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What Are The Ethical Considerations When Deciding Who Gets The Coronavirus Vaccine First?

Doctors and health officials work inside the campus hall of spiritual organisation Radha Soami Satsang Beas (RSSB), converted into a COVID-19 coronavirus care centre, in New Delhi on July 6, 2020. - India on July 6 became the third-highest coronavirus caseload in the world, as officials warned hospitals in the United States were in danger of being overwhelmed by a surge in infections. (Photo by Xavier GALIANA / AFP) (Photo by XAVIER GALIANA/AFP via Getty Images)
XAVIER GALIANA/AFP via Getty Images
Doctors and health officials work inside the campus hall of spiritual organisation Radha Soami Satsang Beas (RSSB), converted into a COVID-19 coronavirus care centre, in New Delhi on July 6, 2020.

Who gets to be first in line for a COVID-19 vaccine? U.S. health authorities hope by late next month to have some draft guidance on how to ration initial doses, but it’s a vexing decision.

Who gets to be first in line for a COVID-19 vaccine? U.S. health authorities hope by late next month to have some draft guidance on how to ration initial doses, but it’s a vexing decision.

“Not everybody’s going to like the answer,” Dr. Francis Collins, director of the National Institutes of Health, recently told one of the advisory groups the government asked to help decide. “There will be many people who feel that they should have been at the top of the list.”

Traditionally, first in line for a scarce vaccine are health workers and the people most vulnerable to the targeted infection. But Collins tossed new ideas into the mix: Consider geography and give priority to people where an outbreak is hitting hardest. And don’t forget volunteers in the final stage of vaccine testing who get dummy shots, the comparison group needed to tell if the real shots truly work. Huge studies this summer aim to prove which of several experimental COVID-19 vaccines are safe and effective. Moderna Inc. and Pfizer Inc. began tests last week that eventually will include 30,000 volunteers each; in the next few months, equally large calls for volunteers will go out to test shots made by AstraZeneca, Johnson & Johnson and Novavax. And some vaccines made in China are in smaller late-stage studies in other countries. For all the promises of the U.S. stockpiling millions of doses, the hard truth: Even if a vaccine is declared safe and effective by year’s end, there won’t be enough for everyone who wants it right away -- especially as most potential vaccines require two doses. It’s a global dilemma. The World Health Organization is grappling with the same who-goes-first question as it tries to ensure vaccines are fairly distributed to poor countries -- decisions made even harder as wealthy nations corner the market for the first doses.

With files from the Associated Press

Guests:

Aaron Kheriaty, M.D., professor of psychiatry and director of the Medical Ethics Program at the School of Medicine at UC Irvine; he tweets

Govind Persad, law professor at the University of Denver where he focuses on bioethics and health law; he tweets

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