTE IDH", "Subtemas": [ { "id": 1, "nombre": "Caso contencioso" } ] } ], "controlCons": "Rechazo de fondo", "esNotaSeparada": "0", "esVotoSalvado": "0", "modified": "2026-05-16 20:01:47.33", "id": "ext-1-0007-322464", "numeroDocumento": "00374", "esResolucionClave": "0", "restrictores": "Caso contencioso", "claseAsunto": "Acción de inconstitucionalidad", "tipoTexto": "1", "enteSistematizador": "SALA CONSTITUCIONAL", "descriptores": "SENTENCIAS SALA CONSTITUCIONAL - CORTE IDH", "rutaTesauro": [ "TEMAS SALA CONSTITUCIONAL", "TEMAS SALA CONSTITUCIONAL||8. JURISPRUDENCIA CIDH", "TEMAS SALA CONSTITUCIONAL||8. JURISPRUDENCIA CIDH||SENTENCIAS SALA CONSTITUCIONAL - CORTE IDH" ], "subNumeroDocumento": "1", "contenidosInteresOrden": "3", "ramaDerecho": "8. JURISPRUDENCIA CIDH", "resultado": "Rechazo", "despachoOrden": "8", "despacho": "Sala Constitucional", "esResolucionEstructural": "0", "esResolucionOral": "0", "fecha": "2022-01-05", "tipoDocumento": "EXT", "esCriterioUnificador": "0", "tipoContenido": "Voto de mayoría", "sourceName": "Documentos", "formatoDocumento": "ESCRITO", "tipoResolucion": "De Fondo", "tipoInformacion": "Resolución Judicial", "html": "<p class=\"MsoNormal\" style=\"margin: 0cm 60.85pt 0cm 0cm; text-align: justify; line-height: normal; background-image: initial; background-position: initial; background-size: initial; background-repeat: initial; background-attachment: initial; background-origin: initial; background-clip: initial;\"><span style=\"font-size: 10pt; font-family: Arial, sans-serif; color: black; background-image: initial; background-position: initial; background-size: initial; background-repeat: initial; background-attachment: initial; background-origin: initial; background-clip: initial;\">“…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<o:p></o:p></span></p>\n\n<p class=\"MsoNormal\" style=\"text-align:justify;line-height:normal\"><span style=\"font-size: 10pt; color: black; background-image: initial; background-position: initial; background-size: initial; background-repeat: initial; background-attachment: initial; background-origin: initial; background-clip: initial;\">CO11/22<o:p></o:p></span></p>\r\n" }, "previousdocs": [], "nextdocs": [] } ], "contenidosInteresOrden": "4", "despacho": "Sala Constitucional", "despachoOrden": "8", "enteSistematizador": "SALA CONSTITUCIONAL", "esCambioCriterio": "0", "esCriterioUnificador": "0", "esNotaSeparada": "1", "esProtegida": "1", "esResolucionClave": "0", "esResolucionEstructural": "0", "esResolucionOral": "0", "esResolucionRelevante": "1", "esVotoSalvado": "1", "expediente": "210223410007CO", "fecha": "2022-01-05", "formatoDocumento": "ESCRITO", "hora": "09:20", "id": "sen-1-0007-1063030", "numeroDocumento": "00374", "redactor": "Fernando Castillo Víquez", "sentenciasRelacionadas": [ "sen-1-0007-1069227", "sen-1-0007-1074697", "sen-1-0007-1107731" ], "sourceName": "Documentos", "subNumeroDocumento": "1", "tipoDocumento": "SNT", "tipoInformacion": "Resolución Judicial", "tipoResolucion": "De Fondo", "resultado": "Rechazo", "controlCons": "Rechazo de fondo", "tipoTexto": "1", "previousdocs": [], "nextdocs": [], "html": "<!DOCTYPE html PUBLIC \"-//W3C//DTD XHTML 1.0 Transitional//EN\"\r\r\n \"http://www.w3.org/TR/xhtml1/DTD/xhtml1-transitional.dtd\">\r\r\n<html xmlns=\"http://www.w3.org/1999/xhtml\" xml:lang=\"en\" lang=\"en\"><head>\r\r\n<title></title>\r\r\n<meta http-equiv=\"content-type\" content=\"text/html;charset=windows-1252\"/>\r\r\n<meta http-equiv=\"Content-Style-Type\" content=\"text/css\"/>\r\r\n</head>\r\r\n<body>\r\r\n<p align=\"right\"><font face=\"WASP 39 L\" color=\"#010101\" size=\"4\"><span style=\" font-size:14pt\">_*</span></font><font face=\"WASP 39 L\" size=\"4\"><span style=\" font-size:14pt\">_{210223410007CO}</span></font><font face=\"WASP 39 L\" color=\"#010101\" size=\"4\"><span style=\" font-size:14pt\">_*</span></font></p>\r\r\n<p align=\"justify\" style=\"margin-left:0mm; margin-right:0mm; text-indent:0mm; margin-top:0.00mm; margin-bottom:1.58mm;\"><font face=\"TIMES NEW ROMAN\" color=\"#010101\" size=\"4\"><span style=\" font-size:14pt\"><b>_Exp:</b></span></font><font face=\"TIMES NEW ROMAN\" size=\"4\"><span style=\" font-size:14pt\"><b>_{21-022341-0007-CO}</b></span></font><font face=\"TIMES NEW ROMAN\" color=\"#010101\" size=\"4\"><span style=\" font-size:14pt\"><b></b></span></font></p>\r\r\n<p align=\"justify\"><font face=\"TIMES NEW ROMAN\" color=\"#010101\" size=\"4\"><span style=\" font-size:14pt\"><b>_{Res. N&#186; 2022000374}</b></span></font></p>\r\r\n<p align=\"justify\"><font face=\"TIMES NEW ROMAN\" color=\"#010101\" size=\"4\"><span style=\" font-size:14pt\"><b>_{<br />}</b></span></font></p><p align=\"justify\"><font face=\"TIMES NEW ROMAN\" color=\"#010101\" size=\"4\"><span style=\" font-size:14pt\"><b>_{CONSTITUTIONAL CHAMBER OF THE SUPREME COURT OF JUSTICE.}</b></span></font></p> San José, at nine twenty minutes on January fifth, two thousand twenty-two.

Action 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.” **Whereas:** **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.

In 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.

The 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.

It 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.

It 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.

It 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.

It 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.

Caso 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.

That 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.

2.- 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.

3.- 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.

4.- 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.

Drafted by Magistrate Castillo Víquez; and,

Considering:

I.- 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.

II.- 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).

III.- 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.

IV.- 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:

"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." Likewise, 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).

In 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.

V.- 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:

1. 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.

2. 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.

3. 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.

4. 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.

5. 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.

6. 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.

7. 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.

8. 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.

9. 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.

10. 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.

11. 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.

12. 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.

13. 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.

Executive Decree No. 43249-S challenged here provides as follows:

"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:

"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.

When 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." It 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." Given 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.

**VI.- On the mandatory nature of vaccination, the principle of legal reservation, and the right to life and health.** In 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:

"**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.

**VI.- REGULATORY FRAMEWORK:** The Civil Code provides as follows:

"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).

The Ley General de Salud, 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".

On the other hand, regarding the obligations of the administered parties, the referred law states 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.

They are especially obligated to comply:

(…)

• b)The preventive measures that the health authority orders when a disease appears".

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

Furthermore, Article 3 of the Ley Nacional de Vacunación states:

"(...) 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.**

The 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.

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 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).

In 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:

"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".

From 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.

Likewise, 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".

On 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.

For 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.

**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**.

**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:

"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 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 will be carried out in 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 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:

"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 • 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.

(…)

Persons 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." That 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.

What 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.

**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.

Said 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.

In 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..." The 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.

On 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.

As 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:

"(...) 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 (...)"

The 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:

"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:

'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 reference 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 anaphylaxis treatment is required.

-Do not administer during Pregnancy or Lactation.

-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.' In 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:

'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 • 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.

(...)

Persons 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.' 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." It 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:

"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.

When 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." Similarly, 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." As 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.

VII.- 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:

"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:

'8.6 Information to the user:

User education must be mandatory before, during, and after vaccination:

- 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.

-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.

Furthermore, the patient must be reiterated the importance of complying with the application date of the second dose just as indicated.

-Note on the vaccination card the type of vaccine and the application date of the first and second dose.

-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).

-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.

-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.' From 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." Based 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.

VIII.- 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:

"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).

Without 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:

"III.- On the statutory regime.

Our 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…

Having 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…

Even 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).

Corollary 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).

In 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.

IX.- 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.

Regarding these rights, this Court, in judgment No. 2018-17048 of 9:15 a.m. on October 12, 2018, has stated the following:

"On freedom of thought and expression, the American Convention on Human Rights prescribes in Article 13 the following:

"Article 13. Freedom of Thought and Expression.

1. 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.

2. 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:

• a)respect for the rights or reputations of others; or b) the protection of national security, public order, or public health or morals.

3. The right of expression may not be restricted by indirect methods or means (…)" (emphasis added).

In 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)." Now, 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:

"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:

"Article 2.- FREE PROVISION AND EFFECTIVE ACCESS The 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." "Article 3.- MANDATORY NATURE In 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..." "Article 6.- FUNCTIONS The Commission shall have the following basic functions and objectives:

• a)Guarantee the mandatory nature and free provision of vaccines and the effective access of the entire population to them..." "Article 11.- TARGET POPULATION, CONDITIONS, AND AUTHORIZATION The 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..." Taking 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." Likewise, 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:

"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:

"Article 14 1. States Parties shall respect the right of the child to freedom of thought, conscience, and religion.

2. 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.

3. 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).

With 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.

It 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) In 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.

X.- 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.

In 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.

On 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.

XI.- 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.

The 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:

Of the International Covenant on Economic, Social and Cultural Rights:

"Article 2 1. 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. 2. 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. 3. 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." "Article 5 1. 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. 2. 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." "Article 6 1. 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. 2. 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." "Article 7 The 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: a) Remuneration which provides all workers, as a minimum, with: i) 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; ii) A decent living for themselves and their families in accordance with the provisions of the present Covenant; b) Safe and healthy working conditions; c) 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; d) Rest, leisure and reasonable limitation of working hours and periodic holidays with pay, as well as remuneration for public holidays." Of the Universal Declaration of Human Rights:

"Article 12 No 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." Of the American Convention on Human Rights:

"Article 1 Obligation to Respect Rights 1. 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. 2. For the purposes of this Convention, "person" means every human being." "Article 3 Right to Juridical Personality Every person has the right to recognition as a person before the law." "Article 4 Right to Life 1. 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. 2. 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. 3. The death penalty shall not be reestablished in states that have abolished it. 4. In no case shall capital punishment be inflicted for political offenses or related common crimes. 5. 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. 6. 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." "Article 5 Right to Humane Treatment 1.

Every person has the right to have their physical, psychological, and moral integrity respected." Having 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:

"…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) In 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.

XII.- On the alleged violation of the principle of reasonableness and proportionality in the penalty for not getting vaccinated.

It 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.

Notwithstanding 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.

Decreto Ejecutivo N° 43249-S, regarding which this action is brought, provides the following:

"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:

"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.

When 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." By 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.

XIII.- 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.

XIV.- 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.

As 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.

XV.- 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:

"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 (…)" In 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.

XVI.- 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.

Therefore:

The 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.

For 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.

*210223410007CO* Res. Nº 2022000374 SALA CONSTITUCIONAL DE LA CORTE SUPREMA DE JUSTICIA. San José, a las nueve horas veinte minutos del cinco de enero de dos mil veintidos .

Acción de inconstitucionalidad promovida por Arcelio Hernández Mussio, mayor, casado, abogado, con cédula 1-832-451, vecino de San José, contra el “Decreto Ejecutivo 43249-S, titulado "Reforma al Decreto Ejecutivo n.° 42889-S del 10 de marzo de 2021, denominado reforma al Decreto Ejecutivo n° 32722-S del 20 de mayo de 2005, "Reglamento a la Ley Nacional de Vacunación” y Establecimiento de la obligatoriedad de la vacuna del covid-19", el artículo 46 del Código Civil, Ley n.° 63 del 28 de septiembre de 1887, el acuerdo tomado por el Directorio Legislativo, en el artículo 11 de la sesión n.° 180-2021, celebrada el 27 de octubre de 2021, que introduce el artículo 61 bis al Reglamento Autónomo de Servicio de la Asamblea Legislativa; la Ley n.° 5395 del 30 de octubre de 1973, Ley General de Salud, la Ley n.° 8811-"Ley Nacional de Vacunación" del 18 de julio de 2001, el Decreto Ejecutivo n.° 32722-"Reglamento a la Ley Nacional de Vacunación" del 20 de mayo de 2005, el Decreto Ejecutivo n.° 37808- "Norma Nacional de Vacunación" del 08 de enero de 2013, el Decreto Ejecutivo n.° 30965-S-“Reglamento sobre gestión de los desechos infectocontagiosos que se generan en establecimientos que prestan atención a la salud y afines" del 17 de diciembre de 2002", el Decreto Ejecutivo n.° 41045-S del 10 de mayo de 2016 "Reglamento General de Habilitación de Servicios de Salud"; los Lineamientos Nacionales para la Vigilancia de la enfermedad COVID-19; los Lineamientos generales para el uso del Equipo de Protección Personal (EPP), para prevenir la contra COVID-19 en los establecimientos de salud de la Caja Costarricense de Seguro Social, versión #7, junio 2021, Ministerio de Salud, LS-SS-013, Lineamientos sobre la vacunación contra el virus SARS-CoV-2 para la prevención de la COVID-19 -- así como toda norma o reglamento emitido por otras instituciones públicas que se opongan al principio de consentimiento informado previo y libre”.

Resultando:

