The best way to respond to these questions is through the development of a medical ethics framework. Medical ethics is based on a set of values that professionals can refer to in the case of any confusion or conflict. In the case of initial limited stocks of the coronavirus vaccine, society will have some important decisions to make. Such a framework has been drawn up by the Center for Health Security at Johns Hopkins Bloomberg School of Public Health. The framework considers matters from the U.S. perspective, but there are many elements applicable to each nation state.
Aside from the announcement from Vladimir Putin that the Russian Federation has developed a vaccine, no approved coronavirus vaccine yet exists. COVIDVax.news regularly monitors leading vaccine manufacturers and a useful progress chart can be viewed on-line. The final steps involve safety and efficacy testing. Vaccine development is not straightforward, as we showed earlier:
The assessment from John Hopkins is titled “Interim Framework for COVID-19 Vaccine Allocation and Distribution in the United States”. The proposal draws up pre-set tiers of high-priority candidates. These set out the stages for different groups in terms of receiving the first vaccines.
The tiers are:
Tier 1
Most essential in sustaining the ongoing COVID-19 response.
At greatest risk of severe illness and death, and their caregivers.
Most essential to maintaining core societal functions.
Tier 2
Involved in broader health provision.
Facing greater barriers to access care if they become seriously ill.
Contributing to maintenance of core societal functions.
Whose living or working conditions give them elevated risk of infection, even if they have lesser or unknown risk of severe illness and death.
The tiers recognize the contributions made by essential workers, and acknowledges the risk of the coronavirus to key workers. This is an important standpoint since these workers have been overlooked in previous drug allocation schemes. The objective is to ensure that healthcare and vulnerable workers get the vaccines first. Whether the U.S. government will take notice is a different matter.
