Just allocation of COVID-19 vaccines.
Anders Herlitz,Zohar Lederman,Jennifer R. B. Miller,Marc Fleurbaey,Sridhar Venkatapuram,Caesar Atuire,Lisa Eckenwiler,Nicole Hassoun,Nicole Hassoun +8 more
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The most advanced attempt at coordinating vaccine distribution is the COVID-19 Vaccines Global Access (COVAX) facility, a collaboration that brings together governments, companies, international organisations and others to accelerate the development and manufacture of COVID19 vaccines as mentioned in this paper.Abstract:
Authorized COVID-19 vaccines must be distributed fairly. Several proposals have emerged offering guidelines for how to do this. However, insofar as the aim is to have the greatest health impact, these proposals fall short. We offer three suggestions to strengthen them
The most advanced attempt at coordinating vaccine distribution is the COVID-19 Vaccines Global Access (COVAX) facility, a collaboration that brings together governments, companies, international organisations and others to accelerate the development and manufacture of COVID-19 vaccines.1 A total of 182 countries have joined the facility so far, which has secured about US$2 billion for its advance market commitment (AMC). The AMC will allow 92 low-income and middle-income countries to obtain vaccine doses as they are approved or authorised. Currently, COVAX is set up so that in a first phase poor countries can vaccinate 3% of their populations, while rich countries can vaccinate up to 50%. Though the facility hopes to allow all members to vaccinate at least 20% of their populations by the end of 2021.2 3 Other proposals by the WHO suggest prioritising healthcare workers, the elderly and, those with comorbidities that put them at greater risk of severe illness if infected with COVID-19, people from certain high-risk sociodemographic groups and some teachers.
Another sophisticated proposal, the ‘Fair Priority’ Model, suggests countries with vaccines contribute to global distribution once their COVID-19 transmission rates drop to R<1. In phase I, they argue that vaccines should primarily be distributed to minimise standard expected years of lives lost. Other considerations, such as gross national income and poverty rates, can and should …read more
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Disparities in COVID-19 Vaccination among Low-, Middle-, and High-Income Countries: The Mediating Role of Vaccination Policy.
TL;DR: In this paper, a cross-sectional ecological study was conducted to analyze the association between country income level and COVID-19 vaccination coverage and explore the mediating role of vaccination policy.
Journal ArticleDOI
Global access to COVID-19 vaccines: a scoping review of factors that may influence equitable access for low and middle-income countries.
TL;DR: In this paper, the authors conducted a scoping review following the guidelines for Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews and a five-stage framework for scoping studies.
Journal ArticleDOI
COVID-19 vaccinations are associated with reduced fatality rates: Evidence from cross-county quasi-experiments.
TL;DR: In this article, the authors evaluated the association of COVID-19 vaccine coverage with case fatality ratio (CFR) on a global scale and found that a 10% increase in vaccine coverage was associated with a 7.6% reduction in the CFR (95% confidence interval (CI = -12.6 to -2.7%, P = 0.002).
Journal ArticleDOI
On the Ethics of Vaccine Nationalism: The Case for the Fair Priority for Residents Framework
Ezekiel J. Emanuel,Allen Buchanan,Shuk Ying Chan,Cécile Fabre,Daniel Halliday,R. J. Leland,Florencia Luna,Matthew S. McCoy,Ole Frithjof Norheim,G. Owen Schaefer,Kok-Chor Tan,Christopher Heath Wellman +11 more
Abstract: COVID-19 vaccines are likely to be scarce for years to come. Many countries, from India to the U.K., have demonstrated vaccine nationalism. What are the ethical limits to this vaccine nationalism? Neither extreme nationalism nor extreme cosmopolitanism is ethically justifiable. Instead, we propose the fair priority for residents (FPR) framework, in which governments can retain COVID-19 vaccine doses for their residents only to the extent that they are needed to maintain a noncrisis level of mortality while they are implementing reasonable public health interventions. Practically, a noncrisis level of mortality is that experienced during a bad influenza season, which society considers an acceptable background risk. Governments take action to limit mortality from influenza, but there is no emergency that includes severe lockdowns. This “flu-risk standard” is a nonarbitrary and generally accepted heuristic. Mortality above the flu-risk standard justifies greater governmental interventions, including retaining vaccines for a country's own citizens over global need. The precise level of vaccination needed to meet the flu-risk standard will depend upon empirical factors related to the pandemic. This links the ethical principles to the scientific data emerging from the emergency. Thus, the FPR framework recognizes that governments should prioritize procuring vaccines for their country when doing so is necessary to reduce mortality to noncrisis flu-like levels. But after that, a government is obligated to do its part to share vaccines to reduce risks of mortality for people in other countries. We consider and reject objections to the FPR framework based on a country: (1) having developed a vaccine, (2) raising taxes to pay for vaccine research and purchase, (3) wanting to eliminate economic and social burdens, and (4) being ineffective in combating COVID-19 through public health interventions.
References
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Multivalue ethical framework for fair global allocation of a COVID-19 vaccine.
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