1.- Por escrito recibido en la Secretaría de la Sala el 4 de noviembre de 2021, se solicita que se declare inconstitucional el “Decreto Ejecutivo 43249-S, titulado "Reforma al Decreto Ejecutivo n.° 42889-S del 10 de marzo de 2021, denominado reforma al Decreto Ejecutivo n° 32722-S del 20 de mayo de 2005, "Reglamento a la Ley Nacional de Vacunación” y Establecimiento de la obligatoriedad de la vacuna del covid-19", el artículo 46 del Código Civil, Ley n.° 63 del 28 de septiembre de 1887, el acuerdo tomado por el Directorio Legislativo, en el artículo 11 de la sesión n.° 180-2021, celebrada el 27 de octubre de 2021, que introduce el artículo 61 bis al Reglamento Autónomo de Servicio de la Asamblea Legislativa; la Ley n.° 5395 del 30 de octubre de 1973, Ley General de Salud, la Ley n.° 8811-"Ley Nacional de Vacunación" del 18 de julio de 2001, el Decreto Ejecutivo n.° 32722-"Reglamento a la Ley Nacional de Vacunación" del 20 de mayo de 2005, el Decreto Ejecutivo n.° 37808- "Norma Nacional de Vacunación" del 08 de enero de 2013, el Decreto Ejecutivo n.° 30965-S-“Reglamento sobre gestión de los desechos infectocontagiosos que se generan en establecimientos que prestan atención a la salud y afines" del 17 de diciembre de 2002", el Decreto Ejecutivo n.° 41045-S del 10 de mayo de 2016 "Reglamento General de Habilitación de Servicios de Salud"; los Lineamientos Nacionales para la Vigilancia de la enfermedad COVID-19; los Lineamientos generales para el uso del Equipo de Protección Personal (EPP), para prevenir la exposición por Coronavirus (COVID19); el Manual de Procedimientos para la ejecución de vacunación contra COVID-19 en los establecimientos de salud de la Caja Costarricense de Seguro Social, versión #7, junio 2021, Ministerio de Salud, LS-SS-013, Lineamientos sobre la vacunación contra el virus SARS-CoV-2 para la prevención de la COVID-19 -- así como toda norma o reglamento emitido por otras instituciones públicas que se opongan al principio de consentimiento informado previo y libre”, por estimar que violentan el principio del consentimiento informado desarrollado en los artículos 20, 21 y 28 de la Constitución Política, el artículo 22 de la Ley General de Salud, el artículo 2 de la ley n.° 8239, "Derechos y deberes de las personas usuarias de los servicios de salud públicos y privados", los artículos 1 y 4 del Reglamento de la Caja Costarricense de Seguro Social (CCSS); el principio de igualdad y no discriminación derivado del artículo 33 de la Constitución Política; la libertad de pensamiento y expresión desarrollada por los artículos 28 y 29 de la Constitución Política, y los artículos 19 de la Declaración Universal de Derechos Humanos, 19 del Pacto Internacional de Derechos Civiles y Políticos, 4 de la Convención Americana de Derechos Humanos, y 13 del Pacto de San José; el principio de legalidad (artículos 11 de la Constitución Política y 11 de la Ley General de la Administración Pública) por la aplicación del término vacuna; el principio precautorio ante la obligatoriedad de vacunación sin realización de exámenes médicos previos; el principio de jerarquía de las normas, desarrollado en los artículos 7, 48, 129 y 140 inciso 3) de la Constitución Política; el principio de convencionalidad; leyes posteriores a ley nacional de vacunas; la jurisprudencia de la Corte Interamericana de Derechos Humanos relacionada con el derecho a la vida y al consentimiento informado; el principio de razonabilidad y proporcionalidad en la sanción por no vacunarse, y por la adopción de la medida en sí, el principio de autodeterminación informativa, según el artículo 24 de la Constitución Política, relacionado con la información privada contenida en el expediente médico, el derecho a la vida y a la salud, según los artículos 21, 40, 46, 50, 73 de la Constitución Política y el artículo 5 inciso primero de la Convención Americana sobre Derechos Humanos, los cuales protegen el valor vida humana en todas sus manifestaciones, como lo es la salud y la disposición de la persona humana sobre su propio cuerpo, a su integridad física, psíquica y moral, y a impedir cualquier intervención que no sea autorizada previamente en una ley, y los límites de la potestad reglamentaria establecida en el artículo 140, inciso 3) y 18) de la Constitución Política, así como al principio de reserva de ley. Refiere que el asunto es el recurso de amparo que se tramita en el expediente 21-021972-0007-CO, en el cual figura como recurrente y ha invocado la inconstitucionalidad de la normativa supra indicada. Refiere que, según el concepto de consentimiento previo informado, pleno y libre, así como la autonomía informativa, no está obligado a consentir la vacunación, ni a que se almacenen sus datos sensibles. Además de ello, señala que es una acción que atañe e interesa a la colectividad. Aduce haber recibido una comunicación en la que se pone en riesgo su designación como asesor ad honorem en la Asamblea Legislativa, si no se vacuna contra la covid 19. Eso, porque mediante acuerdo tomado por el Directorio Legislativo, en el artículo 11 de la sesión n.° 1802021, celebrada el 27 de octubre de 2021, se acordó adicionar un artículo 61 bis al Reglamento Autónomo de Servicio de la Asamblea Legislativa. En dicho documento, se le impone la vacunación contra la covid-19 como obligatoria, so pena de una eventual revocatoria de su designación como asesor ad honorem, lo cual implica desde ya una amenaza de sanción, que hace nugatorio su derecho de dar o no dar su consentimiento previo, informado, pleno y libre. Según el concepto de consentimiento previo informado y libre, así como la autonomía informativa, no está obligado a consentir la vacunación, ni a que se almacenen sus datos sensibles, en el referido acuerdo, no se contempla su derecho fundamental de dar o no dar su previo consentimiento informado libremente para la vacunación, y se hace referencia al Decreto Ejecutivo n.° 43249-S, que contiene una declaratoria de obligatoriedad que es contraria a sus derechos fundamentales, por lo que la Asamblea Legislativa actúa de manera arbitraria al darle mayor rango e importancia a un decreto ejecutivo, que está por debajo de la ley y de los convenios internacionales suscritos por Costa Rica. Por eso, esta acción se presenta contra el decreto n.° 42889-S, “Reforma Reglamento a la Ley Nacional de Vacunación y numerales 2, 3 y 6 inciso a) de la ley n.° 8111, Ley Nacional de Vacunación”, así como la demás normativa ya indicada, por infringir principios del derecho internacional y constitucionales, originar el acto subjetivo de la obligatoriedad de vacunación covid de forma generalizada, sin consentimiento previo informado, el cual debe ser obtenido sin coacción ni amenaza, para que sea libre. Refiere que, dicha obligatoriedad de la vacunación señalada en el decreto n.°42889-S, “Reforma Reglamento a la Ley Nacional de Vacunación en concordancia con los numerales 2, 3 y 6 inciso a) de la ley n.° 8111, Ley Nacional de Vacunación”, vulnera groseramente una serie de derechos fundamentales y constitucionales de todo ser humano, al incidir directamente en su derecho a la vida, a la salud, la intimidad, la dignidad humana, al trabajo, a la autonomía de la voluntad, consentimiento informado, autodeterminación informativa, principio de legalidad, seguridad jurídica y derecho a una justicia; teniendo el privilegio de vivir en un Estado de Derecho y país democrático, con fuertes bases en el profundo respeto de los derechos humanos y fundamentales de todo habitante de nuestro territorio nacional. Ante la falta de información, sus dudas sobre los controles de garantía de calidad, estabilidad, eficiencia, inmunidad y efectos adversos de la obligatoriedad de vacunas covid-19, entre muchas otras, es que le resulta ofensivo el obligarlo a vacunarse contra la covid-19 para continuar con su labor de asesor, lo que haría nugatorio su derecho humano a consentir libremente la inoculación. Indica que, al día de hoy, hay una total oscuridad sobre los términos del contrato del Estado con Pfizer, no se sabe quién se hará responsable de eventuales daños a la salud producto de la vacunación obligatoria, en violación al principio del consentimiento informado pleno, es decir, con acceso a toda la información relevante para la toma de la decisión, que debe adoptarse libremente. La obligatoriedad de la vacunación covid-19, sin un consentimiento escrito, previo y debidamente informado, vulnera, además de lo ya indicado líneas atrás, el derecho a la dignidad humana (artículo 33 constitucional), a la autodeterminación informativa derivado de la autonomía de la voluntad (artículos 24, 28 y 46 párrafo final constitucional), el derecho al trabajo, y a la justicia (artículo 41 constitucional). Este último numeral, otorga el derecho a toda persona y trabajador, a que "ocurriendo a las leyes, todos han de encontrar reparación para las injurias o daños que hayan recibido en su persona, propiedad o intereses morales. Debe hacérseles justicia pronta, cumplida, sin denegación y en estricta conformidad con las leyes", razones por las cuales, el consentimiento escrito previo y debidamente informado, dado libremente, sin coacción o amenaza, constituye un derecho humano para toda persona obligada a vacunarse contra la covid, que posea un documento con el cual puede ejercer dicho derecho constitucional y a su vez, resguardar su vida, su salud y bienestar, de conformidad con los artículos 21 y 50 de la Constitución Política. La inercia, omisión y abstención de las autoridades públicas, en la obligatoriedad de la vacunación generalizada sin un consentimiento previo debidamente informado, pleno y libre de la persona a inocular, sin duda vulnera el derecho a la vida, a la salud y a recibir información adecuada y veraz, según los numerales 21, 27, 46 párrafo final y 50 de nuestra Constitución Política. Esa medida preventiva es un derecho constitucional, necesario e imprescindible, para evitar daños graves o irreparables en la salud y la de cualquier ser humano, ante la posibilidad de algún efecto adverso de la vacuna contra la covid-19, pero no está previsto en su obligatoriedad. Los principios del respeto a la dignidad humana, la autonomía de la voluntad, el consentimiento informado previo, pleno y libre, y la autodeterminación informativa, cuentan con la protección de principios constitucionales como el principio de legalidad, la seguridad jurídica y el derecho de acceso a la justicia, derechos constitucionales ampliamente protegidos en los artículos 1, 7, 11, 20, 21, 27, 30, 33, 40, 41, 46 párrafo final, 50 y 148 de la Constitución Política, así como en los instrumentos jurídicos internacionales de los artículos 3, 5, 6, 7, 8, 12, 18, 19, 23 y 28 de la Declaración Universal de Derechos Humanos, los artículos 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 y 28 de la Declaración Universal sobre Bioética y Derechos Humanos, artículos 4.1. y 11 de la Convención Americana sobre Derechos Humanos, artículos 1.1, 2.3.a.b., 5.2., 6.1, 9.1, 10.1. y 17 de Pacto Internacional de Derechos Civiles y Políticos. La inconstitucionalidad del Decreto Ejecutivo n.° 42889-S, “Reforma Reglamento a la Ley Nacional de Vacunación y numerales 2, 3 y 6 inciso a) de la ley n.° 8111 Ley Nacional de Vacunación”, al indicar la obligatoriedad de la vacunación covid-19, genera una solicitud patronal directa, para exigir información médica y de salud, que resulta información de carácter privado, al amparo del artículo 24 de la Constitución Política, en concordancia con la legislación nacional interna, según los artículos 1, 2, 3, 4, 10, 19, 22, 152 y 345 inciso 3) de la ley n.° 5395, Ley General de Salud, artículo 1, 3 inciso e) y 7 inciso 1.c) de la ley n.° 8968, Ley de Protección frente al Tratamiento de sus datos personales, artículo 1 de la ley n.° 7425, Ley sobre registro, secuestro y examen de documentos privados e Intervención de las comunicaciones y artículos 6, 8, 10 y 11 de la ley n.° 7771, Ley General Sobre el VIH-SIDA. Constitucionalmente, tanto el decreto como los numerales reclamados, al señalar la frase "obligatoriedad" de la vacunación covid-19 resultan inconstitucionales, debido a que son un exceso de prevención que constituye una represión, en un país que se dice ser un Estado de Derecho, donde la intervención mínima constituye parte fundamental de nuestro sistema democrático, y que por eso, la obligatoriedad de la vacunación covid-19 con la falta de una garantía de su calidad y estabilidad, deviene en una fuerte, arbitraria y grosera intromisión de la potestad de imperio en los derechos fundamentales e inalienables. Señala que la aplicación de la vacuna contra la covid-19 inició a finales de diciembre de 2020, y desde ese momento no se cumplió con el consentimiento informado. Simplemente se partió de la alarma de muerte por la pandemia para vulnerar este derecho, el cual es derivado de la aplicación de los artículos 20 y 21 de la Constitución Política. Durante casi doce meses de estarse aplicando la vacunación, la Caja Costarricense de Seguro Social no ha brindado a los asegurados un documento que contenga el consentimiento previo debidamente informado. La anterior vulneración se ve acrecentada con el decreto aquí impugnado, pues se obliga a los funcionarios públicos a vacunarse bajo la amenaza de perder el empleo en caso de no hacerlo, esto sin que prive un examen médico previo que prevenga para evitar daños graves o irreparables a la salud, pudiendo de esta forma, garantizar el adecuado y tangible ejercicio del derecho fundamental de resguardar la vida y la salud. Refiere que, una de las principales características que reviste el consentimiento informado se basa en su carácter previo, pero sobre todo libre, característica recogida por diversos instrumentos internacionales, suscritos por nuestro país. Además de ser previo, el consentimiento debe darse de una manera libre (principio de libertad derivado del artículo 28 de la Constitución Política, es decir, el consentimiento debe ser brindado de manera libre, voluntaria, autónoma, sin presiones de ningún tipo, sin utilizarlo como condición para el sometimiento a otros procedimientos o beneficios, sin coerciones, amenazas, o desinformación. Señala que, desde el inicio de la vacunación contra la covid-19, no se brindó este derecho fundamental a las personas vacunadas, es decir, ha habido una total omisión de la CCSS en cumplir con este derecho. La situación solamente empeora, cuando se establece la obligatoriedad de la vacunación para los funcionarios públicos e indirectamente para todos los trabajadores del sector privado, porque es más que evidente que, ante la amenaza de la pérdida del empleo (en la situación de crisis sanitaria y económica que enfrentamos), hay una coerción total, de manera que, en el caso de poder emitir un consentimiento, este no sería libre ni voluntario. Otro tema de gran trascendencia es la gran desinformación que existe alrededor de la vacunación, ya que hay miles de dudas sobre la calidad, eficacia, estabilidad, inmunidad y efectos adversos a la salud de las vacunas. No ha habido información clara y veraz. La información que brinde el profesional al paciente debe ser una "información adecuada", es decir, que se le facilite al paciente "los datos relevantes de la intervención que se trata". En resumen, se dice que debe existir conformidad entre el sujeto pasivo titular del bien jurídico protegido -la persona humana- con la acción desplegada por el sujeto activo, el profesional investigador competente, es decir, un "acuerdo de voluntades" entre ambos sujetos, respecto a un mismo objeto. Adicionalmente, desde la perspectiva jurídica se debe reconocer que el consentimiento informado comprende tanto aspectos de índole ético propios del conocimiento científico involucrado, como de la bioética, y se deriva del respeto ineludible de los Derechos Humanos consagrados en el ordenamiento jurídico internacional y nacional, en especial del derecho a la vida, la dignidad humana, el derecho a la salud, la libertad de elección, la integridad física y mental, así como otros derechos inherentes a la persona humana por su condición de ser humano y por el simple hecho de estar vivo. Hace referencia a la sentencia del Tribunal Europeo de Derechos Humanos (TEDH) del 10 de junio de 2010. “Case of Jehovah´s witnesses of Moscow and others v. Russia, CE: ECHR:2010:0610JUD000030202, apdo. 136”. Señala que el TEDH admitió en un asunto resuelto en la primera década de este siglo, que "la aceptación o el rechazo de un tratamiento médico o la elección de una forma de tratamiento alternativo es vital para los principios de autodeterminación y autonomía personal". Ante la omisión del consentimiento informado, se lesionan, como se indicó, los artículos 20, 21 y 28 de la Constitución Política. De la conjunción de estos tres artículos se deriva el consentimiento informado. Referencia una sentencia de este Tribunal. Indica que, en cuanto a nivel normativo legal del derecho interno costarricense, el artículo 22 de la Ley General de Salud dispone que "ninguna persona podrá ser sometida a tratamiento médico o quirúrgico que implique grave riesgo para su integridad física, su salud o su vida, sin su consentimiento previo o el de la persona llamada a darlo legalmente si estuviere impedido para hacerlo. Se exceptúa de este requisito las intervenciones de urgencia.". Cita a su vez los incisos i), h) e i) del artículo 2 de la Ley de Derechos y Deberes de las Personas Usuarias de los Servicios Públicos, en relación con la obligación de obtener el consentimiento informado. Señala que dicha normativa encuentra sustento en la Declaración Universal sobre Bioética y Derechos Humanos que, a pesar de no estar ratificada por nuestro país, contiene entre sus principios el respeto a la autonomía y responsabilidad individual, al indicar que "se habrá de respetar la autonomía de la persona en lo que se refiere a la facultad de adoptar decisiones, asumiendo la responsabilidad de éstas y respetando la autonomía de los demás. Para las personas que carecen de la capacidad de ejercer su autonomía, se habrán de tomar medidas especiales para proteger sus derechos e intereses" (artículo 5). Señala que el decreto impugnado contradice el mismo "Reglamento de la Caja de Seguro Social (CCSS), acerca del consentimiento informado. Denota que el consentimiento informado es parte del derecho de información, se requiere de la información necesaria e imprescindible, para la toma de decisiones previas dirigidas a si una persona decide o no aplicarse la vacuna, independientemente de si es o no funcionario público. Referencia el artículo 4 de ese mismo reglamento de la CCSS, y aduce que, la debida comunicación no ha operado en este caso, pues, pese a que el decreto 48889-S indica en el artículo 2: "Para cuando sean citados por los encargados para tal efecto y de acuerdo con la planificación institucional respectiva, las personas contempladas en el párrafo anterior deberán vacunarse, con excepción de aquellos funcionarios que, por contraindicación médica debidamente declarada, no les sea posible recibir la vacuna contra el Covid-19…”, no ha habido información plena acerca de las contraindicaciones, reacciones adversas e interacción medicamentosa con otros productos farmacéuticos, y se vacía de contenido el significado de un consentimiento dado libremente. Señala que el decreto que se impugna como inconstitucional, hace una distinción sin fundamento entre personas que trabajan en el sector público versus aquellas que laboran en el sector privado. En el primer caso, la vacunación la hace obligatoria, mientras que, en el segundo, lo deja al arbitrio del patrono. Esto conlleva una discriminación sin fundamento atendible. Tanto un grupo como el otro está compuesto por seres humanos con igual dignidad y valor ante la ley. Considera que, la obligatoriedad de la vacunación contra la covid-19 a los funcionarios públicos y privados, sin un consentimiento escrito previo y debidamente informado, resulta inaplicable por ser contraria a los valores fundamentales y a los artículos 33 y 48 constitucionales, 2.1 y 7 de la Declaración Universal de Derechos Humanos, 11 de la Declaración Americana de los Derechos del Hombre, 3 y 26 del Pacto Internacional de Derechos Civiles y Políticos, 1.1, 2 y 24 de la Convención Americana sobre Derechos Humanos, “Pacto de San José". La simple comparación de las normas transcritas con la disposición cuestionada demuestra que la obligación de vacunarse de manera específica a los trabajadores del sector público y potencialmente a los trabajadores del sector privado, constituye una discriminación en perjuicio de la clase trabajadora, pues de manera laxa crea una equivalencia inexacta entre el decreto que obliga a vacunarse a los funcionarios del sector salud con la obligación de vacunar a todos los funcionarios del sector público y privado, contraviniendo con ello el espíritu constitucional y universal de igualdad y no discriminación. Señala que el decreto en cuestión constituye una lesión grosera al principio de igualdad consagrado en el artículo 33, dado que no existe una justificación técnica que demuestre la necesidad de obligar a todos los funcionarios públicos a vacunarse, es decir, el gobierno parte de la condición de ser funcionario público para establecer el condicionamiento de estar vacunado, esto como requisito para conservar el empleo, hecho que constituye una acción arbitraria y propia de los sistemas antidemocráticos. Además de ser una amenaza real a un empleado o funcionario público, que se puede penalizar incluso con cárcel, de no ser acatada. Para nadie es un secreto que nuestro país ha ido avanzando de manera notable en el principio de no discriminación laboral, por lo que deben seguirse enfrentando nuevas formas de discriminación. Aunado a lo anterior, el artículo 7 de la ley VIH Sida, garantiza la confidencialidad, la no discriminación, el no estar obligado a dar información y sus cláusulas son parte importante de la jurisprudencia que se ha creado con el tiempo en el país, para evitar formas de discriminación por parte de patronos contra los trabajadores y que paradójicamente es ahora el Estado mismo el emanador de odiosas prácticas segregacionistas y discriminatorias, sin haber realizado investigaciones científicas fundamentadas que sustenten esos criterios. La obligatoriedad de la vacunación para los funcionarios públicos por su condición laboral es discriminatoria, y constituye una imposición bajo la amenaza de la pérdida de empleo. La vacunación como parte de un procedimiento médico debe ser una decisión voluntaria de las personas como parte de su libertad de elegir y no simplemente la decisión de un ministro o del Poder Ejecutivo. Denota que el decreto impugnado no obliga al resto de la población a vacunarse contra la covid-19, únicamente a los 330.000 funcionarios públicos, lo que estima violenta las normas y principios enunciados en este acápite. Incluso, se impone, por decreto ejecutivo, la obligatoriedad de la vacunación a funcionarios públicos que son de otros poderes, y de entidades públicas con niveles de autonomía incluso a nivel constitucional, como son los gobiernos locales y ciertas instituciones autónomas que tienen una autonomía reforzada por disposiciones constitucionales. De acuerdo con lo expuesto, el decreto ejecutivo cuestionado no establece criterios fundamentales que permitan justificar la obligatoriedad de la aplicación para el grupo de los trabajadores públicos, potencialmente para los trabajadores del sector privado, y no así para el resto de la población. Indica que, el decreto en cuestión vulnera la libertad de pensamiento y expresión, (artículos 28 y 29 de la Constitución Política, artículos 19 de la Declaración Universal de Derechos Humanos, 19 del Pacto Internacional de Derechos Civiles y Políticos, 4 de la Convención Americana de Derechos Humanos, y 13 del Pacto de San José. Nuestro país cuenta con abundante legislación nacional e internacional y jurisprudencia que protege el derecho a la libre expresión. Considera que, es necesario que las personas que no se vacunan tengan el derecho de pensar de manera distinta o contraria a las personas que sí desean hacerlo, si el pensamiento divergente no es considerado se empiezan a abrir las puertas del autoritarismo, y esto es algo muy peligroso en un Estado democrático como el nuestro. No es posible que se admita como única causa de excepción para no vacunarse los motivos de salud, ya que esto cercena, de forma absoluta, la libre expresión y pensamiento, pues delimita a una sola causa la manifestación de la voluntad de las personas que, por diversas motivaciones no desean ser inoculadas. Todas las personas tienen el derecho de disentir recibir la vacunación, pues no ha habido información clara y veraz de los efectos de esta para la salud de la población, por lo que si una persona no tiene claridad de los efectos que provocará a su salud, tiene el derecho de sentirse seguro no vacunándose, pues la inoculación no previene el contagio. Además, señala que las personas vacunadas no son inmunes al contagio y pueden infectarse. La vacuna, además, no va a proteger de manera indefinida, por lo que las personas vacunadas no tienen inmunidad permanente. No es fácil obtener estudios confiables con resultados que concuerdan con la realidad observada en la población. Por ejemplo, en Costa Rica el 52% de la población cuenta con la vacunación completa (2 dosis), y el 86% cuenta con una dosis. (https://www.ocss.sa.cr/web/coronavirus/vacunacion). A pesar de eso, los hospitales están saturados, y personas con las 2 dosis de vacunación están infectadas y algunos internados en las unidades de cuidados intensivos. ¿Cómo es esto posible, si las vacunas supuestamente protegen contra hospitalización y muerte por COVID en más de un 90%, según publicaron en un estudio realizado en Francia con la misma variante Delta del virus? El país está con más fallecimientos que el año pasado cuando no había vacunas. Está científicamente comprobado que la efectividad de las vacunas depende mucho del momento en la cual se mide. A las dos semanas de haberse colocado la segunda vacuna, como es el caso en el estudio francés, está en su momento de máxima efectividad. Si se mide después de 45 meses de haberse vacunado se reduce a una efectividad de tan solo 53% para evitar contagios para la vacuna de Pfizer y de un 67% para la vacuna de AstraZeneca. Después de 6 meses también se reduce su efectividad contra la hospitalización. En Singapur, donde la vacunación con las dos dosis se ha realizado en el 78% de la gente (www.ourworldindata.org, de la Universidad de Oxford) la tasa de mortalidad se ha duplicado en relación con la primera ola de contagios de la pandemia. En Israel, cerca al 70% ha recibido la doble dosis y el 45% está con el booster (tercera dosis). Actualmente, la tasa de contagios está entre las más altas del mundo (235/100.000) y muy superior al de Costa Rica (24/100.000). Indica que, algunos opinarán que es porque el virus se propaga en las personas no vacunadas. Para saber si eso es una plausible explicación, los datos del pequeño país Gibraltar puede dar una indicación. El país cuenta con solamente 33.680 habitantes y una tasa de vacunación completa del 99.7%. Además, es muy estricta en los requisitos para entrar al país. Exigen la doble vacunación o una prueba PCR negativa, además de una cuarentena obligatoria de 10 días. La tasa de contagios fue de 33.6/100.000 personas en la última semana. Para poner este dato en perspectiva, es un poco más alto al de Costa Rica actualmente, y considerado por la CDC (Center for Disease Control de los EEUU) como de alerta roja (más de 25/100.000). Entonces, ni con el 99.7% de su población vacunada han logrado controlar el virus (datos de www.ourworldindata.org y John Hopkins University). Otro ejemplo que asombra es la cantidad de contagios ocurridos recientemente en la Universidad de Duke, Carolina del Norte. Obligaron la vacunación a estudiantes y personal, y a pesar de que el 98% de los estudiantes tenían su vacunación completa, y el personal al 92%, tuvieron un rebrote de 364 casos positivos en una semana (finales de agosto), de los cuales solamente 8 correspondían a no vacunados. ¿Qué pasa en los países donde la tasa de vacunación es de las más bajas? Un país muy interesante es India, el país más poblado del mundo, donde por primera vez fue identificada la variante Delta del virus. Tiene una tasa de vacunación de solo un 19%. En el Estado de Uttar Pradesh, con 220 millones de habitantes, implementaron una estrategia de realizar pruebas y ofrecer a las personas con un resultado positivo y las que conviven en la misma casa, un tratamiento basado en algunos medicamentos antivirales entre los cuales la Ivermectina, vitamina D3, suplementos de Zinc, entre otros, tanto de manera profiláctica como terapéutica. Hoy día tiene una tasa de contagio y de mortalidad por covid-19 muy baja. Tiene 34 de los 75 distritos libre de COVID-19. Señala que, pareciera que la vacuna, de la cual no se conocen los efectos secundarios a mediano y largo plazo y que se encuentra aún en fase experimental, sin garantía ni responsabilidad por parte del fabricante, no es la única alternativa para salir de la crisis sanitaria por SARS-CoV-2. En consecuencia, las personas que no desean vacunarse tienen el derecho de disentir de hacerlo como parte de su derecho de pensamiento y libre vacuna, porque la dignidad humana debe estar por encima de un supuesto interés de la ciencia o incluso de la sociedad. Aduce violación del principio de legalidad (artículos 11 de la Constitución Política y 11 de la Ley General de la Administración Pública), Ley Nacional de Vacunación, Reglamento a la Ley Nacional de Vacunas por la aplicación del término vacuna. El objeto que persigue la vacunación con su aplicación, es el inducir a la inmunidad activa, hecho que no es el que acontece con la inoculación masiva que está imponiendo este gobierno a los funcionarios públicos y privados. Los actos de la administración pública deben enmarcarse en el bloque de legalidad, si hay un vicio se lesiona la validez del decreto en cuestión y, por tanto, todo el procedimiento consecuente a este. Cuestiona el que pueda obligarse a la inoculación masiva, bajo un término que no existe, de acuerdo con la actual reglamentación que claramente define qué es una vacuna. El Estado debe cumplir en la emisión de sus actos con los requisitos de legalidad, necesidad y proporcionalidad. Toda actuación o conducta de la administración pública (actos administrativos, actuaciones materiales y servicios públicos) deben estar autorizados, de forma expresa, por el ordenamiento jurídico. El principio de legalidad se caracteriza por delimitar la actuación de la administración pública, debido a que la circunscribe a la existencia previa de una norma escrita o no escrita que lo permita. En este caso, la inoculación masiva no cumple con el objetivo esencial que caracteriza la definición de vacuna, que es el inducir inmunidad activa protectora contra la enfermedad infecciosa correspondiente. Ante la inexistencia del efecto esperado con la aplicación de la vacuna contra la covid-19, se lesiona el principio de legalidad, pues crea una obligación a partir de un término que no encuadra dentro de nuestro ordenamiento jurídico. El hecho de que lo que establece la Ley Nacional de Vacunas, Ley número 8111, es la obligatoriedad de ponerse vacunas, no sustancias experimentales que no han alcanzado dicho nivel. Ante la falta de certeza, se impone un principio pro salud, en beneficio de las personas que no desean introducir una sustancia que no se sabe a ciencia cierta qué es, ni qué efectos produce a corto, mediano y largo plazo. A esto se añade, que la inoculación no cumple con el objetivo que define la vacuna. Por ejemplo, en Costa Rica el 52% de la población cuenta con la vacunación completa (2 dosis), y el 86% cuenta con una dosis. A pesar de eso, los hospitales están saturados, y personas con las 2 dosis de vacunación están infectadas, y algunos internados en las unidades de cuidados intensivos. Es decir, de manera evidente, las personas vacunadas igualmente se contagian y enferman, algo que en teoría no debería suceder si una persona está vacunada. Por otra parte, se debe tomar en consideración un aspecto de gran envergadura en esta acción, que es el desconocimiento de la población en general de temas técnicos, lo cual contribuye a la generalización de la denominación de "vacuna" a este medicamento en pruebas clínicas en proceso. Esto da una falsa alarma apoyada por la ambigüedad de discurso político. Además, están obligando a la población a someterse a una prueba de ensayos clínicos en vivo, sin que les digan, abiertamente, que el perfil de vacuna es experimental, y sin consentimiento informado, de acuerdo con los Comités de Ética y Principios de Buenas Prácticas Clínicas (BPC Y responsabilidad Clave de los Investigadores en el Contexto de Ensayo Clínico: Solidaridad de la OMS de Estudios Clínicos-WHO COVID-19). Indica que, a pesar de que las autoridades en su doble discurso dejan ver que tienen conocimiento pleno de esto, aun así, están obligando a la población a dar un paso en un procedimiento experimental sin conocimiento pleno, pero claramente declarado por la OMS. En lo dicho anteriormente coincide el propio ministro de Salud, tal como lo hizo saber el pasado 31 de mayo 2021 en la comparecencia ante la Asamblea Legislativa en la sesión extraordinaria #04, donde explícitamente indicó a los diputados: "En esto de cuánto dura la inmunidad de la vacuna todavía no hay claridad, sigue habiendo estudios y seguimiento por parte de las diferentes compañías y entendemos que se espera que por lo menos 9 meses después haya inmunidad, hay algunos estudios más recientes, todavía tendremos mucho que conocer de esto que se habla de una posibilidad de inmunidad hasta de muchos años más y por eso debemos seguir pendiente de los estudios” (Línea de tiempo 2:38:00 horas del Plenario Legislativo, sesión extraordinaria #04, lunes 31 de mayo 2021). Los datos obtenidos y la realidad reflejan completamente lo contrario a lo señalado por el Ministro de Salud, pues las evidencias con el paso del tiempo demuestran que los efectos de las vacunas disminuyen con el tiempo, al punto de que ya hay países que están aplicando una tercera dosis y no se descarta una cuarta. Lo anterior denota que es un perfil de vacuna sin estudios clínicos contundentes, según lo manifestó el propio ministro Salas, por lo que se debe tomar en cuenta que, aunque de manera prematura se catalogó como "vacuna", y ahora lo aprobaron como "vacuna", lo que importa es el estudio clínico a tiempo real. Además, confirman que no se conoce el periodo de inmunidad, por ende, si no se conoce ni el tiempo de efectividad hasta terminar el estudio, tampoco se puede conocer, de manera certera, las contraindicaciones, interacciones y reacciones adversas. Claro está que los resultados de los ensayos clínicos se están dando con el transcurso del tiempo, ya que estos ensayos se están realizando "En Vivo" en la población y hasta finalizarse se conocerá la información técnico-científica demostrable, a inicios de 2023, según la fecha de inicio de los estudios clínicos. A partir de lo expresado, considera que el decreto impugnado por esta vía, no se rige de acuerdo con lo establecido en la normativa del propio reglamento de cita, de la Ley General de la Administración Pública ni de nuestra Constitución. El principio precautorio, dispone que "cuando una actividad representa una amenaza o un daño para la salud humana o el medio ambiente, hay que tomar medidas de precaución, incluso cuando la relación causa-efecto no haya podido demostrarse científicamente de forma concluyente". Dicho principio tiene como fundamentos de la ética médica -el principio de no maleficencia, primum non nocere, y contiene muchos de los atributos de la buena praxis en salud pública, como son la prevención primaria y el reconocimiento de que las consecuencias imprevistas e indeseables de la actuación humana no son infrecuentes, su aplicación pasa por la divulgación de la información científica disponible a todos los estamentos implicados, el fomento de la toma de decisiones basada en la limitación de los niveles de exposición (manejo de la exposición de forma más restrictiva y prudente), la formulación de objetivos con alcance y evaluación a largo plazo y la búsqueda de alternativas más seguras. La bondad del principio de precaución para la salud pública reside en que su implementación requiere la utilización de metodología científica propia de este campo y promueve la innovación y los avances tecnológicos en un entorno de transparencia y participación democrática. La obligación creada en el decreto impugnado, aunado a la negativa de la Caja de Seguro Social de realizar exámenes médicos preventivos, lesiona dicho principio, pues la aplicación de las vacunas contra la covid-19 generan fuertes dudas de su calidad, eficacia, estabilidad, inmunidad y efectos adversos. El riesgo para la vida y salud es significativo y abrumador ante la ausencia real y tangible de medidas preventivas necesarias, ante la obligatoriedad de la vacunación covid-19, que garanticen proteger la vida de todo trabajador y de cualquier ser humano que resida en la Nación, pues la vida no depende de solo la vida en sí misma, sino también de la prevención de cualquier daño, así sea mínimo en la salud. El gobierno ha sido irresponsable en informar debidamente a la población. El Ministerio de Salud y otras instituciones como la CCSS, han asegurado que las "vacunas" son “seguras". Sin embargo, lo cierto es que se ha manejado un doble discurso, porque mientras afirman que las "vacunas" son seguras, por otra parte, aceptan que faltan estudios que demuestren la efectividad y seguridad de las mismas. Es por esta enorme confusión, falta de datos, estudios sobre la efectividad y seguridad de las vacunas a corto y largo plazo, que la población debe ser resguardada y bajo ninguna circunstancia obligar a las personas a vacunarse, así lo ha manifestado incluso la Organización Mundial de la Salud. Además, los coronavirus y deben combinarse con las medidas sanitarias que ya el año pasado año se generalizaron para frenar los contagios, como el uso de mascarilla, lavado frecuente de manos, la ventilación de los hogares, la distancia física o el evitar lugares concurridos. La portavoz de la OMS, insistió en que es necesario seguir utilizando las medidas citadas anteriormente, pues según ella "Lo que queremos es reducir la transmisión. Y no sabemos si las vacunas pueden prevenir esto". Ante la falta de certeza, refiere que no es posible que se esté obligando a un grupo de funcionarios públicos y privados a vacunarse, diferenciándolos del resto de la población, exponiendo sus vidas y poniendo en riesgo la seguridad de sus familias. Por todas estas consideraciones, señala que se lesiona el principio precautorio, dado que la vacunación obligatoria representa una amenaza para la salud humana y, además, porque la relación causa efecto no ha podido demostrarse científicamente de forma concluyente y, para muestra, las mismas declaraciones de la Organización Mundial de la Salud. Señala que se vulnera el principio de jerarquía de las normas, el artículo 7, 48, 129 y 140 inciso 3) de la Constitución Política y el principio de convencionalidad. En materia de derechos humanos no existe una separación formal entre Derecho Internacional y Derecho Constitucional, pues se trata de un mismo derecho. Lo sustancial priva sobre lo formal. Lo verdaderamente imponente es la mayor protección, independientemente de si esa protección se encuentra reconocida en un instrumento internacional, la Constitución Política o una ley de la República. Debido a ello, el control de convencionalidad, base fundamental de nuestro sistema constitucional en el Estado de Derecho, nos debería bastar para señalar, que el Decreto Ejecutivo n.