Ezekiel J. Emanuel, Govind Persad, Adam Kern, Allen E. Buchanan, Cecile Fabre, Daniel Halliday, Joseph Heath, Lisa M. Herzog, R. J. Leland, Ephrem T. Lemango, Florencia Luna, Matthew McCoy, Ole F. Norheim, Trygve Ottersen, G. Owen Schaefer, Kok-Chor Tan, Christopher Heath Wellman, Jonathan Wolff & Henry S. Richardson
Science 1:DOI: 10.1126/science.abe2803 (2020)
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Abstract |
In this article, we propose the Fair Priority Model for COVID-19 vaccine distribution, and emphasize three fundamental values we believe should be considered when distributing a COVID-19 vaccine among countries: Benefiting people and limiting harm, prioritizing the disadvantaged, and equal moral concern for all individuals. The Priority Model addresses these values by focusing on mitigating three types of harms caused by COVID-19: death and permanent organ damage, indirect health consequences, such as health care system strain and stress, as well as economic destruction. It proposes proceeding in three phases: the first addresses premature death, the second long-term health issues and economic harms, and the third aims to contain viral transmission fully and restore pre-pandemic activity.
To those who may deem an ethical framework irrelevant because of the belief that many countries will pursue "vaccine nationalism," we argue such a framework still has broad relevance. Reasonable national partiality would permit countries to focus on vaccine distribution within their borders up until the rate of transmission is below 1, at which point there would not be sufficient vaccine-preventable harm to justify retaining a vaccine. When a government reaches the limit of national partiality, it should release vaccines for other countries.
We also argue against two other recent proposals. Distributing a vaccine proportional to a country's population mistakenly assumes that equality requires treating differently situated countries identically. Prioritizing countries according to the number of front-line health care workers, the proportion of the population over 65, and the number of people with comorbidities within each country may exacerbate disadvantage and end up giving the vaccine in large part to wealthy nations.
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Keywords | COVID-19 global justice vaccines prioritarianism poverty gap nationalism national partiality cosmopolitanism SEYLL |
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Back to WHAT? The Role of Research Ethics in Pandemic Times.Jan Helge Solbakk, Heidi Beate Bentzen, Søren Holm, Anne Kari Tolo Heggestad, Bjørn Hofmann, Annette Robertsen, Anne Hambro Alnæs, Shereen Cox, Reidar Pedersen & Rose Bernabe - 2021 - Medicine, Health Care and Philosophy 24 (1):3-20.
Crisis Nationalism: To What Degree Is National Partiality Justifiable During a Global Pandemic?Eilidh Beaton, Mike Gadomski, Dylan Manson & Kok-Chor Tan - 2021 - Ethical Theory and Moral Practice 24 (1):285-300.
Global Health and the COVID-19 Pandemic: A Care Ethics Approach.Fiona Robinson - 2021 - Journal of Global Ethics 17 (3):340-352.
Ethics of Vaccination Prioritization and Compulsory Vaccination: An Integrative Approach.Nikolaus Knoepffler, Jürgen Zerth & Martin O’Malley - 2021 - Ethics and Bioethics (in Central Europe) 11 (3-4):153-162.
The Ethics of COVID-19 Vaccine Allocation: Don't Forget the Trade-Offs!Julian W. März, Anett Molnar, Søren Holm & Michael Schlander - 2022 - Public Health Ethics 15 (1):41-50.
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