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Who gets a COVID-19 vaccine first–and how do you decide?

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Photo by Ruby Wallau/Northeastern University

A third potential COVID-19 vaccine emerged on Monday, with pharmaceutical company AstraZeneca joining Moderna and Pfizer in announcing promising results from early-stage clinical trials. As the companies jockey for emergency use authorization from the U.S. and other countries, a new question has emerged: If the vaccines are approved, who gets a dose first?

The first step should be to establish a shared set of values, rather than target specific populations, according to Mark Wells, a visiting lecturer of philosophy who studies how ethical theories can inform public policy. The second step, says Wendy Parmet, Matthews Distinguished University Professor of Law, “is figuring out a way to implement a plan without stumbling over existing inequities.”

And there’s broad consensus among biomedical ethicists, he says, on a handful of such values.

“We should be worried about preventing people from dying from diseases and about fair and equitable distribution of resources,” Wells says, “as well as being committed to respecting people and facilitating a high quality of life for people.”

These values—mitigating harm, equality, honesty and respect, and general welfare—can then be used as a framework within which to hammer out the specifics, he says.

In the U.S., the members of president-elect Joe Biden’s COVID-19 task force will be some of the architects of these dynamic frameworks and their details, and there is already some indication of how it might play out, Wells says.

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