° 42889-S, es inconstitucional, pues se contrapone a los instrumentos jurídicos internacionales aquí mencionados y relativos a Derechos Humanos, los cuales son de rango superior; por lo que la obligatoriedad de la vacunación contra la COVID-19, dentro de nuestro ámbito laboral y como seres humanos, vulnera dichas herramientas jurídicas internacionales, afectando el derecho a la vida, a la salud y a la dignidad humana, ante la injerencia del Estado, a fin de mantener el respeto jurídico internacional de la dignidad humana, sobre todo en tiempos de globalización del mercado farmacéutico. Cita los artículos 2, 5, 6, y 7 del Pacto Internacional de Derechos Económicos Sociales y Culturales, el ordinal 12 de la Declaración Universal de Derechos Humanos, y los numerales 1.2. 3, 4 y 5.1 de la Convención Americana de Derechos Humanos. Aduce que, en forma expresa y clara, este instrumento internacional reconoce la condición de persona a todo ser humano y su personalidad jurídica, indicando que, como persona, tiene derecho a que se le respete su vida y, por ende, su salud, así como su integridad física, psíquica y moral. Refiere que, es claro que la obligatoriedad de la vacuna violenta estos derechos humanos fundamentales reconocidos internacionalmente, ya que atentan contra la integridad física de las personas, al imponerle a los funcionarios del sector público y extendiéndolo a trabajadores del sector privado, a introducir en su cuerpo una vacuna sin que medie un consentimiento informado, previo, pleno y libre, sin que se respete su autonomía de la voluntad. Asimismo, transgrede gravemente el derecho a la integridad psíquica y moral de las personas, al forzar a dichos funcionarios a inocularse, de forma intimidatoria, ya que, en caso de no hacerlo, se exponen a multas y sanciones administrativas y penales, e incluso al despido sin responsabilidad patronal o revocatoria del nombramiento o designación, como en su caso. Todos los derechos descritos en la normativa citada se relacionan de manera directa con el derecho a la vida, a la salud y al consentimiento informado individual que, a su vez se asocia al consentimiento informado colectivo o social, que permite la aplicación de las normas y procedimientos que interesan directamente a la sociedad, como las campañas de detección de enfermedades, campañas de vacunación y de investigación en seres humanos, entre otros. El consentimiento informado es individual (derecho del hombre) y permite la toma de decisiones que debe estar, necesariamente, apoyada en una buena información. Además de una buena información, es imprescindible ofrecer un abanico de opciones, donde se señale, de manera certera, la posibilidad de tomar una o varias decisiones, en el caso de que existan, con conocimiento de las consecuencias, posibles efectos secundarios y problemas que puedan surgir. Todo esto evidentemente no se da con la obligatoriedad impuesta en el decreto en cuestión, por lo que vulnera los derechos establecidos en la normativa internacional debidamente ratificada por este país. En concordancia con lo anterior, señala que el decreto lesiona el principio de convencionalidad, pues el país se ha comprometido a garantizar el derecho a la salud, así como la imposibilidad de injerencias arbitrarias de los gobiernos en las personas. Este país estaría incumpliendo lo pactado en los tratados de cita, e iría en franco retroceso de estos derechos con la aplicación del decreto acusado. Refiere que, el decreto ejecutivo de vacunación obligatoria presenta una clara violación a la ley n.° 8239 del 02 de abril de 2002, “Ley de Derechos y deberes de las personas usuarias de los servicios de salud públicos y privados”, concretamente en relación con lo establecido en el artículo 2 inciso c), pues claramente hace referencia al deber de obtener el consentimiento informado antes de someter a un individuo a cualquier procedimiento médico. Partiendo de lo establecido por la Corte Interamericana de Derechos Humanos en la sentencia del 30 de noviembre de 2016, en el caso I.V. Vs. Bolivia, el consentimiento informado debe ser "brindado de manera, libre, voluntaria, autónoma, sin presiones de ningún tipo, sin utilizarlo como condición para el sometimiento a otros procedimientos o beneficios, sin coerciones, amenazas o desinformación”. De tal forma que, el decreto acusado lesiona el derecho a dar el consentimiento informado, como es entendido por la Corte Interamericana de Derechos Humanos y de la forma en que se encuentra recogido en la ley n.° 8239 del 2 de abril de 2002. Por su parte, el inciso m) de la norma de cita es claro en señalar el derecho de toda persona a mantener total privacidad sobre su historial clínico, excepto cuando mediante ley especial, deba darse noticia a las autoridades sanitarias, lo cual es evidentemente contrario al artículo 1 del decreto impugnado, debido a que el decreto en cuestión implícitamente obliga al trabajador a revelar información privada, concerniente a su historial clínico, a alguien que, según indica el propio decreto, no es una autoridad sanitaria, por lo que las instituciones del Estado distintas a las autoridades sanitarias no están legitimadas para exigir dicha información. La obligación de vacunarse y de revelar información referente al historial médico, lesiona lo dispuesto en el artículo 9 inciso 1) de la "Ley Protección de la Persona frente al tratamiento de sus datos personales”, y su trasgresión está sancionada en el ordinal 31. Así, ninguna persona está obligada a suministrar datos sobre su salud a nadie que no sea funcionario del área de salud, por lo que, el decreto impugnado constituye una clara trasgresión a esa ley. Considera que el decreto impugnado es contrario a la jurisprudencia desarrollada por la Corte Interamericana en los siguientes fallos: 1) Corte IDH. Caso Poblete Vilches y otros Vs. Chile. Fondo, Reparaciones y Costas. Sentencia de 8 de marzo de 2018. Serie C n.° 349. Cita extractos de los párrafos 106, 109, 113, 114 y 174. 2) Corte IDH. Caso Cuscul Pivaral y otros Vs. Guatemala. Excepción Preliminar. Fondo, Reparaciones y Costas. Sentencia de 23 de agosto de 2018. Serie C n.° 359. Cita extractos de los párrafos 79, 83, 84, 85, 86, 93, 105 y 107. 3) Corte IDH. Caso Hernández Vs. Argentina. Excepción Preliminar. Fondo. Reparaciones y Costas. Sentencia de 22 de noviembre de 201 9. Serie C n.° 39513. Cita los párrafos 62, 73, 76, 78 y 81. 4) Corte IDH. Caso Ximenes Lopes Vs. Brasil. Sentencia de 4 de julio de 2006. Serie C No. 149. Cita los párrafos 89, 90, 96 y 97. 5) Corte IDH. Caso Albán Cornejo y otros Vs. Ecuador. Fondo. Reparaciones y Costas. Sentencia de 22 de noviembre de 2007. Serie C n.° 17118. Cita los párrafos 116, 121, 123, 132, 133 y 134. 6) Corte IDH. Caso I.V. Vs. Bolivia. Excepciones. Preliminares, Fondo, Reparaciones y Costas. Sentencia de 30 de noviembre de 2016. Serie C n.° 329. Cita los párrafos 160, 161, 166, 167, 175, 176, 181, 182, 184, 189, 191 y 192. 7) Corte IDH. Caso Poblete Vilches y otros Vs. Chile. Fondo, Reparaciones y Costas. Sentencia de 8 de marzo de 2018. Serie C n.° 349. Cita extractos de los párrafos 160, 161, 162 y 170. 8) Corte IDH. Caso Comunidad Indígena Yakye Axa Vs. Paraguay. Fondo, Reparaciones y Costas. Sentencia de 17 de junio de 2005. Serie C n.° 125. Cita un extracto del párrafo 162. 9) Corte IDH. Caso Comunidad Indígena Sawhoyamaxa Vs. Paraguay. Fondo. Reparaciones y Costas. Sentencia de 29 de marzo de 2006. Serie C n.° 146. Cita el párrafo 177. 10) Corte IDH. Caso Comunidad Indígena Xákmok Kásek Vs. Paraguay. Fondo. Reparaciones y Costas. Sentencia de 24 de agosto de 2010. Serie C n.° 214. Cita los párrafos 186 y 187. 11) Corte IDH. Caso de la “Masacre de Mapiripán" Vs. Colombia. Sentencia de 15 de septiembre de 2005. Serie C n.° 134. Cita el párrafo 162. 12) Corte IDH. Caso Vera Vera y otra Vs. Ecuador. Excepción Preliminar, Fondo, Reparaciones y Costas. Sentencia de 19 de mayo de 2011. Serie C n.° 226. Cita el párrafo 43. 13) Corte IDH. Caso Suárez Peralta Vs. Ecuador. Excepciones Preliminares. Fondo, Reparaciones y Costas. Sentencia de 21 de mayo de 2013. Serie C n.° 261. Cita el párrafo 130. 14) Corte IDH. Caso Chinchilla Sandoval y otros Vs. Guatemala. Excepción Preliminar, Fondo, Reparaciones y Costas. Sentencia de 29 de febrero de 2016. Serie C n.° 312. Cita el párrafo 170. 15) Corte IDH. Caso Artavia Murillo y otros (Fecundación in Vitro) Vs. Costa Rica. Excepciones Preliminares, Fondo, Reparaciones y Costas. Sentencia de 28 de noviembre de 2012. Serie C n.° 257. Cita el párrafo 147. 16) Corte IDH. Caso I.V. Vs. Bolivia. Excepciones Preliminares, Fondo, Reparaciones y Costas. Sentencia de 30 de noviembre de 2016. Serie C n.° 329. Cita los párrafos 155 y 270. 17) Corte IDH. Asunto B, respecto de El Salvador. Medidas Provisionales. Resolución de la Corte Interamericana de Derechos Humanos de 29 de mayo de 2013. Cita el párrafo 15. 18) Corte IDH. Caso Poblete Vilches y otros Vs. Chile. Fondo, Reparaciones y Costas. Sentencia de 8 de marzo de 2018. Serie C n.° 349. Cita el párrafo 152. 19) Corte IDH. Caso I.V. Vs. Bolivia. Excepciones Preliminares, Fondo, Reparaciones y Costas. Sentencia de 30 de noviembre de 2016. Serie C n.° 329. Cita los párrafos 156 y 163. 20) Corte IDH. Caso Albán Cornejo y otros Vs. Ecuador. Fondo, Reparaciones y Costas. Sentencia de 22 de noviembre de 2007. Serie C n.° 171. Cita el párrafo 68. 21) Corte IDH. Caso I.V. Vs. Bolivia. Excepciones Preliminares, Fondo, Reparaciones y Costas. Sentencia de 30 de noviembre de 2016. Serie C n.° 329. Cita el párrafo 311. 22) Corte IDH. Caso Ximenes Lopes Vs. Brasil. Sentencia de 4 de julio de 2006. Serie C n.° 149. Cita los párrafos 103, 125, 126 y 147. Indica que, los casos resueltos por la Corte Interamericana son emblemáticos para los Estados por las interpretaciones que realiza y, debido a que constituyen estándares internacionales de protección. Asimismo, establecen jurisprudencia trascendental para los tribunales internos del Estado, que coadyuva a la generación de normas y precedentes guiados a la luz del Derecho Internacional de los Derechos Humanos. Las resoluciones de la Corte Interamericana impactan de manera significativa en el ordenamiento jurídico interno, de modo que conducen a la implementación o modificación de las normas internas, así como al establecimiento de mecanismos de protección de derechos humanos tendientes a realizar una integración entre los estándares internacionales y el derecho nacional. De allí que sea de gran relevancia, el señalar que las sentencias condenatorias dictadas han evidenciado las deficiencias de los ordenamientos jurídicos y, con ello, se ha generado presión internacional para el impulso de reformas, la investigación y consecución de procesos en aras de determinar y sancionar a los responsables de cometer violaciones de derechos humanos, por lo que, a través de estas, los Estados han debido modificar su ordenamiento jurídico interno a través de reformas constitucionales, reformas legales y pautas de interpretación que permiten la inserción de los estándares establecidos por la Corte Interamericana al derecho interno. Solicita que se declare la inconstitucionalidad del decreto n.° 42889-S, pues no solo se pone en riesgo el derecho a la vida y a la salud, sino que se vulnera todo el sistema democrático, de manera que las bases del Estado de Derecho se ven seriamente afectadas, debido a la intromisión directa, totalitaria y arbitraria del Estado costarricense y nunca antes vista en la historia de este país, con graves consecuencias para toda nuestra sociedad. Apunta la vulneración del principio de razonabilidad y proporcionalidad en la sanción por no vacunarse (despido sin responsabilidad patronal y/o multa aproximada de 500.000 colones), por la obligatoriedad de la medida en sí, lo cual atenta contra el derecho al trabajo. Señala que el decreto en cuestión lesiona el principio de razonabilidad y proporcionalidad, por lo siguiente: a) Ni la CCSS, ni el Ministro de Salud, Daniel Salas, en ninguna forma han fundamentado técnica o científicamente el grado de eficacia de la vacuna, en relación con evitar la propagación de la covid-19 (por ella misma y sin considerarse con otras medidas), por lo que no es posible realizar una valoración de proporcionalidad, necesidad y razonabilidad de la medida que atenta contra (o lesiona) el principio de autonomía de la voluntad. b) Las sanciones por no vacunarse para los funcionarios públicos son desproporcionadas, pues las sanciones o penas que pudieran recibir los funcionarios públicos por no vacunarse, se trata de tipos penales o administrativos-sancionatorios en blanco, que contravienen el principio de tipicidad penal y administrativa-sancionatoria, y son excesivos, afectan el trabajo, que también es un derecho fundamental. Se pretende abrir procedimientos administrativos tendientes a despedir sin responsabilidad patronal a los funcionarios públicos que no se vacunen, o que no le brinden información a la entidad para la cual laboran, sobre si se han vacunado o no, y si tiene el cuadro completo de vacunas o no. Adicionalmente, se amenaza a los funcionarios públicos con la imposición de una multa aproximada de 500.000 colones y la remisión del caso al Ministerio Público para determinar si se está ante la comisión de un delito. A partir del decreto que estipula la declaratoria de obligatoriedad, se han girado instrucciones a las diferentes instituciones públicas y al sector privado para que sancionen, incluso con sanciones no establecidas en la Ley de Vacunación como el despido, a todas aquellas personas que no quieran recibir la inoculación de la mal llamada vacuna. Para cuando sean citados por los encargados para tales efectos y, de acuerdo con la planificación institucional respectiva, las personas contempladas en el párrafo anterior deberán vacunarse, con excepción de aquellos funcionarios que, por contraindicación médica debidamente declarada, no les sea posible recibir la vacuna contra la Covid-19. 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 la covid-19. Lo anterior ha generado una inmensa presión mediática, al grado de coaccionar a las personas que no se quieren vacunar con la amenaza del despido, como se ha publicado en diferentes medios de comunicación. La obligatoriedad acusada va en contra de los principios enunciados, pues las personas trabajadoras se ven coaccionadas a someterse a una inoculación obligatoria, pese a sus temores fundados de sufrir daños a corto o largo plazo, debido a las inminentes acciones disciplinarias, ya que pueden ser sancionados con multas o despidos, lo que ha hecho que, ante la disyuntiva de vacunarse o perder sus trabajos, que es el medio por el cual llevan el sustento a sus familias en medio de una de las peores crisis económicas de los últimos 40 años, las personas se están viendo obligadas por la coerción ejercida, a vacunarse en contra de su voluntad. Indica que, queda en evidencia la falta de razonabilidad, además, de la medida en sí (obligatoriedad de la vacunación), por cuanto se ha alegado que una de las principales razones que justifican el decreto es el supuesto aumento en los contagios y la necesidad de detener la propagación del virus. Sin embargo, mucho antes de que se emitiera el decreto, la tasa de contagios venía disminuyendo significativamente como lo publicaron varios medios de prensa. Incluso, se ha informado a la población que el CEACO, hospital especializado para la atención de personas infectadas del virus, está siendo desmantelado en estos momentos, ya que, según las autoridades de Salud, no se requiere por la reducción significativa de casos. Según una publicación del Centro Centroamericano de Población de la Universidad de Costa Rica: "La tendencia manifiesta de la tasa R es a la baja aproximadamente desde el 21 de agosto. Esta tendencia se ha mantenido. Las tasas de esta semana han mantenido una tendencia moderada a la baja que se espera se mantenga por las próximas semanas". En el mismo artículo se indica que la tasa de reproducción de la covid-19 en Costa Rica bajó ligeramente a R =0,77, según los datos de nuevos diagnósticos actualizados al martes 19 de octubre (Gráfico 1). Denota que el reporte de un nuevo diagnóstico tiene un retraso aproximado de seis días con respecto al momento del contagio, por lo que esta estimación de R corresponde probablemente al miércoles 13 de octubre como se consigna en el gráfico. Lo anterior evidencia que mucho tiempo antes de la publicación del Decreto Ejecutivo n.° 43249-S, incluso antes de que se tomara el Acuerdo de la Comisión Nacional de Vacunación y Epidemiología, en la sesión extraordinaria XLV2021 del 23 de setiembre de 2021, ya la tasa de contagio desde el 21 de agosto de 2021 venía en disminución, a inicios de setiembre ya había bajado por debajo de 1, y en la actualidad ya está en un 0.77, por lo que el contagio ha disminuido sin la necesidad de la vacunación obligatoria. Ahora bien, tampoco se puede afirmar que esa disminución ha sido producida por la vacunación, ya que más bien se debe a un comportamiento que ha venido presentando el virus durante el transcurso del tiempo, donde se presentan oleadas o picos de contagios con disminuciones, independientemente de las personas vacunas. En Costa Rica, para el 20 de setiembre de 2021 donde se alcanzó uno de los niveles más altos de contagios, se presentaban 1.514 casos nuevos, a pesar de que ya se habían aplicado 4.872.085 dosis y vacunado a 3.144.786 personas. Refiere que las sanciones establecidas en el decreto acusado vulneran claramente el principio de razonabilidad y proporcionalidad, al ser desproporcionadas e innecesarias, en virtud de toda la argumentación citada. Por otro lado, no se puede pasar por alto, que todo acto administrativo debe estar debidamente fundamentado. El decreto impugnado establece, como elemento central de su fundamentación, en el considerando III, que: “...las normas de salud son de orden público. Ante ello, el Ministerio de Salud como autoridad competente podrá ordenar y tomar las medidas especiales para evitar el riesgo o daño a la salud de las personas, o que estos se difundan o agraven, así como para inhibir la continuación o reincidencia en la infracción de los particulares. Dichas normas legales, que establecen la competencia del Ministerio de Salud en materia de salud, consagran la potestad de imperio en materia sanitaria, que le faculta para dictar todas las medidas técnicas que fueren necesarias para enfrentar y resolver los estados de emergencia sanitarios…”. El concepto de orden público, como fundamento del decreto, es vago, poco preciso y ha servido para que la Dirección de Asuntos Jurídicos emita el criterio general, que también se impugna. Lo que debe reafirmarse, entonces, es que el -ya de por sí indeterminado-concepto de orden público, no puede ser fundamento justificado para la arbitrariedad, como sucede en este caso. Señala que comparte las razones separadas de la magistrada Hernández López, suscritas en relación con el ejercicio del poder por parte del Ejecutivo, en tiempos de pandemia, rescatando lo siguiente: 1.La limitación de derechos constitucionales tiene que ser autorizada por la Asamblea Legislativa, según el artículo 121.7 de la Constitución. 2. Aún en "estado de emergencia" los únicos derechos y garantías que la misma Constitución permite suspender, se refieren a aquellos regulados en los artículos 22, 23, 24, 26. 28. 29, 30 y 37. De manera que las garantías relacionadas con el derecho al trabajo, artículos 56 y 63, no están comprendidos dentro de aquellos que puedan sufrir suspensiones o limitaciones en casos de emergencia. 3. Aún en casos de aquellas garantías susceptibles de suspensión, no es posible su anulación, o que de su suspensión de emergencia resulte luego la imposibilidad de recuperar tales derechos, o que su suspensión sea indefinida. Se limita igualmente, de manera absoluta la posibilidad de que el Estado actúe de forma arbitraria. 4. La misma Sala Constitucional ha establecido el "test de razonabilidad" para determinar si un derecho constitucional ha sido conculcado. Esa prueba exige comprobar lo siguiente, cuando menos: a. Que tan necesaria es la intervención estatal en la vida de los ciudadanos, tomando en cuenta que aquí, priva el principio de mínima intervención. b. Que en caso de que sea necesaria una intervención estatal, deberá llevarse a cabo por la autoridad pública o ente estatal al que la ley le reconoce competencia. c. Que, en tales casos, la acción estatal debe sujetarse a los principios constitucionales establecidos en los artículos 9 y 11 de la Constitución: División de Poderes, Legalidad, Interdicción de la Arbitrariedad y Desviación de Poderes. d. La Administración debe valorar las diversas acciones que se pueden o deben llevar a cabo en el caso concreto, debiendo escoger siempre la que respete el principio de mínima intervención sobre las libertades de las personas, de manera tal que la intervención necesaria respete la temporalidad de la acción y la garantía del restablecimiento del derecho constitucional, "en lo que resta del proyecto de vida de la persona. Particularmente, se debe de garantizar, que el sacrificio sobre el derecho o garantía del afectado, se verá compensado, por los beneficios que obtendrán, el resto de las personas. y la propia persona sobre la cual se impuso la limitación". e. Según el diseño constitucional, hay derechos que únicamente pueden ser limitados o suspendidos, mediante aprobación de dos terceras partes de los votos de la Asamblea Legislativa. Así, el actuar del Ministerio de Salud y el Ministerio de Trabajo, viola flagrantemente la Constitución Política, pues el decreto impugnado, firmado el 7 de octubre de 2021, establece que será obligatoria la vacuna de la covid-19 para el personal del sector público y el sector privado, a partir del 15 de octubre de 2021. El día 12 de octubre de 2021, la Dirección de Asuntos Jurídicos del Ministerio de Trabajo, apoyándose en el decreto y fundamentándose en el inciso h del artículo 81 del Código de Trabajo, concluye que: “3. Si una persona funcionaria pública o trabajadora del sector privado, para quien la persona empleadora ha dispuesto la vacunación como obligatoria en su centro de trabajo, se niega de manera manifiesta, reiterada e injustificada a vacunarse, quedaría facultada la persona empleadora para proceder con el despido sin responsabilidad patronal, de conformidad con el inciso h) del artículo 81 del Código de Trabajo”. Indica que, sin ningún fundamento que sustente el criterio jurídico, el Ministerio de Trabajo establece, apoyado en el decreto, que quien se niegue a vacunarse cae en la categoría de la persona que no toma medidas para evitar la covid-19. Aduce que esto es un hecho falso que contradice la ciencia, ya que, además, es un hecho público y notorio, que las personas vacunadas también se enferman, y en lo que aquí interesa, también contaminan a los demás transmitiendo el virus. Las actuales vacunas contra la covid-19 no evitan que quienes se vacunen transmitan el virus. De ahí que, si en un lugar de trabajo, público o privado, todos los trabajadores pueden contaminarse entre sí, vacunados o no vacunados, es absolutamente desproporcionado e inconstitucional llegar a la conclusión de que se justifica el despido sin responsabilidad patronal, únicamente de quienes no se vacunen, concluyendo falsamente que sólo los vacunados evitan la enfermedad. Todo patrono, incluido el Estado, está en absoluta libertad de despedir a sus trabajadores, siempre y cuando respete las garantías constitucionales y legales a que tiene derecho todo trabajador. De manera que, si en el caso de quienes no se vacunen, el patrono quiere tomar la decisión de despedir a esa persona, deberá hacerlo con responsabilidad patronal, pagando todos los extremos debidos. No se puede aceptar que el Poder Ejecutivo, basado en una situación de emergencia y supuestamente con fundamento en el orden público, limite derechos constitucionales de la manera en que lo hace, pues el despido sin responsabilidad patronal es absolutamente desproporcionado, sobrepasa el límite de la división de competencias, y hace que la sanción que se impone, deje de ser temporal y torna en irrecuperable el derecho conculcado, pues con semejantes decisiones, el empleado pierde, de forma definitiva, su trabajo y todos los derechos laborales anexos a su contrato de trabajo, además de la amenaza de imponerle una multa de un salario base y de remitir el caso del funcionario que no acepte vacunarse al Ministerio Público. Considera que ello claramente configura una violación flagrante al principio de razonabilidad y proporcionalidad, tanto por la vaguedad del término "orden público", como en la sanción para los funcionarios públicos y trabajadores del sector privado que no se vacunen. Estima que el decreto impugnado también vulnera el principio de autodeterminación informativa, al solicitarse información privada referida al expediente médico y ante la ausencia del consentimiento informado previo a la inoculación. El derecho de autodeterminación informativa es uno de los derechos fundamentales derivados del artículo 24 de la Constitución Política, el cual asegura el respeto de la intimidad y de la dignidad humana por medio de una efectiva protección a los datos personales que consten en ficheros, archivos, registros o bases de datos, independientemente de que estos sean de carácter privado o público. La autodeterminación informativa faculta a toda persona a conocer quién posee registrada información sobre ella, el tipo de información que se mantiene y con qué objeto. Además, concurrentemente, implica la posibilidad de rectificación, bloqueo y eliminación de esa información. Refiere que esta Sala Constitucional desarrolló y protegió ese derecho a través de un abundante y remarcado desarrollo jurisprudencial. No obstante, se enfatizó en la necesidad de que se emitiera una ley que viniera a positivizar los principios derivados de la jurisprudencia, al mismo tiempo que reforzara la protección de los habitantes del país frente a cualquier indebida vulneración de este derecho. Una expectativa que se concretizó en el año 2011, con la promulgación de la Ley de Protección de la Persona frente al tratamiento de sus datos personales, norma que cuenta a su vez con la debida reglamentación (Decreto Ejecutivo n.° 37554-JP del 30 de octubre de 2012), ambas nomas se basan en los parámetros establecidos por el Tribunal Constitucional. Dicha ley protege los datos sensibles, entre ellos la salud. La Ley de Protección de la persona frente al tratamiento de sus datos personales garantiza a cualquier persona, independientemente de su nacionalidad, residencia o domicilio, el respeto de su derecho a la autodeterminación informativa en relación con su vida o actividad privada y, demás derechos de la personalidad, así como la defensa de su libertad e igualdad con respecto al tratamiento automatizado o manual de los datos correspondientes a su persona o bienes, según lo dispone el artículo 1. La calificación de "orden público" remarca la trascendencia del bien jurídico tutelado y la necesidad de su acatamiento obligatorio por todos los sujetos, tanto de derecho privado como público. El artículo 2 de dicho cuerpo normativo, establece su marco de acción, disponiendo que abarca las bases de datos automatizadas o manuales, sea que pertenezcan a organismos públicos o privados, además, contempla cualquier modalidad de uso posterior que se haga de esa información. Exceptúa de su aplicación a las bases de datos mantenidas por personas físicas o jurídicas con fines exclusivamente internos, personales o domésticos. No obstante, si estas bases son objeto de comercialización deberán sujetarse a las disposiciones de la ley. La protección está referida a los datos concernientes a una persona o bien. En este sentido, datos personales, o sea, datos pertenecientes a una persona identificada e identificable. El concepto de datos personales es amplio, ya que comprende cualquier dato de una persona identificada e identificable. No obstante, para efectos de su protección, la ley diferencia entre varias categorías de datos personales. Los datos relativos a la salud se califican de sensibles, como tales, sujetos a un mayor grado de protección. Basta recordar que, como regla general, hay una prohibición para el tratamiento de datos sensibles, las personas no están obligadas a suministrar este tipo de información. La materialización del derecho de autodeterminación informativa, en torno a los principios de consentimiento informado y de calidad de información, impuso como requerimientos básicos para la recopilación de datos, la obligación de informar acerca de la base de datos y de contar con el consentimiento del titular de los datos o su representante, así como el velar por la calidad de la información (artículos 5, 6 y 7 de la Ley de Protección de la Persona frente al tratamiento de sus datos personales), por lo que, de esta manera, quien solicite o recopile para su procesamiento datos personales sobre una persona, inexorablemente debe observar como mínimo, las siguientes pautas obligatorias: • informar de previo a las personas titulares o a sus representantes de modo expreso, preciso e inequívoco la existencia de una base de datos de carácter personal; los fines que se persiguen con la recolección de los datos, los destinatarios de la información y quiénes podrán acceder a ella, • la obligatoriedad o no de brindar las respuestas a las preguntas que se le formulen durante la recolección de los datos, • el tratamiento que se dará a los datos solicitados; • las consecuencias de la negativa de suministrar los datos; • la posibilidad de ejercer los derechos que le asisten; • la dirección del responsable de la base de datos (artículo 5, acápite primero de la Ley de Protección de Datos). • Obtener el consentimiento expreso de la persona titular de los datos o de su representante, consentimiento que debe constar por escrito, en documento ya sea físico o electrónico (artículo 5, acápite segundo de la misma ley). • Velar por la calidad de la información, esto es, constatar que los datos sean actuales, veraces, exactos y que se adecúen a fines determinados, explícitos y legítimos. Aunado a lo anterior, al responsable de la base de datos se le impone un deber de adoptar las medidas de índole técnica y de organización necesarias con el objeto de garantizar la seguridad de los datos personales y evitar su alteración, destrucción accidental o ilícita, pérdida, tratamiento o acceso no autorizado, así como cualquier otra acción contraria a la ley en mención, contemplando como mínimo dentro de esas medidas, los mecanismos de seguridad física y lógica más adecuados, acordes con el desarrollo tecnológico que impere en el momento dado. Asimismo, sobre dichos responsables y quienes participen en cualquier fase del proceso de tratamiento de datos personales, recae en correspondencia con esa información, un deber de confidencialidad, sea por su condición profesional o funcional (artículo 11 de la Ley de Protección de Datos). Entre los principios fundamentales de protección de los datos personales, se encuentra el de consentimiento del afectado. La ley puede exceptuar la necesidad de ese consentimiento, permitiendo la recolección y entrega de datos en determinados casos, pero en el caso que nos ocupa, no nos encontramos bajo ninguno de los supuestos de excepción establecidos en el artículo 8 de la ley de cita, por lo que el principio es vulnerado debido al tratamiento que realiza el gobierno en cuanto a la desprotección de información de carácter sensible, por tratarse de tema médico, la salud de las personas, y ahora los departamentos de recursos humanos solicitan a sus empleados esta información, sin ninguna legitimación legal para hacerlo, y encima de todo, lesionando lo establecido en las disposiciones señaladas de la Ley de Protección frente al Tratamiento de sus datos personales. Igualmente, añade la ausencia del consentimiento informado (adecuado y con opciones variadas), respecto del acceso al expediente médico, y con información previa de los posibles efectos de la vacunación, así como de los exámenes anteriores a dicha inoculación. El tratamiento de los datos personales y en especial, de los datos sensibles, está ampliamente resguardado por la ley de cita, la jurisprudencia constitucional y la Constitución Política. Por ello, es violatorio del principio de autodeterminación, los datos sensibles no pueden estar en manos de cualquier persona, sin el consentimiento informado que debiera conformar el expediente médico de toda persona. Ese consentimiento debe ser dado de acuerdo con la autonomía del paciente, y con los derechos y obligaciones en materia de información y documentación clínica para todo acto en el ámbito de la salud, caracterizando este consentimiento para ser otorgado de manera libre, voluntaria y consciente, y no de la forma en que la administración está actuando, sin ni siquiera brindar este derecho a los funcionarios que obliga el decreto impugnado. Agrega que, la obligatoriedad de la vacunación como la dispuesta en el decreto impugnado, por la mera condición de funcionario público, sin que medie consentimiento libre e informado, sin que se conozcan cuáles son los posibles efectos en la salud o vida de la persona sometida a dicha inoculación, sin que las personas conozcan de buena fuente si corren el riesgo de sufrir graves secuelas, se corresponde con los tratamientos crueles o degradantes de los cuales refiere el artículo 40 constitucional, sobre todo si no se pondera el hecho de que existen personas que tienen diversos padecimientos. En forma correlativa al derecho fundamental a la vida tutelado en el numeral 21 constitucional, está el artículo 20 de la Carta Magna, el cual garantiza el derecho a la libertad de toda persona, y su capacidad de disponer sobre su propio cuerpo. Ambas normas constituyen la fuente constitucional del consentimiento informado, ya que, de este deriva la libertad a elegir qué tratamiento le es más favorable en el restablecimiento de su salud, o poder elegir si desea participar de un proceso de investigación formal, atendiendo tal consentimiento como un derecho fundamental e inherente a la persona, y no como en el que nos ocupa, en donde se obliga a la vacunación, sin garantizar el consentimiento previo debidamente informado a los trabajadores, vulnerando con ello su derecho a la vida, a la salud y a recibir información adecuada y veraz. Considera que el decreto impugnado también vulnera los límites de la potestad reglamentaria establecida en el artículo 140 incisos 3 y 18 de la Constitución Política, así como el principio de reserva de ley. Refiere que, de la sentencia 2010-1668 de esta Sala, se desprende: 1- El marco jurídico que rige la política estatal en materia de salud que deben desarrollar las autoridades competentes, se encuentra regulado por la Ley General de Salud. 2- Que los reglamentos de la Caja de Seguro, relacionados con la experimentación en seres humanos, al ser reglamentos que por su carácter de norma general no resultan ser el mecanismo jurídico idóneo para garantizar la tutela de los derechos fundamentales directamente relacionados con la experimentación en seres humanos, entre ellos, el derecho a la vida, la libertad personal, la integridad física, el derecho a la salud y otros derechos involucrados. 3- Derechos que por su característica de fundamentales e inherentes al ser humano, deben ser regulados y limitados únicamente mediante ley especial emitida por la Asamblea Legislativa, pues, tanto el ejercicio de la libertad de experimentación científica, como la protección del derecho a la vida y la dignidad humana en relación con este tipo de experimentaciones, son cuestiones y materias de reserva de ley. El interés científico nunca puede violentar o estar por encima del derecho a la vida, la salud, la integridad física o mental, la dignidad y cualquier otro derecho o libertad fundamental inherente a la persona, por su sola condición de ser humano, aún y mediando el consentimiento libre y voluntario. Todos los supuestos beneficios de procedimientos como la vacunación contra el covid-19, para el ser humano, la sociedad y la humanidad deben ser obtenidos mediante el respeto y protección de los derechos fundamentales de todos y cada uno de los inoculados, de ahí que este tipo de procedimientos de los que se ha omitido brindar información sobre sus posibles efectos no pueden ser regulados por un reglamento, al margen del derecho a la vida humana, el derecho a la salud, la intimidad y la dignidad humana. Insiste que, el Decreto Ejecutivo n.° 42889-S, “Reforma del Reglamento a la Ley Nacional de Vacunación y numerales 2, 3 y 6 inciso a) de la ley n.° 8111, Ley Nacional de Vacunación”, al obligar a los funcionarios públicos a vacunarse sin que la Caja Costarricense de Seguro Social informe acerca de los posibles efectos, menos aún de los derechos laborales respecto a la póliza de riesgos de trabajo ante un efecto adverso ocasionado, producto de dicha obligatoriedad de la vacunación covid-19, violenta los derechos constitucionales de todos los funcionarios públicos -y potencialmente de todos los trabajadores del sector privado- de forma grosera respecto a los derechos a la intimidad, integridad y dignidad humana, tal y como lo hace ver la destacada jurisprudencia de esta Sala en relación con los reglamentos de experimentación en seres humanos de la Caja Costarricense de Seguro Social. Aduce que, lo que se pretende con esta acción implica incluso un cambio de criterio en la jurisprudencia de esta honorable Sala Constitucional, lo cual es permitido por la Ley de la Jurisdicción Constitucional. Esto, porque la Sala Constitucional ha defendido la obligatoriedad de la vacunación en ciertos casos, lo cual ha de ser revisado por la Sala, haciendo los ajustes necesarios a su jurisprudencia. La Sala ha reconocido "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, en el resguardo de la salud pública y la prevención de las enfermedades constituye un fin constitucionalmente legítimo". Hasta aquí no habría conflicto con la postura de la Corte Interamericana de Derechos Humanos, porque esos fines se pueden conseguir sin la obligatoriedad, por medio de campañas educativas y de sensibilización, pero la Sala Constitucional ha ido más allá, y ha dicho que esa importancia de la vacunación, puede justificar válidamente la obligatoriedad de las vacunas, lo cual representa una interpretación contraria a la dignidad humana y los instrumentos internacionales sobre bioética. El artículo 13 de la Ley de la Jurisdicción Constitucional establece el principio de que la jurisprudencia y los precedentes de la Sala Constitucional son vinculantes erga omnes, salvo para sí misma. Debido a lo anterior, se debe no solo hacer una ponderación de derechos en posible conflicto, sino, de una vez por todas dejar claro, que el ser humano no debe ser visto como un mero instrumento para alcanzar metas sociales, como sucede en el caso de la vacunación obligatoria, sino que, en todo momento y en todos los casos, la dignidad humana debe ser el norte que guíe la toma de decisiones a nivel legislativo, ejecutivo y judicial. Solo así se podrá tener certeza, que situaciones tan lamentables como las que han sucedido en Costa Rica, por tenerlo al revés, se vuelvan a repetir. Solicita que: 1. Se tenga por admitida la presente acción de inconstitucionalidad, y se suspenda la obligatoriedad de la inoculación sustentada en el decreto impugnado mientras se resuelve por el fondo esta acción. 2. Se declare inconstitucional y en consecuencia se anule el Decreto n.° 42889-S, Reforma Reglamento a la Ley Nacional de Vacunación y numerales 2, 3 y 6 inciso a) de la Ley n.° 8111, Ley Nacional de Vacunación, así como toda la normativa que se oponga al consentimiento informado previo, pleno y libre, en lo referente a la obligatoriedad de la vacunación para todos los funcionarios públicos y potencialmente de todos los trabajadores del sector privado. 3. Se prevenga al Ministerio de Salud de que no podrá seguir aplicando la obligatoriedad de la vacunación.

