Planning How to Allocate and Distribute a COVID-19 Vaccine

August 19, 2020

Researchers from the Berman Institute of Bioethics have co-authored a new report providing an ethical framework for making decisions about allocation and distribution of a COVID-19 vaccine during the initial period when such a vaccine has first been authorized for use and is still in limited supply.

Released by the Center for Health Security at Johns Hopkins Bloomberg School of Public Health, the report, Interim Framework for COVID-19 Vaccine Allocation and Distribution in the United States, proposes specific tiers of high-priority candidates for receiving a first vaccine based on this framework, including recognizing the contributions of essential workers who have been overlooked in previous allocation schemes:

Tier 1 includes those:

  • 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 includes those:

  • 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 framework is guided by the following ethical principles, which the report authors believe should guide COVID-19 vaccine allocation and help identify more specific policy goals and objectives around vaccine policies:

  • Promotion of the common good, by promoting public health while enabling social and economic activity.
  • The importance of treating individuals fairly and promoting social equity, for example by addressing racial and ethnic disparities in COVID-19 mortality, and by recognizing the contributions of essential workers who have been overlooked in previous allocation schemes. 
  • The promotion of legitimacy, trust and a sense of community ownership over vaccine policy, while respecting the diversity of values and beliefs in our pluralist society.

The Berman Institute’s Anne Barnhill, Carleigh Krubiner and Alan Regenberg are among the co-authors, as is former Hecht-Levi Fellow Justin Bernstein, and Ruth Faden contributed.

You can access the new report here.