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How Can the World Allocate COVID-19 Vaccines Fairly?

It’s an ethical question that experts like Alison Buttenheim of the School of Nursing, Harald Schmidt of the Perelman School of Medicine, and Kok-Chor Tan of the School of Arts & Sciences are contemplating. One fact is certain, they say: Distribution must not exacerbate persisting disparities.

ARS-CoV-2 emerged with a bang, appearing out of nowhere and spreading with lightning speed. It affects the body in ways similar to other respiratory illnesses, yet also differently. It forced countries to take drastic actions—mask-wearing, social distancing, shutting down economies—never before seen or most recently experienced a century ago. Now, just a year after the world first heard about a novel coronavirus in Wuhan Province, China, vaccines that very effectively combat COVID-19 already exist.

Yet with vaccine approval, even the limited kind dictated by an Emergency Use Authorization (EUA) like the one the United States just issued for the Pfizer-BioNTech vaccine, the question of distribution remains. The answer is not straightforward, with a seemingly unending set of decisions necessary before the shots actually reach individuals.

At the broadest level, how do international dose allocations look? From there, how does each country circulate its stock? In the U.S., that means to 64 jurisdictions, most of them states. Jurisdictions then distribute to health systems or nursing homes or whichever facilities top their list, and those places independently decide who moves to the front. And on and on down the line. Without digging too deep, it’s easy to see the monumental task at hand for those deciding how to spread out what is, at present, a scant resource.

As of this writing, COVAX, an initiative jointly run by the World Health Organization (WHO) and several other global organizations, recommended proportional allocation to start, meaning each of more than 180 participating countries—which does not currently include the U.S.—would get vaccine doses for 3% of its population, prioritizing essential health workers. In the U.S. in early December, the Advisory Committee on Immunization Practices (ACIP) of the Centers for Disease Control and Prevention (CDC) published a “final” framework that also put health care workers first but did not account for elderly populations in the same way previous versions had.

This is an excerpt from a larger article that originally appeared in Penn Today. It was written by Michele Berger, senior science news officer in University Communications.