2.- Por escrito incorporado el 22 de diciembre de 2021, el accionante reitera sus alegatos de inconstitucionalidad y detallar cada una de las normas que se acusan de ser inconstitucionales, con la respectiva argumentación para cada caso. PRIMERA : en cuanto al artículo 46 Código Civil, Ley N° 63 del 28 de septiembre de 1887, alega que la frase con excepción de los casos de vacunación obligatoria o de otras medidas relativas a la salud pública es inconstitucional, porque violenta el principio de consentimiento previo informado y libre, la dignidad humana. Se acusa que la frase con excepción de los casos de vacunación obligatoria o de otras medidas relativas a la salud pública, de este artículo, resulta violatoria de la libertad personal, específicamente, del principio del consentimiento informado, que está tutelado por la jurisprudencia de la Corte Interamericana de Derechos Humanos, así como por resoluciones de la Comisión Interamericana de Derechos Humanos. Esta norma permite que la vacunación sea obligatoria en Costa Rica, al excluir la posibilidad de negarse a recibir una vacuna que se haya incluido en la lista del esquema ordinario obligatorio, por parte de las autoridades sanitarias. Al excluir la vacunación de esa posibilidad, se viola groseramente la obligación del Estado costarricense de asegurar un consentimiento previo, informado, pleno y libre para toda persona que vaya a recibir una vacuna del Estado. SEGUNDA: El artículo 150 de la Ley General de Salud, Ley N° 5395 del 30 de octubre de 1973, permite que la vacunación sea obligatoria en Costa Rica, al excluir la posibilidad de negarse a recibir una vacuna que se haya incluido en la lista del esquema ordinario obligatorio, por parte de las autoridades sanitarias. Al excluir la vacunación de esa posibilidad, se viola groseramente la obligación del Estado costarricense de asegurar un consentimiento previo, informado, pleno y libre para toda persona que vaya a recibir una vacuna del Estado. TERCERA: La misma Ley General de Salud, en relación con las competencias del Ministro de Salud, permite que la vacunación sea obligatoria en Costa Rica, al excluir la posibilidad de negarse a recibir una vacuna que se haya declarado como obligatoria, por parte de las autoridades sanitarias. Al excluir la vacunación de esa posibilidad, se viola groseramente la obligación del Estado costarricense de asegurar un consentimiento previo, informado, pleno y libre para toda persona que vaya a recibir una vacuna del Estado. CUARTA: De la Ley Nacional de Vacunación, Ley Nº 8111 del 18 de julio del 2001, el artículo 3, indica que esa norma faculta a la Comisión Nacional de Vacunación y Epidemiología establecer la obligatoriedad de las vacunas “cuando lo estime necesario” en coordinación con el Ministerio de Salud y la Caja Costarricense de Seguro Social, por lo que permite que la vacunación sea obligatoria en Costa Rica, al excluir la posibilidad de negarse a recibir una vacuna que se haya declarado como obligatoria, por parte de las autoridades sanitarias. Al excluir la vacunación de esa posibilidad, se viola groseramente la obligación del Estado costarricense de asegurar un consentimiento previo, informado, pleno y libre para toda persona que vaya a recibir una vacuna del Estado. QUINTA: De esta misma ley Nº 8111 del 18 de julio del 2001, el artículo 11, permite que la Comisión Nacional de Vacunación y Epidemiología, junto con las autoridades del Ministerio de Salud y la CCSS, determine los sectores de la población que deban ser vacunados, ya sea facultativa u obligatoriamente, y es aquí donde encontramos un problema, al violentarse el principio del consentimiento previo informado, pleno y libre, que tutela la Convención Americana de Derechos Humanos y la jurisprudencia de la Corte IDH y las resoluciones de la Comisión IDH. Por lo tanto, la frase “ además, decidirá si la vacunación es obligatoria o facultativa” es inconstitucional y debe ser anulada. SEXTA: El artículo 1 inciso e) del Reglamento a la Ley Nacional de Vacunación” del 20 de mayo de 2005 contempla una categoría de vacunas que serían obligatorias. La obligatoriedad, como se sostiene en esta acción, sin posibilidad de un consentimiento libre, es contraria a las garantías individuales dadas por la jurisprudencia de la Corte IDH, específicamente la sentencia del 30 de noviembre de 2016, caso I.V. vs Bolivia y las resoluciones 4/2020 y 1/2021 de la Comisión IDH, entre otras. SÉPTIMA : El Decreto Ejecutivo N° 43249-S firmado por el Poder Ejecutivo el 7 de octubre del 2021, oficializó el acuerdo de la Comisión Nacional de Vacunación y Epidemiología No. XLV-2021 del 23 de setiembre de 2021, cuya vigencia rige a partir del 15 de octubre de 2021, decreto mediante el cual se aprobó la obligatoriedad de la vacuna contra el Covid-19 para todos los funcionarios del sector público, así como para aquellos empleados del sector privado cuyos patronos, dentro de sus disposiciones laborales internas, hayan optado por incorporar dicha vacunación como obligatoria en sus centros de trabajo. Este Decreto Ejecutivo violenta el principio del consentimiento previo, informado, pleno y libre que garantiza la jurisprudencia de la Corte IDH, específicamente la sentencia del 30 de noviembre de 2016, caso I.V. vs Bolivia, en la cual la Corte IDH dijo en sus párrafos 159, 160, y siguientes. En concordancia con lo anterior, la resolución 1-21 de la COMISIÓN INTERAMERICANA DE DERECHOS HUMANOS, del 10 de abril del presente año, dice el consentimiento informado se fundamenta en cuatro principios que consolidan su validez, a saber, el principio de beneficencia, el principio de no maleficencia, el principio de justicia y el principio de autonomía. Solicita tener por enmendada la acción de inconstitucionalidad, con el fin de cumplir con los requisitos formales correspondientes.

