As the United States prepares to distribute a COVID-19 vaccine as early as next month, the Penn Science Cafe held an event discussing the ethical questions surrounding global vaccine distribution given a limited initial supply.
The Wednesday event, titled “The Global Ethics of Vaccine Distribution,” featured philosophy professor and chair Michael Weisberg and philosophy professor Kok-Chor Tan, who recently co-authored a global framework for vaccine allocation with Vice Provost for Global Initiatives Ezekiel Emanuel, who was recently appointed to President-elect Joe Biden’s Transition COVID-19 Advisory Board.
Tan said the three basic principles that were most relevant when developing their framework, called the Fair Priority Model, included benefiting people and preventing harm, prioritizing disadvantaged nations, and equal moral concern. Equal moral concern is not discriminating on the basis of differences like sex, race, and religion, Tan said.
Guided by these three principles, the model proposes three phases of distribution to prevent more urgent harms earlier.
In phase one, the distribution of vaccines would be focused towards countries most impacted by premature death and contraction. In phase two, distribution would target preventing indirect harms such as economic hardships and increased poverty caused by lockdowns. The final phase of distribution would aim to reduce community spread and establish a return to normalcy, Tan said.
The framework proposed by Tan and his co-authors differs from the allocation mechanism designed by the World Health Organization which would ensure equal distribution proportionate to each country’s population. In their article, the developers of the Fair Priority Model wrote that the WHO's allocation mechanism assumes equality requires treating differently situated countries identically, rather than equitably responding to each country's distinctive needs.
“If we simply give countries an equal amount proportionate to their population, it seems insensitive and condemning to the different impacts COVID-19 is having on different countries,” Tan said.
Tan and Weisberg also spoke about the dangers of “vaccine nationalism,” as national governments seek to follow their own interests instead of pursuing a more globally coordinated response to the pandemic. According to the speakers, vaccine nationalist approaches are counterproductive to reducing global transmission.
“You can [vaccinate] every single person in America, but so long as the pandemic is raging elsewhere, we're gonna be isolating the rest of the world,” Weisberg said.
There are currently six vaccines approved for early or limited use, The New York Times reported. Pfizer and BioTech recently requested emergency use authorization from the Food and Drug Administration for its vaccine which is more than 90% effective. Moderna also announced that a preliminary analysis of their trial showed their vaccine to be 94.5% effective.
Although some participants expressed concern that the proposed model would penalize countries such as Taiwan and New Zealand for instituting effective lockdowns while rewarding countries like Brazil and the United States for the opposite, Tan said that saving lives should be the top priority regardless of a country's successful COVID-19 mitigation.
“It’s about saving lives, not rewarding countries for good behavior. We should not penalize people who have been let down by their governments," Tan said. "Vaccine distribution is only one part of the multifaceted response to the pandemic.”