For most of the readers of our blog, this is a key issue. Who will get the COVID vaccine first. If you haven’t already, check out our Tuesday post. Reopening and the Disabled.
Looking for Answers: Who Will Get the COVID Vaccine First
The Ethics of a COVID Vaccine Distribution
To address this issue, we look to insights from Johns Hopkins University (JHU):
With something in the order of 150 COVID-19 vaccine candidates now in different stages of testing and development, a global public health strategy needs to be thinking several steps ahead, beyond the science. Once a vaccine is proven safe and effective, how will it reach everyone in the world who needs it, and on what kind of timeline?
Ruth Faden, a bioethicist at JHU, is working to address these high-stakes questions as a member of the World Health Organization’s COVID-19 Vaccines Working Group, a team from different countries making recommendations on fair and equitable global access to a coronavirus vaccine.
She notes the following:
We look at the global level. The private sector is really driving the vaccine development process. Rather than government or academic labs. Major efforts are underway to see how private industrial developers can make vaccines available at an affordable price to all countries . Particularly low and middle-income ones. Initially there will be scarce supply of the vaccine. And governments will scramble to procure it. Unless these efforts work, the winners will be fairly predictable. Countries with the resources.
On the next level, some wealthy countries will likely have substantial amounts of vaccine. Over time, if all goes well, these countries must decide how much product to keep and how much, if any, they will share with countries where the vaccine may be in very short supply.
With “vaccine nationalism,” countries see their obligations as primarily, if not exclusively, to their own residents. Although we expect that those countries will meet their own health needs first, should they ignore the needs of people living in other countries with severe economic constraints? From an ethics perspective, a balance must be struck.
Faden also says:
Essential workers usually top the list. But not only because they often face elevated risks. The reason they are considered essential is that, unless they do their jobs, society can’t function. From an ethical sense, we owe them something for taking increased risks for the sake of others. Yet, you should imagine the complications here. What jobs should we include as “essential worker”? How many people will that include? Should health care workers come before food workers?
In addition, Also high on the priority list, we include those most at risk medically. The people most likely to suffer serious illness and death if infected. We know age is a big risk factor for COVID-19. Therefore, many vaccine developers want to determine the effectiveness of their vaccines for this population. Some other risk factors may vary country by country; for example, in the US, we see obesity having a major impact.
For sure, we know about pandemics that the poorest and least powerful in society get hurt the most. In the U.S., we see that happening with people of color experiencing disproportionately high rates of infections and deaths. There is an important conversation to be had about whether, as a part of the much overdue racial reckoning, we should consider putting people of color high on the list for vaccine priority in the early days.
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