3.- Por escrito incorporado el 3 de enero de 2022, Mariela Fallas Pacheco, solicita ser tenida como coadyuvante en esta acción, con base en los mismos argumentos del accionante.

4.- El artículo 9 de la Ley de la Jurisdicción Constitucional faculta a la Sala a rechazar de plano o por el fondo, en cualquier momento, incluso desde su presentación, cualquier gestión que se presente a su conocimiento que resulte ser manifiestamente improcedente, o cuando considere que existen elementos de juicio suficientes para rechazarla, o que se trata de la simple reiteración o reproducción de una gestión anterior igual o similar rechazada.

Redacta el Magistrado Castillo Víquez; y,

Considerando:

I.- De previo. Sobre la gestión de coadyuvancia. Mediante mediante escrito incorporado el 3 de enero de 2022, Mariela Fallas Pacheco solicita que se presentó gestión de coayuvancia en esta acción de inconstitucionalidad. El artículo 83 de la Ley de la Jurisdicción Constitucional establece, al efecto, que en los quince días posteriores a la primera publicación del aviso a que alude el párrafo segundo del artículo 81, las partes que figuren en los asuntos pendientes a la fecha de la interposición de la acción, o aquellos con interés legítimo, podrán apersonarse dentro de ésta, para coadyuvar en las alegaciones que pudieren justificar su procedencia o improcedencia, o para ampliar, en su caso, los motivos de inconstitucionalidad en relación con el asunto que les interesa. En este caso concreto, la solicitud de coadyuvancia resulta improcedente, no solo porque la gestión carece de firma, autenticación y el correspondiente timbre del Colegio de Abogados, sino también, porque la coadyuvancia supone una intervención procesal accesoria y su suerte sigue la de la intervención principal que, por los motivos que se detallan infra, resulta inadmisible.

II.- Sobre los requisitos de admisibilidad de la acción de inconstitucionalidad. El proceso de marras fue instaurado con el propósito de garantizar la supremacía de la Constitución Política, frente a normas u otras disposiciones de carácter general. En función de esto y por voluntad expresa del legislador es de alto grado técnico, por lo que para su admisibilidad se deben cumplir de manera estricta determinados requisitos que dispone la ley. Entre los requerimientos exigidos están: la adecuada fundamentación de los motivos de inconstitucionalidad con cita concreta del Derecho de la Constitución que se considere infringido (artículo 78), la firma de quien interpone la acción debidamente autenticada por un profesional en Derecho con el debido pago de los tributos legales (artículo 78), la acreditación de las condiciones de legitimación (poderes y certificaciones), y la certificación literal del libelo donde se hizo la reserva de inconstitucionalidad en el asunto previo (artículo 79).

III.- Sobre la legitimación del accionante. Este Tribunal considera que la legitimación del accionante proviene del párrafo primero del artículo 75, en tanto se encuentra pendiente de resolución y debidamente cursado, el recurso de amparo n.° 21-021972-0007-CO. En dicho proceso, el gestionante adujo que es asesor “ad honorem” en la Asamblea Legislativa de uno de los diputados. Asimismo, que, fundamentados en el Decreto Ejecutivo n.° 43249-S, que reformó el Decreto Ejecutivo n.° 42889-S del 10 de marzo de 2021, mediante acuerdo adoptado por el Directorio Legislativo, en el artículo 11 de la sesión n.° 180-2021 del 27 de octubre de 2021, se dispuso adicionar un artículo 61 bis al Reglamento Autónomo de Servicio de la Asamblea Legislativa, en el cual se exige la comprobación de la vacuna contra la covid-19, al personal regular y de confianza de la Asamblea Legislativa, así como de los que laboran de manera ad honorem; salvo que, por contraindicación médica, debidamente declarada por el especialista tratante, no les sea posible recibirla. De lo contrario, a los funcionarios ad honorem -como es su caso-, se les revocará su designación, lo cual le fue comunicado el pasado 29 de octubre. Refiere el asunto base que, lo anterior implica una amenaza de sanción que hace nugatorio su derecho de otorgar o no su consentimiento previo, informado, pleno y libre, que ello le genera un daño y una pérdida de oportunidades para asesorar y proponer proyectos de ley. Además, asegura que tiene derecho a decidir si se vacuna o no, al tenor del principio de consentimiento informado, el cual debe ser previo y libre; así como para almacenar y administrar sus datos sensibles, que incluye todo lo relacionado a su expediente médico; empero, el reglamento en disputa no contempla tal solicitud. Conforme lo anterior, el asunto base resulta medio razonable para amparar los derechos del accionante como funcionario ad hororem de una institución pública, por lo que está legitimado para plantear sus argumentos en lo relativo a su condición de funcionario público. Por ende, le asiste la legitimación para accionar ante esta jurisdicción en ese sentido.

IV.- Sobre otras formalidades y la admisibilidad de esta acción. Según ha indicado este Tribunal en su jurisprudencia, el requerimiento de una fundamentación suficiente no se traduce en una mera formalidad, sino que constituye un requisito esencial de admisibilidad. Así lo dispuso en la sentencia n.° 2013-16944 de las 14:30 horas del 18 de diciembre de 2013:

“II.- INADMISIBILIDAD POR FALTA DE FUNDAMENTACIÓN. De conformidad con el artículo 78 de la Ley de la Jurisdicción Constitucional, en el escrito en que se interponga la acción de inconstitucionalidad, se deberán exponer los fundamentos en forma clara y precisa, con cita concreta de las normas o principios que se consideren infringidos. Dicho requisito no se traduce en una mera formalidad, sino en un requisito esencial de admisibilidad, pues en virtud del principio pro sentencia - desarrollado en otras ocasiones por esta Sala- según el cual, los requisitos de admisibilidad deben interpretarse en sentido favorable a la acción, además, el Derecho Constitucional es de orden público preferente y en garantía de su supremacía y vigencia hay un interés público en virtud del cual los obstáculos para la admisión y resolución de fondo de una acción, deben interpretarse y aplicarse restrictivamente. Así las cosas, todas las normas procesales deben ser interpretadas y aplicadas de manera tal que se obtenga el dictado de la sentencia, lo anterior, no solo facilita la administración de la justicia, sino que además, evita que se impongan obstáculos para no alcanzarla (ver en igual sentido, las sentencias números 93-5175, 3041-97. 01-06. 2874-06. 1622-08 y 2887-08). En consecuencia, la falta de fundamentación de la acción, impide el dictado de una sentencia debidamente motivada y congruente con lo pretendido. Asimismo, resulta improcedente que esta Sala se pronuncie por el fondo de normas cuestionadas en una acción, cuando el que acciona no fundamenta las razones por las cuales impugna, toda vez, que ello implicaría efectuar un control constitucional en abstracto a manera de ejercicio académico, lo que no es compatible con la finalidad de un proceso de esta naturaleza." (El énfasis no es del original).

En el sub examine, el accionante plantea la acción, contra el “Decreto Ejecutivo 43249-S, titulado "Reforma al Decreto Ejecutivo n.° 42889-S del 10 de marzo de 2021, denominado reforma al Decreto Ejecutivo n° 32722-S del 20 de mayo de 2005, "Reglamento a la Ley Nacional de Vacunación” y Establecimiento de la obligatoriedad de la vacuna del covid-19", el artículo 46 del Código Civil, Ley n.° 63 del 28 de septiembre de 1887, el acuerdo tomado por el Directorio Legislativo, en el artículo 11 de la sesión n.° 180-2021, celebrada el 27 de octubre de 2021, que introduce el artículo 61 bis al Reglamento Autónomo de Servicio de la Asamblea Legislativa; la Ley n.° 5395 del 30 de octubre de 1973, Ley General de Salud, la Ley n.° 8811 - "Ley Nacional de Vacunación" del 18 de julio de 2001, el Decreto Ejecutivo n.° 32722 - "Reglamento a la Ley Nacional de Vacunación" del 20 de mayo de 2005, el Decreto Ejecutivo n.° 37808 - "Norma Nacional de Vacunación" del 08 de enero de 2013, el Decreto Ejecutivo n.° 30965-S-“Reglamento sobre gestión de los desechos infectocontagiosos que se generan en establecimientos que prestan atención a la salud y afines" del 17 de diciembre de 2002", el Decreto Ejecutivo n.° 41045-S del 10 de mayo de 2016 "Reglamento General de Habilitación de Servicios de Salud"; los Lineamientos Nacionales para la Vigilancia de la enfermedad COVID-19; los Lineamientos generales para el uso del Equipo de Protección Personal (EPP), para prevenir la contra COVID-19 en los establecimientos de salud de la Caja Costarricense de Seguro Social, versión #7, junio 2021, Ministerio de Salud, LS-SS-013, Lineamientos sobre la vacunación contra el virus SARS-CoV-2 para la prevención de la COVID-19 - así como toda norma o reglamento emitido por otras instituciones públicas que se opongan al principio de consentimiento informado previo y libre”; sin embargo, en la fundamentación brindada en el líbelo de interposición, únicamente se refirió al decreto n.° 42889-S del 10 de marzo de 2021, y específicamente, respecto de la reforma parcial que fue introducida a este, mediante el Decreto Ejecutivo n.° 43249-S. Respecto de la demás normativa impugnada, la acción carece de fundamentación, pues el accionante, no solo omitió referirse a las disposiciones y contenido de cada normativa o lineamiento cuestionado, sino también en señalar cómo son violentadas las normas y los principios fundamentales, de forma individualizada. Si bien, con posterioridad, el actor aportó un escrito pretendiendo enmendar esas deficiencias, lo cierto es que, se limitó a citar las normas sin desarrollar cada una de ellas, a fin de contraponerlas con el Derecho de la Constitución, únicamente, reclama la obligatoriedad de la vacuna sin el consentimiento informado, pero sin ofrecer una verdadera fundamentación y argumentación respecto de cada norma impugnada. Igualmente, pretende impugnar, de forma abierta y generalizada “toda norma o reglamento emitido por otras instituciones públicas que se opongan al principio de consentimiento informado previo y libre”, lo cual es totalmente improcedente, pues corresponde al accionante el determinar y fundamentar, adecuadamente, las disposiciones cuya nulidad pretende en este tipo de procesos. Así las cosas, la acción resulta admisible, únicamente contra el Decreto Ejecutivo n.° 42889-S del 10 de marzo de 2021, reformado parcialmente mediante el Decreto Ejecutivo n.° 43249-S del 7 de octubre de 2021, al haber cumplido con todas las formalidades respectivas. En lo demás, se considera que lo procedentes es rechazar de plano la acción.

V.- Sobre el objeto de la acción. Señalado lo anterior, se tiene que el accionante solicita que se declare la inconstitucionalidad del Decreto Ejecutivo n.° 42889-S del 10 de marzo de 2021, reformado parcialmente mediante el Decreto Ejecutivo n.° 43249-S del 7 de octubre de 2021, por estimar que violenta:

El principio del consentimiento informado desarrollado en los artículos 20, 21 y 28 de la Constitución Política, el artículo 22 de la Ley General de Salud, el artículo 2 de la ley n.° 8239, "Derechos y deberes de las personas usuarias de los servicios de salud públicos y privados", los artículos 1 y 4 del Reglamento de la Caja Costarricense de Seguro Social (CCSS), y en la jurisprudencia de la Corte Interamericana de Derechos Humanos. Aduce que el decreto impugnado es inconstitucional, por cuanto no prevé la existencia de un consentimiento libre, previo e informado, sino que, muy al contrario, dispone la obligatoriedad de la vacunación contra la covid-19 en contra del principio de autodeterminación y con graves consecuencias en caso de incumplimiento, para los funcionarios públicos y algunos trabajadores del sector privado, sin dar previamente toda la información requerida que garantice su vida.

El principio de igualdad y no discriminación derivado del artículo 33 de la Constitución Política. Señala que el decreto impugnado establece un trato discriminatorio en perjuicio del trabajador del sector público, para quien es obligatoria la vacuna; sin embargo, para los del sector privado, lo deja al arbitrio del patrono. Refiere que no existe una justificación técnica que demuestre la necesidad de obligar a todos los funcionarios públicos a vacunarse. Cuestiona que, por decreto ejecutivo se obligue a vacunar a funcionarios de otros poderes y municipios, lesionando su autonomía.

La libertad de pensamiento y expresión desarrollada por los artículos 28 y 29 de la Constitución Política, y los artículos 19 de la Declaración Universal de Derechos Humanos, 19 del Pacto Internacional de Derechos Civiles y Políticos, 4 de la Convención Americana de Derechos Humanos, y 13 del Pacto de San José, ya que las personas que no se vacunan tienen el derecho de pensar, de manera distinta o contraria a las personas que sí desean hacerlo, pues no ha habido información clara y veraz de los efectos de esta para la salud de la población. Indica que, si una persona no tiene claridad de los efectos que provocará en su salud, tiene el derecho de sentirse seguro no vacunándose, pues la inoculación no previene el contagio. Además, las personas vacunadas no son inmunes al contagio y pueden infectarse, pues la vacuna no protege de manera indefinida, por lo que las personas vacunadas no tienen inmunidad permanente. Aduce que no se conocen los efectos secundarios a mediano y largo plazo, y que se encuentra aún en fase experimental, sin garantía ni responsabilidad por parte del fabricante, de que sea la única alternativa para salir de la crisis sanitaria por SARS-CoV-2, por lo que las personas que no desean vacunarse tienen el derecho de disentir de hacerlo como parte de su derecho de pensamiento y libre expresión, lo que va muy de la mano con la posibilidad de no dar el consentimiento para la aplicación de una vacuna, porque la dignidad humana debe estar por encima de un supuesto interés de la ciencia o incluso de la sociedad.

