Everyone who is reading this has been affected by COVID-19 in some way. Whether doing school online, losing someone you know, or getting COVID yourself, everyone has been affected. Throughout the past year scientists and researchers have been working nonstop to develop a vaccine to protect people from the disease. Right now in the US there are three vaccines that have been approved for use (although one has recently been paused) along with at least four more around the world. Throughout this pandemic each country has taken their own approach to the virus and vaccine distribution with varying results. These differences in rollout and distribution are important and could be considered controversial as they prioritize different things.
This is an intro video explaining the COVAX program, its benefits and its controversies:
Here are some graphs that show the difference in COVID vaccine distribution worldwide:
These differences which are highlighted throughout the graphs are important to note because they demonstrate different issues within the world and different countries. As shown in the first graph titled “Share who would get a COVID-19 vaccine if it was available to them this week” the differences in the willingness of people to get the vaccine in order to help achieve herd immunity. To me, this related to the principle of beneficence, which means benefiting the public/one’s self, because there was a variety of opinions when getting this vaccine to protect oneself and others. This also highlights the principle of autonomy (the ability to make an informed decision for oneself) because people are choosing whether or not to follow the advice of the WHO and their governments and whether that aligns with their personal beliefs or not.
This map highlights another principle of bioethics: justice. This principle is important in relation to distributing resources in an ethical way. The differences highlighted throughout the map shows the different priorities of need, namely equity, need, and responsibility, as in many places the people in the greatest need are gaining access to the vaccine first. This relates to the idea of responsibility because it is the responsibility of the public to protect these people who are more likely to have severe effects or those who are more often exposed to COVID first.
This data again shows the principle of beneficence because with this many people getting vaccinated (and now over 100 million in the US), the world is getting closer to achieving herd immunity to protect against the virus.
This bar graph shows the differences in fully vaccinated people as of March 1, 2021. This shows the differences in countries with vaccine rollout. With countries like Chile and Indonesia, they rely on the international COVAX vaccine distribution and other forms of worldwide responsibility in order to gain the same access to vaccines as other countries like the US have. With the development of vaccines such as Pfizer and Moderna, the US has prioritized their own citizens in their vaccine distribution process in order to protect their citizens first. Here this could be seen through the lens of power because a powerful country such as the US is giving its own citizens access first because they have the power to control where the vaccine is spread. Another lens that this could be looked through is need. Since the COVID-19 pandemic has spread since early 2020, the US is now leading in most COVID cases and deaths, so by distributing the vaccine to the US first over countries like Russia and Brazil, these vaccine companies are prioritizing countries based on need.
Throughout this pandemic, many ethical issues have been raised:
Autonomy: This is an ethical issue because the ability of being able to make a well-informed decision about getting a vaccine is unknown. With new technologies, researchers have been able to create, test, and distribute vaccines at an unprecedented rate. But because of this short timeline, long term effects of getting or not getting vaccine are unknown, so a perfectly autonomous decision cannot be made because not all of the information are made, but these vaccines are safe and effective as recent studies have shown. Another difference within countries is the rural/urban divide because in more rural areas, they have less access to medical care and medical knowledge than do urban areas, so they cannot make an equally autonomous decision because they do not know a lot of information about the vaccine.
Beneficence: This principle relates to global vaccine rollout because it should be fashioned in order to make the most positive impact on the global community as fast and as effectively as possible. This brings up the question of what is the best way to do this? Should first-responders be given the vaccine first? Should the elderly? Should the immunocompromised? Who should be? This is what the graph above shows as different groups and different numbers of groups are prioritized.
Non-maleficence: This principle is very closely connected to the previous principle. Basically, this principle means how can we not harm the patient if we cannot benefit them. This brings up similar questions to the last principle of who should be prioritized in vaccine distribution in order to help the most people and prevent the most future deaths and illnesses. How should this be carried out? Who should be prioritized?
Justice: This is a major question that has been brought up through this presentation but this topic talks about how should resources be allocated fairly? The ideas of need, equity, equality, and responsibility all play into this as people discuss how to distribute the vaccine to the world. Some countries like the US are doing it based on responsibility, focusing on their own people first and giving access to those who are first responders and the elderly. Dissimilarly, in India they are using the vaccine as a way to spread their influence and increase their global standing as they are distributing vaccines to surrounding countries as part of their distribution plan.
So, what do you think? What factors should play into global vaccine distribution, which idea wins, and how should these countries proceed?