Should those who refuse vaccination be considered responsible even if they do not intend to harm others? We argue that they should, at least if vaccines are easily available and they have been adequately informed about the risks of transmitting disease to others. In any case, there are many situations in which we consider (and hold) people responsible for unintended harms that result from their imposition of risk on others. Consider, for example, reckless driving.
Reckless drivers, though, are not held responsible for "unintended harms that result from their imposition of risk on others"; they are held responsible for harms that result from their doing a potentially harmful action that turned out to be harmful, even if they did not intend to do harm. Obviously if their actions did not themselves turn out to be harmful they could not be held responsible for resulting harms, but only for something else. I suppose the idea could be that we take reckless drivers to be responsible for their active imposition of risk on others, and therefore for any harms that happen because of it. But this would then seem to beg the question in this context, since the question at hand is whether nonvaccination is in fact an analogous active imposition of risk (rather than, for instance, simply a non-reduction of risk that does not work in an analogous way), not whether nonvaccinators would be responsible for harms if it were. And the actual paper doesn't help clarify this much:
This response is implausible because there are numerous examples—unrelated to vaccination—which illustrate the credibility of considering individuals responsible for harms that they both (i) did not intend and (ii) did not cause directly by their actions, but merely failed to prevent. Consider:
Intoxicated driver. A driver is driving while intoxicated at a safe and reasonable speed. Due to her intoxication, however, she blacks out briefly. During the blackout, she runs a red light, and her vehicle collides with a pedestrian, killing him.
In such cases, the relevant agent does not intend the harm: the harm comes about as a result of failures to act.
This is even more baffling; the harm doesn't come about as a result of failures to act, but as a result of driving while intoxicated, which is not a failure to act but an action that is in itself dangerous to other drivers because in itself it tends to harm. The reason for the 'failure to act' line is that the driver goes unconscious and so fails to brake; but if it happened not due to intoxication but unexpectedly and entirely for reasons the driver could not have prevented -- for instance, a medical condition of which they were unaware -- such a failure to act would not be relevant to any moral responsibility. It's only because the driver is already actively doing something dangerous that the failure to brake becomes morally significant.
Moral responsibility in cases involve driving always seem to require a specific action that itself serves as the framework for assessing any responsibility for consequences for failures to act; they don't seem suitably analogous for this kind of comparison.