El principio de legalidad establecido en los artículos 11 de la Constitución Política y 11 de la Ley General de la Administración Pública, por la utilización del término vacuna en el caso de la inoculación contra la covid-19, la cual no cumple con la característica principal, inducir a la inmunidad activa protectora contra la enfermedad infecciosa correspondiente, según el artículo 1 inciso p) del Reglamento a la Ley Nacional de Vacunas. Están obligando a la población a someterse a una prueba de ensayos clínicos en vivo sin que les digan abiertamente que el perfil de vacuna es experimental, y sin consentimiento informado, de acuerdo con los Comités de Ética y Principios de Buenas Prácticas Clínicas. Refiere que es un perfil de vacuna sin estudios clínicos contundentes, según lo manifestó el propio ministro Salas, por lo que se debe tomar en cuenta que, aunque de manera prematura se catalogó como "vacuna", y ahora lo aprobaron como "vacuna", confirman que no se conoce el periodo de inmunidad, por ende, si no se conoce el tiempo de efectividad hasta terminar el estudio, tampoco se pueden conocer, de manera certera, las contraindicaciones, interacciones y reacciones adversas.

El principio precautorio en materia de salud, ante la obligatoriedad de la vacunación sin realización previa de exámenes médicos. Señala que se ha manejado un doble discurso, porque mientras afirman que las "vacunas" son seguras, por otra parte, aceptan que faltan estudios que demuestren la efectividad y seguridad de las mismas. Es por esta enorme confusión, la falta de datos, estudios sobre la efectividad y seguridad de las vacunas a corto y largo plazo, que la población debe ser resguardada y bajo ninguna circunstancia obligar a las personas a vacunarse, y así lo ha manifestado incluso la Organización Mundial de la Salud.

El principio de jerarquía de las normas, desarrollado en los artículos 7, 48, 129 y 140 inciso 3) de la Constitución Política, pues el decreto cuestionado se contrapone a los instrumentos jurídicos internacionales relativos a Derechos Humanos, tales como los artículos 2, 5, 6, y 7 del Pacto Internacional de Derechos Económicos Sociales y Culturales, el ordinal 12 de la Declaración Universal de Derechos Humanos, y los numerales 1.2, 3, 4 y 5.1 de la Convención Americana de Derechos Humanos. la obligatoriedad de la vacuna violenta estos derechos humanos fundamentales reconocidos internacionalmente, ya que atentan contra la integridad física de las personas, al imponerle a los funcionarios del sector público y extendiéndolo a trabajadores del sector privado, a introducir en su cuerpo una vacuna sin que medie un consentimiento informado, previo, pleno y libre, sin que se respete su autonomía de la voluntad. Asimismo, transgrede gravemente el derecho a la integridad psíquica y moral de las personas, al forzar a dichos funcionarios a inocularse, de forma intimidatoria, ya que, en caso de no hacerlo, se exponen a multas, sanciones administrativas y penales, e incluso al despido sin responsabilidad patronal o revocatoria del nombramiento o designación, como en su caso.

El principio de convencionalidad, pues el país se ha comprometido a garantizar el derecho a la salud, así como a la imposibilidad de recibir injerencias arbitrarias de los gobiernos en las personas.

Leyes posteriores a Ley Nacional de Vacunas, tal como el artículo 2 inciso c) de la ley n.° 8239 del 02 de abril de 2002, “Ley de derechos y deberes de las personas usuarias de los servicios de salud públicos y privados”, pues claramente hace referencia al deber de obtener el consentimiento informado antes de someter a un individuo a cualquier procedimiento médico. Por su parte, el inciso m) de la norma de cita, es claro en señalar el derecho de toda persona a mantener total privacidad sobre su historial clínico, excepto cuando mediante ley especial, deba darse noticia a las autoridades sanitarias, lo cual es evidentemente contrario al artículo 1 del decreto impugnado, debido a que el decreto en cuestión implícitamente obliga al trabajador a revelar información privada, concerniente a su historial clínico a alguien que, según indica el propio decreto, no es una autoridad sanitaria. Aduce también que la obligación de vacunarse y de revelar información referente al historial médico, lesiona lo dispuesto en el artículo 9 inciso 1) de la "Ley Protección de la Persona frente al tratamiento de sus datos personales”, y su trasgresión está sancionada en el ordinal 31.

La jurisprudencia de la Corte Interamericana de Derechos Humanos relacionada con el derecho a la vida y al consentimiento informado, pues el decreto impugnado no solo pone en riesgo el derecho a la vida y a la salud, sino que vulnera todo el sistema democrático, de manera que las bases del Estado de Derecho se ven seriamente afectadas, debido a la intromisión directa, totalitaria y arbitraria del Estado.

El principio de razonabilidad y proporcionalidad en la sanción por no vacunarse (despido sin responsabilidad patronal y/o multa aproximada de 500.000 colones), por la obligatoriedad de la medida en sí, lo cual atenta contra el derecho al trabajo. Señala que las autoridades, en ninguna forma han fundamentado técnica o científicamente el grado de eficacia de la vacuna, en relación con evitar la propagación de la covid-19, por lo que no es posible realizar una valoración de proporcionalidad, necesidad y razonabilidad de la medida que atenta contra el principio de autonomía de la voluntad. Por otro lado, las sanciones por no vacunarse para los funcionarios públicos son desproporcionadas, se trata de tipos penales o administrativos-sancionatorios en blanco, que contravienen el principio de tipicidad penal y administrativa-sancionatoria. Se pretende abrir procedimientos administrativos tendientes a despedir sin responsabilidad patronal a los funcionarios públicos que no se vacunen, o que no le brinden información a la entidad para la cual laboran, sobre si se han vacunado o no, y si tiene el cuadro completo de vacunas o no. Adicionalmente, se amenaza a los funcionarios públicos con la imposición de una multa aproximada de 500.000 colones y la remisión del caso al Ministerio Público para determinar si se está ante la comisión de un delito. De ese modo, las personas trabajadoras se ven coaccionadas a someterse a una inoculación obligatoria, pese a sus temores fundados de sufrir daños a corto o largo plazo en su salud, debido a las inminentes acciones disciplinarias. Cuestiona tanto el término de orden público en que se fundamenta la normativa, como las sanciones para los trabajadores que no se vacunen.

El principio de autodeterminación informativa, relacionado con la información privada contenida en el expediente médico, el derecho a la vida y a la salud, según los artículos 21, 24, 40, 46, 50, 73 de la Constitución Política y el artículo 5 inciso primero de la Convención Americana sobre Derechos Humanos, debido a la desprotección de información de carácter sensible, por tratarse de tema médico, ya que impone la obligación de comunicar a los departamentos de recursos humanos esta información, sin ninguna legitimación legal para hacerlo, violentando, además, la Ley de Protección frente al Tratamiento de sus datos personales. Igualmente, estima que se vulnera por la ausencia de un consentimiento libre e informado, sin la información previa de los posibles efectos de la vacunación, así como de los exámenes anteriores a dicha inoculación.

El derecho a la vida y a la salud (artículos 21, 40, 46, 50 y 73 de la Constitución Política), ya que por la mera condición de ser funcionario público se dispone la obligación de vacunarse, sin que las personas conozcan previamente si corren el riesgo o no de sufrir graves secuelas en su cuerpo, lo cual estima un tratamiento cruel y degradante, al no ponderar que existen personas que tienen diversos padecimientos, ante la ausencia de un consentimiento libre y debidamente informado. Se vulnera, además, el derecho de toda persona de disponer sobre su propio cuerpo.

La potestad reglamentaria establecida en el artículo 140, inciso 3) y 18) de la Constitución Política, y del principio de reserva de ley, por imponer la obligatoriedad de la vacunación sin un consentimiento libre y debidamente informado mediante decreto y no por ley. Obligar a los funcionarios públicos a vacunarse sin que la Caja Costarricense de Seguro Social informe acerca de los posibles efectos, menos aún de los derechos laborales respecto a la póliza de riesgos de trabajo ante un efecto adverso ocasionado, producto de dicha obligatoriedad de la vacunación covid-19, violenta los derechos constitucionales de todos los funcionarios públicos, de forma grosera, respecto a los derechos a la intimidad, integridad y dignidad humana.

El Decreto Ejecutivo n.° 43249-S aquí impugnado, dispone lo siguiente:

“Artículo 1 .-Refórmese el artículo 2 del Decreto Ejecutivo N° 42889-S del 10 de marzo de 2021, denominado Reforma al Decreto Ejecutivo N° 32722-S del 20 de mayo de 2005, denominado Reglamento a la Ley Nacional de Vacunación y Establecimiento de la Obligatoriedad de la Vacuna del COVID-19, para que en adelante se consigne lo siguiente:

"Artículo 2 .- Con fundamento en el artículo 3 de la Ley Nacional de Vacunación, Ley número 8111 del 18 de julio de 2001, así como los ordinales 2 y 18 del Reglamento a la Ley Nacional de Vacunación, Decreto Ejecutivo número 32722 del 20 de mayo de 2005, será obligatoria la vacuna del COVID-19 para el personal establecido por la Comisión Nacional de Vacunación y Epidemiología, en las sesiones extraordinarias número VII-2021 del 16 de febrero del 2021, VIII-2021 del 23 de febrero de 2021 y N° XLV-2021 del día 23 de septiembre de 2021, para el caso de este último acuerdo, será en los términos fijados por la Comisión Nacional de Vacunación y Epidemiología para el sector público y el sector privado.

Para cuando sean citados por los encargados para tal efecto y de acuerdo con la planificación institucional respectiva, las personas contempladas en el párrafo anterior deberán vacunarse, con excepción de aquellos funcionarios que, por contraindicación médica debidamente declarada, no les sea posible recibir la vacuna contra el Covid-19. 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." Visto que, sobre varios de los aspectos señalados por el accionante este Tribunal ya se ha pronunciado, se proceden a citar algunos precedentes, que permitirán resolver varios de los alegatos, de manera conjunta o separada, a continuación.

VI.- Sobre la obligatoriedad de la vacunación, el principio de reserva de ley y el derecho a la vida y la salud.

En sentencia n.° 2021-23195 de las 9:15 horas del 15 de octubre de 2021, reiterada recientemente en la n.° 2021-26519 de las 13:10 horas del 24 de noviembre de 2021, este Tribunal reafirmó su criterio, en relación con la obligatoriedad de la vacunación contra la covid-19, que se establece el decreto aquí impugnado, señalando lo siguiente:

“V.- SOBRE EL CASO CONCRETO. La Sala destaca que, de acuerdo a los informes rendidos por el Ministro de Salud y el Gerente Médico, ambos de la Caja Costarricense de Seguro Social, las vacunas que se aplican en el país, contra el coronavirus COVID-19, no son medicamentos en fase experimental.

VI.- MARCO NORMATIVO: 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:

(…)

• b)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.

Además, 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 énfasis 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”.

De lo anterior, 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, fue definida por la Comisión Nacional de Vacunación y Epidemiologia, de conformidad con las potestades otorgadas por la Ley Nacional de Vacunación. Esto llevó a que se emitiera el Decreto No.42889-S “Reforma Reglamento a la Ley Nacional de Vacunación” (Decreto Ejecutivo No.32722-S de 20 de mayo de 2005) en aras de incluir la vacuna en cuestión en el esquema nacional de vacunación.

Asimismo, en ejercicio de las mismas facultades, en el artículo 2 del Decreto No.42889-S, se estableció la obligatoriedad de “la vacuna del Covid-19 para el personal establecido por la Comisión Nacional de Vacunación, en las sesiones extraordinarias número VII-2021 del 16 de febrero del 2021 y VIII del 23 de febrero de 2021”.

Por otro lado, el artículo N° 18 del Decreto Ejecutivo N° 32722, detalla la lista oficial de vacunas, incluidas en el Esquema Público Básico Universal de Costa Rica, artículo reformado por el artículo 1° del decreto ejecutivo N° 42889 del 10 de marzo del 2021, siendo específicamente, en el punto N° 15, en el que se incluye Covid-19.

Por su parte, resulta importante señalar, que el artículo N° 150 de la Ley General de Salud, Ley N° 5395 del 30 de octubre de 1973, de orden público que debe ser cumplida por toda persona que habite nuestro país, también hace mención de la obligatoriedad de la vacunación y revacunación, contra enfermedades transmisibles que determine el Ministerio de Salud.

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 el personal de salud, debe ser entendida a la luz de lo dispuesto por la Ley Nacional de Vacunación, que define el marco general regulatorio en la materia.

VII.- 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 más reciente 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 período 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, las personas amparadas 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 período 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.

VIII.- Asimismo, este Tribunal no puede obviar la prueba aportada en otros recursos de amparo, 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.

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…” El criterio expuesto resulta de plena aplicación al objeto de esta acción. Esta Sala ha descartado que el decreto ejecutivo n.° 42889-S, modificado por el decreto n.° 43249-S, lesione el principio de reserva de ley en la regulación de los derechos fundamentales, toda vez que la aplicación obligatoria de la vacuna contra el coronavirus COVID-19, fue definida por la Comisión Nacional de Vacunación y Epidemiologia, de conformidad con las potestades otorgadas por la Ley Nacional de Vacunación, que define el marco general regulatorio en la materia. De ahí que el decreto aquí impugnado, resulte conforme con la normativa existente al incluir la vacuna en cuestión en el esquema nacional de vacunación autorizado mediante ley.

Por otro lado, tal como lo indica el precedente supra citado y la sentencia n.° 2021-26519, el personal a vacunar será definido bajo el 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, cuyo fundamento no corresponde ser revisado en esta jurisdicción, por tratar aspectos técnicos, médicos y científicos que versan sobre la vulnerabilidad a un virus. Tampoco se trata de una vacuna cuyos estudios, respecto de los efectos, se encuentren en fase experimental, según lo ha tenido por acreditado este Tribunal en diversos recursos de amparo. De modo que, si el accionante disiente de tal criterio, igualmente es una discusión técnica que no correspondería ser dilucidada en esta jurisdicción, sino en la vía de legalidad, a través de los distintos medios de prueba que esa vía contempla y que permite su amplia discusión y verificación técnica y científica. Así las cosas y conforme lo expuesto, no se estima que se esté lesionando el derecho a la salud de las personas, lejos de ello, se pretende asegurarla a nivel colectivo, por un interés público. Así lo señaló este Tribunal en las sentencias supra citadas y al referirse a la legitimidad en general del fin que persigue el establecer el carácter obligatorio de una vacuna, en la sentencia n.° 2020-0019433 de las 09:20 horas de 9 de octubre de 2020, al indicar lo siguiente:

“(…) 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 precedente citado previamente -n.° 2021-23195-, también descarta la afirmación del accionante de que la población no ha sido informada de los efectos reales que puede producir la vacuna en cuestión, ni que se haya advertido de los riesgos al respecto, al señalar:

“VII.- 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 más reciente 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 período 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, las personas amparadas 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 período 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.” Tampoco es cierto que no se ponderan los padecimientos de las personas, lesionando su derecho a la salud. El decreto impugnado excluye de la vacunación obligatoria contra la covid-19, a aquellos funcionarios que, por contraindicación médica debidamente declarada no les sea posible ser vacunados, resguardando su derecho a la salud. Para tales efectos, el artículo 2 impugnado dispone:

"Artículo 2 .- Con fundamento en el artículo 3 de la Ley Nacional de Vacunación, Ley número 8111 del 18 de julio de 2001, así como los ordinales 2 y 18 del Reglamento a la Ley Nacional de Vacunación, Decreto Ejecutivo número 32722 del 20 de mayo de 2005, será obligatoria la vacuna del COVID-19 para el personal establecido por la Comisión Nacional de Vacunación y Epidemiología, en las sesiones extraordinarias número VII-2021 del 16 de febrero del 2021, VIII-2021 del 23 de febrero de 2021 y N° XLV-2021 del día 23 de septiembre de 2021, para el caso de este último acuerdo, será en los términos fijados por la Comisión Nacional de Vacunación y Epidemiología para el sector público y el sector privado.

Para cuando sean citados por los encargados para tal efecto y de acuerdo con la planificación institucional respectiva, las personas contempladas en el párrafo anterior deberán vacunarse, con excepción de aquellos funcionarios que, por contraindicación médica debidamente declarada, no les sea posible recibir la vacuna contra el Covid-19. 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." Igualmente, en sentencia n.° 2021-19469 de las 9:20 horas del 31 de agosto de 2021, esta Sala, indicó: “Es decir, las personas amparadas 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.” Corolario de lo expuesto, se descartan las alegadas violaciones al derecho a la vida, la salud, al principio de reserva de ley y de autodeterminación frente a la obligatoriedad de la vacunación contra la covid-19.

VII.- Sobre el consentimiento informado y la protección de la información sensible. En sentencia n.° 2021-24027 de las 10:10 horas del 26 de octubre de 2021, este Tribunal se pronunció sobre este alegato, en relación con el decreto aquí impugnado, reiterando sus precedentes en el siguiente sentido:

“IX. - La parte recurrente insistió en que no se le aplique la vacunación obligatoria sin que medie un consentimiento informado en el que se indique a los pacientes que se trata de un medicamento experimental. Al respecto, es preciso señalar que las autoridades sanitarias competentes en la materia han rechazado que se trate un medicamento experimental, tal y como se señaló supra. En un segundo orden de ideas, convendría destacar que el reconocimiento a la necesidad de que se otorgue un consentimiento informado parte del reconocimiento de los derechos de autonomía e información de los pacientes. Es decir, sobre la base de la información proporcionada por su médico tratante, un paciente opta por aceptar o rechazar una prestación médica. En el caso concreto, como se ha examinado, existen suficientes disposiciones que legitiman la obligatoriedad de la vacuna, por lo que la autonomía, en tales supuestos, se ve disminuida en aras de tutelar el interés y el bienestar general, a saber, la salud pública (art. 21 de la Constitución Política, art. 1° de la Ley General de Salud y normativa sobre vacunación supra citada). Ello no obsta para enfatizar que en todos los casos se debe respetar el derecho a la información de todas las personas a las que se les somete a esta vacunación obligatoria. Sobre el particular, conviene citar nuevamente el Manual de Procedimientos para la ejecución de vacunación contra COVID-19 en los establecimientos de salud de la Caja Costarricense de Seguro Social, que exige justamente velar por el derecho a la información de los usuarios y que dispone lo siguiente:

“8.6 Información al usuario:

La educación al usuario debe de ser obligatoria antes, durante y después de la vacunación:

- Antes de vacunar se debe de realizar consejería y educar a la persona a vacunar, se debe preguntar si padece de alguna alergia, si está embarazada, si es una persona anticoagulada (uso de Heparina o Warfarina). Ya que en caso de cualquiera de estas condiciones la vacunación debe ser intramuros.

-Es de suma importancia explicar al usuario cuál vacuna se le aplicó (Si Pfizer/BioNTech o AstraZeneca) e indicarle que la segunda dosis que se le tiene que aplicar debe ser la misma.

Además, se debe reiterar al paciente la importancia de cumplir con la fecha de aplicación de la segunda dosis tal y como se le indica.

-Anotarle en el carné de vacunación el tipo de vacuna y la fecha de aplicación de la primera y de la segunda dosis.

-Brindar información al usuario sobre los beneficios de recibir la vacuna y sobre los principales efectos secundarios y la importancia de consultar a los servicios de salud en caso de que durante las 3 semanas posteriores a la vacunación presenten dificultad para respirar, dolor en el pecho, visión borrosa o doble, hematomas únicos o múltiples, machas rojizas o violáceas, hinchazón o dolor de una pierna, dolor abdominal persistente, dolor de cabeza intenso o que empeoran más después de 3 días de vacunación).

-Información sobre efectos secundarios reportados y sobre los que podrían presentarse cuando la misma empiece a aplicarse de manera masiva en la población. Y la forma en que se deben de notificar en caso de que alguno de ellos se presente después de vacunados.

-En el caso de la vacuna AstraZeneca, se debe indicar a la persona vacunada la importancia de notificar al igual que con la vacuna de Pfizer algún efecto adverso por medio de los canales ya conocidos.” De lo anterior se concluye que las autoridades están instruidas sobre la obligación de respetar el derecho a la información de los pacientes, y no consta que hayan omitido lo necesario para que haya sido ejercido. En consecuencia, se desestima este extremo del recurso.” A partir de lo anterior, la postura de este Tribunal, cuyo criterio mantiene, es que, aun cuando la vacunación resulte obligatoria para aquellos casos en que no esté médicamente contraindicada, debe brindarse la información necesaria a la persona, a los efectos de resguardar previamente su vida y salud, adoptando las medidas que estime pertinentes. Ahora bien, tal como ahí lo ha señalado este Tribunal y el propio accionante, existen otras disposiciones que complementan el decreto aquí impugnado en relación con el deber de brindar la información suficiente y adecuada de previo a la vacunación; así como existe normativa especial que ordena el resguardo de los datos privados de las personas, y que debe ser garantizada por organismos públicos o privados (artículo 2 de la Ley de Protección de la Persona frente al tratamiento de sus datos personales). De manera que, el hecho de que no lo contemple expresamente esta disposición, no implica su inconstitucionalidad, pues al momento de su aplicación, los funcionarios públicos no están eximidos de las obligaciones establecidas en el resto del ordenamiento jurídico, en los términos aquí señalados; e igualmente, existen instancias encargadas legalmente para verificar su cumplimiento. Por ejemplo, el artículo 13 de esa misma ley referida establece como garantía efectiva: “Toda persona interesada tiene derecho a un procedimiento administrativo sencillo y rápido ante la Prodhab, con el fin de ser protegido contra actos que violen sus derechos fundamentales reconocidos por esta ley. Lo anterior sin perjuicio de las garantías jurisdiccionales generales o específicas que la ley establezca para este mismo fin.”. Por consiguiente, se descartan las violaciones acusadas.

VIII.- Sobre la acusada violación al principio de igualdad. El accionante señala que la normativa impugnada lesiona ese principio, por cuanto establece un trato discriminatorio en perjuicio del trabajador del sector público, para quien es obligatoria la vacuna; sin embargo, para los del sector privado, lo deja al arbitrio del patrono. Refiere que no existe una justificación técnica que demuestre la necesidad de obligar a todos los funcionarios públicos a vacunarse. Cuestiona que, por decreto ejecutivo se obligue a vacunar a funcionarios de otros poderes y municipios, lesionando su autonomía. Sin embargo, el accionante omite fundamentar su argumento, aplicando el debido examen de razonabilidad a la normativa cuestionada. Esta Sala, en reiteradas ocasiones ha señalado lo siguiente:

“Para emprender un examen de razonabilidad de una norma, el Tribunal Constitucional requiere que la parte aporte prueba o al menos elementos de juicio en los que sustente su argumentación e igual carga procesal le corresponde a quien rebata los argumentos de la acción y la falta en el cumplimiento de estos requisitos, hace inaceptables los alegatos de inconstitucionalidad. Lo anterior, debido a que no es posible hacer un análisis de "razonabilidad" sin la existencia de una línea argumentativa coherente que se encuentre probatoriamente respaldada. Ello desde luego, cuando no se trate de casos cuya "irrazonabilidad" sea evidente y manifiesta” (Sentencia n.° 1999-5236 de las 14:00 horas del 7 de julio de 1999, reiterada en las sentencias 2016-14392 de las 9:05 horas del 5 de octubre de 2016, 2019-6935 de las 11:20 horas del 24 de abril de 2019 y 2021-11995 de las 16:31 horas del 26 de mayo de 2021).

Sin la realización del test respectivo, la línea argumentativa del accionante carece de fundamentación, pues de la simple afirmación del gestionante se denotan dos relaciones que no son equiparables, ya que pretende comparar una relación de empleo público con una privada, a pesar de tratarse de dos regímenes con regulaciones totalmente diferentes. En reiteradas ocasiones, este Tribunal se ha pronunciado sobre el régimen estatutario y su diferencia con el sector privado en este sentido:

“III.- Sobre el régimen estatutario. Nuestros constituyentes originales consignaron en la Constitución Política de 1949, que debía existir un régimen laboral administrativo que regulara las relaciones entre los servidores públicos y el Estado, a fin de proteger a los primeros de destituciones arbitrarias (estabilidad en el empleo) y de profesionalizar la función pública (búsqueda de la eficiencia en el servicio y de la idoneidad del funcionario). El objeto de tal cometido fue procurar que la Administración Pública contara con factores organizativos que le permitieran satisfacer el derecho de los ciudadanos al buen funcionamiento de los servicios públicos. Para ello, el procedimiento para seleccionar y nombrar a un servidor en la Administración Pública, debe cumplir con los principios fundamentales que prevén los artículos 191 y 192 constitucionales, con lo que se procura personal idóneo para ocupar un puesto público, con el propósito de garantizar la eficiencia y efectividad en la función pública. El régimen de servicio civil no se erige entonces como un privilegio corporativo, sino como una garantía de la imparcialidad institucional. Para ello, el marco normativo que regula la función pública, debe garantizar la selección del personal con base en criterios de mérito y capacidad, así como en un justo equilibrio entre derechos y responsabilidades de los empleados públicos. También, dicha legislación debe prever instrumentos que a las diferentes administraciones les faciliten la planificación, ordenación y utilización más eficiente de su personal. De ahí que la relación laboral de empleo público esté sujeta a ciertas especificidades y principios, como los de mérito y capacidad en el acceso, y también a determinadas normas de derecho público, como el régimen de incompatibilidades, que garanticen objetividad e imparcialidad en la prestación del servicio público… claro y evidente, que , a partir del año 1949, el ordenamiento jurídico que regula la relación de empleo entre la administración pública y sus servidores en nuestro país, se rige por el derecho público, principio que se reitera en el artículo 112 de la Ley General de la Administración Pública (ver al efecto, la sentencia n.° 1995-3125 de las 16:24 horas del 14 de junio de 1995). Este régimen implica, necesariamente - como se indicó en el precedente supracitado - que esa relación, por su propia naturaleza, se basa en principios generales propios, no solo distintos a los del derecho laboral (privado), sino incluso muchas veces contrapuestos a estos… Menos aún, cuando tales disposiciones laborales podrían ser impuestas al Estado en su condición de patrono, por órganos externos a este en los que confluyen intereses ajenos, y a veces contrarios a los fines de la administración pública. De acuerdo con lo señalado por la Sala en la sentencia n.° 2003-10615, la redacción finalmente dada al artículo 191, junto con el proceso de profunda descentralización que que actualmente resulte válida la existencia de diversas relaciones estatutarias en la Administración, en atención a la independencia funcional y autonomía administrativa que el ordenamiento asegura a varias instituciones públicas. Sin embargo, “lo que no resulta legítimo –según se dijo- es que las relaciones entre cada Administración-patrono y sus funcionarios se rijan por reglas concertadas (contractuales) entre ambas partes, como válidamente ocurre en las relaciones de empleo privado.” La Sala ha reconocido que existen dos grandes categorías de empleados que prestan sus servicios al Estado: los que tienen la condición de "funcionario público", "servidor público", o de "empleado público", y los que laboran para empresas o servicios económicos del Estado, encargados de gestiones sometidas al derecho común. Los primeros han sido definidos, como aquellos que en el desempeño de sus funciones realizan la gestión pública del Estado, a los que en -consecuencia- les es aplicable el régimen de empleo público, con todos los principios y características que derivan de lo dispuesto en los numerales 191 y 192 de la Constitución Política; y mientras que los segundos son aquellos obreros, trabajadores y empleados que si bien laboran para el Estado, no tienen la condición de funcionarios o servidores públicos por no participar en la gestión pública de la administración, toda vez que son contratados por empresas públicas o de servicios económicos del Estado encargados de gestiones sometidas al derecho común conforme al ejercicio de su capacidad de derecho privado, en virtud de lo cual su régimen de empleo se rige con las normas del derecho común, esto es, la legislación ordinaria laboral (ver sentencia n.° 2006-14416).

Corolario de lo anterior, la relación de empleo público que aplica a los servidores públicos, es una relación especial de derecho público o estatutaria, que por tal naturaleza jurídica tiene limitaciones en cuanto a la aplicación del derecho laboral común . Asimismo, su regulación está sometida a los ordinales 11, 191 y 192 de la Constitución Política…”. (Sentencia n.° 2018-231 de las 11:00 horas del 10 de enero de 2018). (El énfasis no es del original).

Aunado a lo anterior, respecto del alegato de que por decreto ejecutivo se obligue a vacunar a funcionarios de otros poderes y municipios, lesionando su autonomía, debe advertirse al accionante que, esta Sala ha señalado en reiteradas ocasiones, que la defensa de la autonomía de las instituciones públicas solo resulta invocable por parte de sus propios órganos y no por tercera persona (véanse las sentencias n.° 2019-16766 de las 9:20 horas del 4 de setiembre de 2019 y 2021-11995 de las 16:31 horas del 26 de mayo de 2021, entre otras). En ese sentido, el accionante carece de legitimación para plantear tal reproche. Por consiguiente, los alegatos en relación con el principio de igualdad resultan improcedentes.

IX.- Sobre la alegada violación a la libertad de expresión y de pensamiento. Aduce el accionante que las personas que no se vacunan tienen el derecho de pensar, de manera distinta o contraria a las personas que sí desean hacerlo, pues no ha habido información clara y veraz de los efectos de lo que denominan vacuna contra la covid-19 para la salud de la población. Indica que, si una persona no tiene claridad de los efectos que provocará en su salud, tiene el derecho de sentirse seguro no vacunándose, pues la inoculación no previene el contagio. Además, las personas vacunadas no son inmunes al contagio y pueden infectarse, pues la vacuna no protege de manera indefinida, por lo que las personas vacunadas no tienen inmunidad permanente. Aduce que no se conocen los efectos secundarios a mediano y largo plazo, y que se encuentra aún en fase experimental, sin garantía ni responsabilidad por parte del fabricante, de que sea la única alternativa para salir de la crisis sanitaria por SARS-CoV-2, por lo que las personas que no desean vacunarse tienen el derecho de disentir de hacerlo como parte de su derecho de pensamiento y libre vacuna, porque la dignidad humana debe estar por encima de un supuesto interés de la ciencia o incluso de la sociedad. Las razones por las cuales el accionante aduce lesionada la libertad de pensamiento y de información respecto de la vacunación y sus efectos sí se ha difundido, y que esta no se encuentra en fase deriva de un interés público en salvaguardar la salud del colectivo, el cual se encuentra justificado legalmente en el artículo 46 del Código Civil, en el artículo 147, el inciso 3 del ordinal 345 de la Ley General de Salud y en el numeral 3 de la Ley Nacional de Vacunación. Se ha difundido en cuáles supuestos está contraindicada y se ha establecido que, a pesar de la obligatoriedad de vacunarse, las personas efectivamente tienen derecho a obtener previamente la información necesaria para resguardar su salud.

En relación con estos derechos, este Tribunal en la sentencia n.° 2018-17048 de las 9:15 horas del 12 de octubre de 2018, ha señalado lo siguiente:

“Sobre la libertad de pensamiento y expresión, la Convención Americana de Derechos Humanos preceptúa en el ordinal 13 lo siguiente:

“Artículo 13. Libertad de Pensamiento y de Expresión.

1. Toda persona tiene derecho a la libertad de pensamiento y de expresión. Este derecho comprende la libertad de buscar, recibir y difundir informaciones e ideas de toda índole, sin consideración de fronteras, ya sea oralmente, por escrito o en forma impresa o artística, o por cualquier otro procedimiento de su elección.

2. El ejercicio del derecho previsto en el inciso precedente no puede estar sujeto a previa censura sino a responsabilidades ulteriores, las que deben estar expresamente fijadas por la ley y ser necesarias para asegurar:

• a)el respeto a los derechos o a la reputación de los demás, o b) la protección de la seguridad nacional, el orden público o la salud o la moral públicas.

3. No se puede restringir el derecho de expresión por vías o medios indirectos (…)” (énfasis agregado).

En esta línea, la Corte Interamericana ha sido conteste al señalar que, a la luz de los ordinales 13 y 29 de la Convención Americana de Derechos Humanos, las limitaciones a la libertad de expresión deben ser compatibles con las necesidades y fines legítimos de una democracia, estar dispuestas en una ley en sentido formal, y ser necesarias y útiles para perseguir dichos fines. Así las cosas, se ha indicado que “las únicas restricciones legítimas del derecho a la libertad de expresión se ejercen mediante la responsabilidad ulterior en el caso de que se abuse de ese derecho. No obstante, la imposición de dicha responsabilidad debe satisfacer cuatro exigencias para que tenga validez en virtud del artículo 13(2): 1) los fundamentos para establecer la responsabilidad deben fijarse previamente; 2) estos fundamentos deben estar expresos con precisión dentro del marco de la ley; 3) los fines que se persiguen deben ser legítimos; y, 4) los fundamentos para establecer la responsabilidad deben ser necesarios para asegurar el fin legítimo que se procura.” (Informe sobre la compatibilidad entre las leyes de desacato y la Convención Americana sobre Derechos Humanos, CIDH, http://www.cidh.oas.org/annualrep/94span/cap.V.htm).” Ahora bien, el decreto en cuestión no impide que las personas piensen de otra manera y expresen su inconformidad al respecto. Y si bien dispone que, a pesar de lo que piensan, deban someterse obligatoriamente a la vacunación, es por una limitación de orden público, motivo por el cual sí puede ser limitado el ejercicio de los derechos fundamentales. Precisamente, la Sala, al evacuar la consulta legislativa n.° 00-009914-0007-CO, respecto de lo que actualmente es la Ley Nacional de Vacunación, en sentencia n.° 2000-11648, se pronunció en el siguiente sentido:

“V.- Obligatoriedad de la vacunación, artículos 2,3,6 y 11 del proyecto. De previo analizar el reclamo planteado por los diputados consultantes, se transcribirán las normas que en criterio de los consultantes podrían ser inconstitucionales por ser contrarias al principio de la autonomía de la voluntad. Los artículos rezan lo siguiente:

"Artículo 2.- GRATUIDAD Y ACCESO EFECTIVO Garantízase a toda la población la obligatoriedad y gratuidad de las vacunas, así como el acceso efectivo a la vacunación, en especial, para la niñez, los inmigrantes y los sectores ubicados por debajo del índice de pobreza." "Artículo 3.-OBLIGATORIEDAD De conformidad con la presente Ley, son obligatorias las vacunaciones contra las enfermedades cuando lo estime necesario la Comisión Nacional de Vacunación y Epidemología, que se crea en esta Ley, en coordinación con el Ministerio de Salud y la Caja Costarricense de Seguro Social..." "Artículo 6.- FUNCIONES La Comisión tendrá como funciones y objetivos básicos:

Garantizar la obligatoriedad y gratuidad de las vacunas y el acceso efectivo de toda la población a ellas..." "Artículo 11.- POBLACIÓN META, CONDICIONES Y AUTORIZACION La Comisión, junto con las autoridades del Ministerio de Salud y la Caja Costarricense de Seguro Social, determinará los sectores de población que deban ser vacunados; además, decidirá si la vacunación es obligatoria o facultativa o dispondrá en qué condiciones deberán suministrarse las vacunas, conforme a los programas que se establezcan al efecto..." Teniendo en cuenta lo dispuesto por las normas transcritas, así como la exposición de motivos del proyecto que se consulta, no considera esta Sala que lleven razón los consultantes, al decir que al establecerse la obligatoriedad de las vacunas sea lesivo del derecho de autonomía de la voluntad. La salud como medio y como fin para la realización personal y social del hombre constituye un derecho humano y social cuyo reconocimiento está fuera de discusión. Es uno de los derechos del hombre que emana de su dignidad como ser humano. De este derecho surge tanto para el individuo y la comunidad organizada, como para el propio estado, una responsabilidad respecto a la salud. En instrumentos internacionales y en declaraciones constitucionales de derechos sociales se incluye el derecho a la salud, a cuyo reconocimiento debe aunarse la imposición del deber de cuidar la salud propia y la ajena . Es así que dentro de una política social global dirigida a solucionar los efectos de las deficiencias sociales, la observancia del principio de la coherencia de los fines, determina que se armonicen las acciones sobre condiciones de trabajo, seguridad social, educación, vivienda, nutrición y población con las de la salud, por la conexidad e interdependencia de una y otra. De esa forma la enunciación en el proyecto consultado de la provisión de asistencia médica gratuita y obligatoria, para toda la población, de ningún modo lesiona el principio de autonomía de la voluntad, mas sin embargo sí garantiza la asistencia sanitaria esencial en resguardo de la responsabilidad ineludible del Estado de velar por la salud de todos y cada uno de los ciudadanos.” Asimismo, y en particular respecto de las limitaciones que caben a otros derechos fundamentales frente al derecho a la vida y la salud, este Tribunal ha establecido lo siguiente:

“En cuanto al primer tema, debe indicarse que, efectivamente, el Derecho de la Constitución reconoce expresamente el derecho de toda persona a la libertad de pensamiento, de conciencia y de religión. Incluso, en el caso específico de los niños, el artículo 14 de la citada Convención sobre los Derechos del Niño establece expresamente:

“Artículo 14 1. Los Estados Partes respetarán el derecho del niño a la libertad de pensamiento, de conciencia y de religión.

2. Los Estados Partes respetarán los derechos y deberes de los padres y, en su caso, de los representantes legales, de guiar al niño en el ejercicio de su derecho de modo conforme a la evolución de sus facultades.

3. La libertad de profesar la propia religión o las propias creencias estará sujeta únicamente a las limitaciones prescritas por la ley que sean necesarias para proteger la seguridad, el orden, la moral o la salud públicos o los derechos y libertades fundamentales de los demás.” (Lo subrayado no corresponde al original).

Con lo que se constata que dicho numeral reconoce la posibilidad de imponer límites razonables al ejercicio de los referidos derechos para proteger la salud pública. En cuyo caso, cabe reiterar que esta Sala ya ha reconocido 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. Nótese que, en este caso, con la aplicación de las referidas vacunas se pretende no solo tutelar la vida y la salud de la menor amparada, sino que la vida y la salud de los demás miembros de la comunidad -incluidos, especialmente, otros niños-, en la medida que dicho plan de vacunación lo que procura es evitar el riesgo potencial de brotes epidémicos de enfermedadas infecciosas que incluso pueden provocar discapacidades permanentes (p.ej. la rubéola congénita) o la muerte (p. ej. el sarampión) de las personas contagiadas, por lo que está en juego la preservación y resguardo de la salud pública. Por lo que debe recordarse que esta Sala ha resaltado:

“(…) La preponderancia de la vida y de la salud, como valores supremos de las personas, está presente y señalada como de obligada tutela para el Estado, no sólo en la Constitución Política, sino también en diversos instrumentos internacionales suscritos por el país como la Declaración Universal de Derechos Humanos, la Convención Americana sobre Derechos Humanos, de la Declaración Americana de los Derechos y Deberes del Hombre y el Pacto Internacional de Derechos Civiles y Políticos. Debe quedar claro no sólo la relevancia de los valores para los cuales el actor reclama tutela, sino también el grado de compromiso que el Estado costarricense ha adquirido en cuanto a acudir de manera incuestionable e incondicional en su defensa. (sentencia número 2000-01954 de las 8:53 horas del 3 de marzo del 2000)” (Sentencia n.° 2020-19433 de las 9:20 horas del 9 de octubre de 2020) En el sub examine ha quedado acreditado que, ambas libertades -pensamiento y expresión-, como todo derecho fundamental, no son absolutas. En todo caso, el decreto impugnado no impide, en modo alguno, la libertad de buscar, recibir y difundir informaciones e ideas de toda índole, aun cuando sean contrarias la vacunación contra la covid-19. Y si bien la manifestación de estas no puede ejercerlas oponiéndose a la vacunación, lo cierto es que ello es una limitación razonable frente a la necesidad del Estado de proteger el derecho fundamental a la salud de todas las personas y prevenir las enfermedades, que tal como en este caso ha tenido efectos mundiales devastadores públicamente constatables. En la sentencia n.° 2021-26519 de las 13:10 horas del 24 de noviembre de 2021, este Tribunal reiteró que, la vacunación contra la covid-19, se trata de una disposición idónea que protege a los mismos funcionarios, coadyuva a lograr una pronta reactivación no solo de los servicios de salud sino en general, reduciendo los costos inherentes a la situación que esta pandemia ha provocado. Además, coadyuva a prevenir que cualquier lugar de trabajo sea una fuente de contagio, y no existe a la fecha, otra alternativa o herramienta con igual o mayor eficacia para proteger la salud de toda la población. Debe tomar en consideración el accionante, que los beneficios de la disposición en estudio trascienden a la sociedad en su conjunto –respecto del derecho a la vida, a la salud y el mejoramiento de las condiciones económicas y sociales, según se desprende de la fundamentación dada en la misma normativa en cuestión–, aspectos que tal y como ya ha sido señalado, son mayores que la afectación que podría recibir un solo trabajador. En consecuencia, se rechaza por el fondo el extremo en cuestión.

X.- Sobre la acusada vulneración al principio de legalidad y a leyes posteriores a la Ley de Vacunas. El accionante señala violentado el principio de legalidad, por cuanto, en su criterio, la utilización del término vacuna en el caso de la inoculación contra la covid-19, no cumple con la característica principal, que es inducir a la inmunidad activa protectora contra la enfermedad infecciosa correspondiente, según el artículo 1 inciso p) del Reglamento a la Ley Nacional de Vacunas. Están obligando a la población a someterse a una prueba de ensayos clínicos en vivo sin que les digan abiertamente que el perfil de vacuna es experimental, y sin consentimiento informado, de acuerdo con los Comités de Ética y Principios de Buenas Prácticas Clínicas. Refiere que es un perfil de vacuna sin estudios clínicos contundentes, y que, si no se conoce el tiempo de efectividad hasta terminar el estudio, tampoco se pueden conocer, de manera certera, las contraindicaciones, interacciones y reacciones adversas.

Al respecto procede reiterar, que esta Sala ha descartado que el decreto ejecutivo n.° 42889-S, modificado por el decreto n.° 43249-S, lesione el principio de reserva de ley en la regulación de los derechos fundamentales, toda vez que la aplicación obligatoria de la vacuna contra el coronavirus COVID-19, fue definida por la Comisión Nacional de Vacunación y Epidemiologia, de conformidad con las potestades otorgadas por la Ley Nacional de Vacunación, que define el marco general regulatorio en la materia. En ese sentido, el decreto aquí impugnado, resulta conforme con la normativa existente al incluir la vacuna en cuestión en el esquema nacional de vacunación autorizado mediante ley, de manera que tampoco lesiona el principio de legalidad. Igualmente se reitera que, el personal a vacunar será definido bajo el 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, cuyo fundamento no corresponde ser revisado en esta jurisdicción, por tratar aspectos técnicos, médicos y científicos que versan sobre la vulnerabilidad a un virus; y que tampoco se trata de una vacuna cuyos estudios, respecto de los efectos, se encuentre en fase que, si disiente del criterio de las autoridades públicas en relación con tales aspectos, incluso en denominarle “vacuna”, igualmente es una discusión técnica que no correspondería ser dilucidada en esta jurisdicción, sino en la vía de legalidad, a través de los distintos medios de prueba que esa vía contempla y que permite su amplia discusión y verificación técnica y científica.

Por otro lado, este Tribunal ha advertido, en reiteradas ocasiones -véase la sentencia 2021-11972 de las 9:30 horas del 26 de mayo de 2021-, que la aparente confrontación entre una norma legal y un decreto, supone un conflicto de legalidad, cuya discusión no corresponde a esta jurisdicción. De ahí que el extremo planteado por el accionante en relación con la violación de otras normas de menor rango que la Constitución Política, también deba ser rechazado.

XI.- Sobre la alegada violación a los principios de convencionalidad, de jerarquía de las normas y de la jurisprudencia de la Corte Interamericana de Derechos Humanos relacionada con el derecho a la vida y al consentimiento informado.

Refiere el gestionante que el decreto cuestionado se contrapone a los instrumentos jurídicos internacionales relativos a Derechos Humanos, tales como los artículos 2, 5, 6, y 7 del Pacto Internacional de Derechos Económicos Sociales y Culturales, el ordinal 12 de la Declaración Universal de Derechos Humanos, y los numerales 1.2, 3, 4 y 5.1 de la Convención Americana de Derechos Humanos, por cuanto, el disponer la obligatoriedad de la vacuna contra la covid-19 a los trabajadores, sin que medie un consentimiento informado, previo, pleno y libre, y sin que se respete su autonomía de la voluntad atenta contra la integridad física de las personas. Los instrumentos internacionales en cuestión disponen lo siguiente:

Del Pacto Internacional de Derechos Económicos Sociales y Culturales:

“Artículo 2 1. Cada uno de los Estados Partes en el presente Pacto se compromete a adoptar medidas, tanto por separado como mediante la asistencia y la cooperación internacionales, especialmente económicas y técnicas, hasta el máximo de los recursos de que disponga, para lograr progresivamente, por todos los medios apropiados, inclusive en particular la adopción de medidas legislativas, la plena efectividad de los derechos aquí reconocidos.

2. Los Estados Partes en el presente Pacto se comprometen a garantizar el ejercicio de los derechos que en él se enuncian, sin discriminación alguna por motivos de raza, color, sexo, idioma, religión, opinión política o de otra índole, origen nacional o social, posición económica, nacimiento o cualquier otra condición social.

3. Los países en desarrollo, teniendo debidamente en cuenta los derechos humanos y su economía nacional, podrán determinar en qué medida garantizarán los derechos económicos reconocidos en el presente Pacto a personas que no sean nacionales suyos.” “Artículo 5 1. Ninguna disposición del presente Pacto podrá ser interpretada en el sentido de reconocer derecho alguno a un Estado, grupo o individuo para emprender actividades o realizar actos encaminados a la destrucción de cualquiera de los derechos o libertades reconocidos en el Pacto, o a su limitación en medida mayor que la prevista en él.

2. No podrá admitirse restricción o menoscabo de ninguno de los derechos humanos fundamentales reconocidos o vigentes en un país en virtud de leyes, convenciones, reglamentos o costumbres, a pretexto de que el presente Pacto no los reconoce o los reconoce en menor grado.” “Artículo 6 1. Los Estados Partes en el presente Pacto reconocen el derecho a trabajar, que comprende el derecho de toda persona a tener la oportunidad de ganarse la vida mediante un trabajo libremente escogido o aceptado, y tomarán medidas adecuadas para garantizar este derecho.

2. Entre las medidas que habrá de adoptar cada uno de los Estados Partes en el presente Pacto para lograr la plena efectividad de este derecho deberá figurar la orientación y formación técnico profesional, la preparación de programas, normas y técnicas encaminadas a conseguir un desarrollo económico, social y cultural constante y la ocupación plena y productiva, en condiciones que garanticen las libertades políticas y económicas fundamentales de la persona humana.” “Artículo 7 Los Estados Partes en el presente Pacto reconocen el derecho de toda persona al goce de condiciones de trabajo equitativas y satisfactorias que le aseguren en especial:

• a)Una remuneración que proporcione como mínimo a todos los trabajadores:
• i)Un salario equitativo e igual por trabajo de igual valor, sin distinciones de ninguna especie; en particular, debe asegurarse a las mujeres condiciones de trabajo no inferiores a las de los hombres, con salario igual por trabajo igual; ii) Condiciones de existencia dignas para ellos y para sus familias conforme a las disposiciones del presente Pacto; b) La seguridad y la higiene en el trabajo; c) Igual oportunidad para todos de ser promovidos, dentro de su trabajo, a la categoría superior que les corresponda, sin más consideraciones que los factores de tiempo de servicio y capacidad; d) El descanso, el disfrute del tiempo libre, la limitación razonable de las horas de trabajo y las vacaciones periódicas pagadas, así como la remuneración de los días festivos.” De la Declaración Universal de Derechos Humanos:

“Artículo 12 Nadie será objeto de injerencias arbitrarias en su vida privada, su familia, su domicilio o su correspondencia, ni de ataques a su honra o a su reputación. Toda persona tiene derecho a la protección de la ley contra tales injerencias o ataques.” De la Convención Americana de Derechos Humanos:

“Artículo 1 Obligación de Respetar los Derechos 1. Los Estados Partes en esta Convención se comprometen a respetar los derechos y libertades reconocidos en ella y a garantizar su libre y pleno ejercicio a toda persona que éste sujeta a su jurisdicción, sin discriminación alguna por motivos de raza, color, sexo, idioma, religión, opiniones políticas o de cualquier otra índole, origen nacional o social, posición económica, nacimiento o cualquier otra condición social.

2. Para los efectos de esta Convención, persona es todo ser humano.” “Artículo 3 Reconocimiento de la Personalidad Jurídica Toda persona tiene derecho al reconocimiento de su personalidad jurídica.” “Artículo 4 Derecho a la Vida 1. Toda persona tiene derecho a que se respete su vida. Este derecho estará protegido por la ley y, en general, a partir del momento de la concepción. Nadie puede ser privado de la vida arbitrariamente.

2. En los países que no han abolido la pena de muerte, ésta sólo podrá imponerse por los delitos más graves, en cumplimiento de sentencia ejecutoriada de tribunal competente y de conformidad con una ley que establezca tal pena, dictada con anterioridad a la comisión del delito.

Tampoco se extenderá su aplicación a delitos a los cuales no se la aplique actualmente.

3. No se restablecerá la pena de muerte en los Estados que la han abolido.

4. En ningún caso se puede aplicar la pena de muerte por delitos políticos ni comunes conexos con los políticos.

5. No se impondrá la pena de muerte a personas que, en el momento de la comisión del delito, tuvieren menos de dieciocho años de edad o más de setenta, ni se le aplicará a las mujeres en estado de gravidez.

6. Toda persona condenada a muerte tiene derecho a solicitar la amnistía, el indulto o la conmutación de la pena, los cuales podrán ser concedidos en todos los casos. No se puede aplicar la pena de muerte mientras la solicitud esté pendiente de decisión ante autoridad competente.” “Artículo 5 Derecho a la Integridad Personal 1. Toda persona tiene derecho a que se respete su integridad física, psíquica y moral.” Una vez revisadas las disposiciones de los instrumentos invocados por el accionante aquí supra citadas, este Tribunal considera necesario reiterar lo señalado previamente, en el sentido de que el decreto aquí impugnado no lesiona el derecho a la vida y salud de las personas, lejos de ello procura el mayor bienestar de la población en general. También se dejó claramente establecido que, no se trata de una solución en fase experimental. De manera que, precisamente, ante la ponderación de derechos fundamentales, la obligatoriedad de las vacunas para procurar el derecho a la salud pública, no resulta inconstitucional ni lesiva de los instrumentos internacionales invocados. Se reitera lo indicado por este Tribunal, en relación con la Ley General de Vacunación en ese sentido:

“…Con lo que se constata que dicho numeral reconoce la posibilidad de imponer límites razonables al ejercicio de los referidos derechos para proteger la salud pública. En cuyo caso, cabe reiterar que esta Sala ya ha reconocido 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. Nótese que, en este caso, con la aplicación de las referidas vacunas se pretende no solo tutelar la vida y la salud de la menor amparada, sino que la vida y la salud de los demás miembros de la comunidad -incluidos, especialmente, otros niños-, en la medida que dicho plan de vacunación lo que procura es evitar el riesgo potencial de brotes epidémicos de enfermedadas infecciosas que incluso pueden provocar discapacidades permanentes (p.ej. la rubéola congénita) o la muerte (p. ej. el sarampión) de las personas contagiadas, por lo que está en juego la preservación y resguardo de la salud pública. Por lo que debe recordarse que esta Sala ha resaltado:

“(…) La preponderancia de la vida y de la salud, como valores supremos de las personas, está presente y señalada como de obligada tutela para el Estado, no sólo en la Constitución Política, sino también en diversos instrumentos internacionales suscritos por el país como la Declaración Universal de Derechos Humanos, la Convención Americana sobre Derechos Humanos, de la Declaración Americana de los Derechos y Deberes del Hombre y el Pacto Internacional de Derechos Civiles y Políticos. Debe quedar claro no sólo la relevancia de los valores para los cuales el actor reclama tutela, sino también el grado de compromiso que el Estado costarricense ha adquirido en cuanto a acudir de manera incuestionable e incondicional en su defensa. (sentencia número 2000-01954 de las 8:53 horas del 3 de marzo del 2000)” (Sentencia n.° 2020-19433 de las 9:20 horas del 9 de octubre de 2020) En el mismo sentido, según se expuso, respecto del derecho al consentimiento previo informado, “existen suficientes disposiciones que legitiman la obligatoriedad de la vacuna, por lo que la autonomía, en tales supuestos, se ve disminuida en aras de tutelar el interés y el bienestar general, a saber, la salud pública…” (Sentencia n.° 2021-24027 de las 10:10 horas del 26 de octubre de 2021). E igualmente se agregó: “Ello no obsta para enfatizar que en todos los casos se debe respetar el derecho a la información de todas las personas a las que se les somete a esta vacunación obligatoria.” Y para tales efectos se hizo referencia al Manual de Procedimientos para la ejecución de vacunación contra COVID-19 en los establecimientos de salud de la Caja Costarricense de Seguro Social, que exige justamente velar por el derecho a la información de los usuarios y eximir de la vacunación a aquellos trabajadores que presentan alguna contraindicación médica. Ciertamente la jurisprudencia de la Corte Interamericana de Derechos Humanos aportada por el accionante hace referencia a la necesidad de que exista un consentimiento informado antes de la realización de cualquier acto médico; sin embargo, debe advertir el gestionante el contexto de tales pronunciamientos, ya que están basados en situaciones ordinarias y no de pandemia como ocurre actualmente, lo cual implica una valoración distinta. Lo expuesto no pretende lesionar los derechos fundamentales de los trabajadores, menos aún conminarlos a realizarse cualquier procedimiento médico, sino más bien, protegerlos y resguardar su vida con una vacuna, frente a una pandemia, que no es una situación ordinaria, cuyos efectos trascienden más allá de una persona o una familia, sino que rebasa fronteras y ha producido consecuencias gravosas a nivel mundial ante las altas cifras de muerte de personas y las condiciones requeridas para brindarles la debida atención médica en momentos de alta o altísima demanda. Adviértase que la disposición en cuestión tiene como objetivo la protección de la salud colectiva y de los derechos de los demás, entre los cuales se incluyen a quienes no pueden ser vacunados por motivos médicos. En ese sentido, el decreto en cuestión no lesiona el principio de jerarquía de las normas, ya que no contraviene lo dispuesto en los convenios internacionales, sino que aplica sus disposiciones de manera integral y armónica, procurando el ejercicio de los mismos sin demérito de aquel del cual depende el ejercicio de todos los demás derechos humanos, la vida. En consecuencia, procede rechazar por el fondo los alegatos del accionante.

XII.- Sobre la acusada violación del principio de razonabilidad y proporcionalidad en la sanción por no vacunarse.

Se acusa que, establecer sanciones como el despido sin responsabilidad patronal y/o multa aproximada de 500.000 colones, ante el incumplimiento de vacunarse contra la covid-19, atenta contra el derecho al trabajo y el principio de razonabilidad y proporcionalidad. Señala que las autoridades, en ninguna forma han fundamentado técnica o científicamente el grado de eficacia de la vacuna, en relación con evitar la propagación de la covid-19, por lo que no es posible realizar una valoración de proporcionalidad, necesidad y razonabilidad de la medida que atenta contra el principio de autonomía de la voluntad. Por otro lado, refiere que las sanciones por no vacunarse para los funcionarios públicos son desproporcionadas, se trata de tipos penales o administrativos-sancionatorios en blanco, que contravienen el principio de tipicidad penal y administrativa-sancionatoria. Indica que se pretende abrir procedimientos administrativos tendientes a despedir sin responsabilidad patronal a los funcionarios públicos que no se vacunen, o que no le brinden información a la entidad para la cual laboran, sobre si se han vacunado o no, y si tiene el cuadro completo de vacunas o no. Adicionalmente, se amenaza a los funcionarios públicos con la imposición de una multa aproximada de 500.000 colones y la remisión del caso al Ministerio Público para determinar si se está ante la comisión de un delito. De ese modo, asegura que las personas trabajadoras se ven coaccionadas a someterse a una inoculación obligatoria, pese a sus temores fundados de sufrir daños a corto o largo plazo en su salud, debido a las inminentes acciones disciplinarias. Cuestiona tanto el término de orden público en que se fundamenta la normativa, como las sanciones para los trabajadores que no se vacunen.

No obstante lo anterior, el accionante no precisa en cuáles disposiciones normativas se establecen las sanciones cuya proporcionalidad cuestiona, lo que impide que este Tribunal pueda pronunciarse al respecto. Adviértase que el decreto ejecutivo n.° 43249-S, aquí impugnado y cuya inconstitucionalidad fue invocada en el asunto base, reformó únicamente el artículo 2 del decreto ejecutivo n.° 42889-S del 10 de marzo de 2021 y del texto del mismo, no se desprenden las sanciones impugnadas por el gestionante.

El decreto ejecutivo n.° 43249-S, respecto del cual versa esta acción, dispone lo siguiente:

“Artículo 1 .-Refórmese el artículo 2 del Decreto Ejecutivo N° 42889-S del 10 de marzo de 2021, denominado Reforma al Decreto Ejecutivo N° 32722-S del 20 de mayo de 2005, denominado Reglamento a la Ley Nacional de Vacunación y Establecimiento de la Obligatoriedad de la Vacuna del COVID-19, para que en adelante se consigne lo siguiente:

"Artículo 2 .- Con fundamento en el artículo 3 de la Ley Nacional de Vacunación, Ley número 8111 del 18 de julio de 2001, así como los ordinales 2 y 18 del Reglamento a la Ley Nacional de Vacunación, Decreto Ejecutivo número 32722 del 20 de mayo de 2005, será obligatoria la vacuna del COVID-19 para el personal establecido por la Comisión Nacional de Vacunación y Epidemiología, en las sesiones extraordinarias número VII-2021 del 16 de febrero del 2021, VIII-2021 del 23 de febrero de 2021 y N° XLV-2021 del día 23 de septiembre de 2021, para el caso de este último acuerdo, será en los términos fijados por la Comisión Nacional de Vacunación y Epidemiología para el sector público y el sector privado.

Para cuando sean citados por los encargados para tal efecto y de acuerdo con la planificación institucional respectiva, las personas contempladas en el párrafo anterior deberán vacunarse, con excepción de aquellos funcionarios que, por contraindicación médica debidamente declarada, no les sea posible recibir la vacuna contra el Covid-19. 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." En virtud de lo expuesto, la falta de precisión del accionante conlleva a una imposibilidad material de este Tribunal en pronunciarse y respecto de tal extremo procede rechazar de plano la acción.

XIII.- Corolario de lo expuesto, procede rechazar por el fondo la acción respecto de la alegada violación a los principios del consentimiento informado, de jerarquía de las normas, de convencionalidad, de reserva de ley, de autodeterminación informativa; y del derecho a la vida y la salud. En lo demás, rechazar de plano la acción.

XIV.- NOTA SEPARADA DEL MAGISTRADO CASTILLO VÍQUEZ. Coincido con mis colegas en los argumentos que esgrimen para rechazar de plano la acción, toda vez que no hay una contradicción evidente y manifiesta entre la ley y el decreto que se impugna. La postura del Tribunal, en el sentido de cuando una norma reglamentaria violenta o excede lo dispuesto en una ley es un tema de legalidad, cuya discusión no corresponde a esta jurisdicción, en términos generales, acierta jurídicamente. No cabe duda que es al Juez ordinario a quien compete determinar los alcances de la interpretación y aplicación de la Ley y, por consiguiente, es él el llamado a establecer si una norma reglamentaria vulnera o no la norma legal. Sin embargo, hay un matiz importante en este asunto, y es que, desde mi punto de vista, cuando hay una evidencia manifiesta, que salta a la vista, que la norma reglamentaria excede, suprime- o contradice el texto de la Ley- no cabe duda que, de forma grosera, se vulnera el principio de fuerza, autoridad o eficacia de la Ley; principio que tiene cobertura constitucional y que debe ser tutelado por este Tribunal.

Como es bien sabido, el principio de fuerza, autoridad o eficacia de ley nos remite a la potencia (fuerza activa), a la resistencia (fuerza pasiva) y al régimen de impugnación de la Ley. Con base en el primer aspecto del concepto, la Ley, una vez que entra en vigencia, deroga o modifica toda norma de igual o inferior rango. Con fundamento en el segundo, la Ley no puede ser derogada ni modificada por una norma de inferior rango. Por último, con base en el tercero, la Ley sólo puede ser impugnada por razones de inconstitucionalidad y, por ende, sólo a través de una resolución de la Sala Constitucional se puede anular.

XV.-VOTO SALVADO DEL MAGISTRADO RUEDA LEAL. Me separo del criterio de la mayoría de este Tribunal y salvo el voto en este asunto, por considerar que la decisión de rechazar de plano esta acción de inconstitucionalidad es prematura. Tal como he expresado en múltiples ocasiones (votos n. os 2021-26494 de las 9:20 horas del 24 de noviembre de 2021, 2021-26488 de las 9:20 horas del 24 de noviembre de 2021, 2021-25377 de las 9:20 horas del 10 de noviembre de 2021, 2021-18405 de las 10:05 horas del 18 de agosto de 2021, entre otros) es incuestionable que la acción de inconstitucionalidad es un proceso, “instaurado con el propósito de garantizar la supremacía de la Constitución Política frente a normas u otras disposiciones de carácter general y que por esa misma razón deben cumplirse un conjunto de formalidades, a efecto de que la Sala pueda válidamente conocer el fondo de la impugnación ” como se ha señalado en la amplia jurisprudencia de esta Sala. Sin embargo, es precisamente la propia ley la que ordena el tratamiento que debe darse a las distintas formalidades y a su eventual incumplimiento, como se extrae del texto del artículo 80 de la Ley de la Jurisdicción Constitucional que señala:

“Artículo 80.- Si no se llenaren las formalidades a que se refieren los dos artículos anteriores, el Presidente de la Sala señalará por resolución, cuáles son los requisitos omitidos y ordenará cumplirlos dentro de tercero día (…)” En este asunto, entre otros requisitos, se echa de menos una fundamentación adecuada y suficiente tal y como lo exige el artículo 79 de la Ley de la Jurisdicción Constitucional, por lo que resulta de incuestionable aplicación la prevención al accionante para que remedie la omisión detectada. De igual forma, no sobra en absoluto dejar sentado que –en mi criterio- tanto la interpretación de los artículos 78 y 79 como la del propio 80 de la Ley que rige esta jurisdicción, debe ser amplia en beneficio de quienes acuden a esta Sala, de modo que el acceso a la justicia constitucional no resulte innecesariamente limitado. Así las cosas, por motivos de forma y sin referirme al fondo del asunto, salvo el voto y ordeno efectuar la prevención citada.

XVI.- Documentación aportada al expediente . Se previene a las partes que de haber aportado algún documento en papel, así como objetos o pruebas contenidas en algún dispositivo adicional de carácter electrónico, informático, magnético, óptico, telemático o producido por nuevas tecnologías, estos deberán ser retirados del despacho en un plazo máximo de 30 días hábiles contados a partir de la notificación de esta sentencia. De lo contrario, será destruido todo aquel material que no sea retirado dentro de este plazo, según lo dispuesto en el "Reglamento sobre Expediente Electrónico ante el Poder Judicial", aprobado por la Corte Plena en sesión N° 27-11 del 22 de agosto del 2011, artículo XXVI y publicado en el Boletín Judicial número 19 del 26 de enero del 2012, así como en el acuerdo aprobado por el Consejo Superior del Poder Judicial, en la sesión N° 43-12 celebrada el 3 de mayo del 2012, artículo LXXXI.

Por tanto:

Se rechaza por el fondo la acción respecto de la alegada violación a los principios del consentimiento informado, de jerarquía de las normas, de convencionalidad, de reserva de ley, de autodeterminación informativa; y del derecho a la vida y la salud. En lo demás, se rechaza de plano la acción. Se rechaza la gestión de coadyuvancia. El magistrado Castillo Víquez consigna nota. Por motivos de forma y sin referirse al fondo, el magistrado Rueda Leal salva el voto y ordena hacer la prevención del artículo 80 de la Ley de la Jurisdicción Constitucional.

Fernando Castillo V.

Paul Rueda L.

Jorge Araya G.

Ana María Picado B.

Ileana Sánchez N.

Aracelly Pacheco S.

Jorge Isaac Solano A.

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