The distribution of COVID-19 vaccinations in 29 countries at the start of 2021

A research team from the Interdisciplinary Center for Ethics at the Jagiellonian University in Krakow (Poland) analyzed the vaccination schedules published by 29 countries at the turn of 2020 and 2021, including members of the EU, the United Kingdom and from Israel, regarding the order in which they provided vaccination for different groups of citizens. The results of their research were published in the latest issue of Journal of Law and Biosciences.

COVID-19 vaccinations were scarce commodities at the start of 2021. The common element of all vaccination policies was to prioritize healthcare workers and nursing facility staff and residents. Only ten countries had also named teachers as a priority group for COVID-19 vaccination, and an even smaller number decided to do the same with grocery store employees (Austria, Germany, Ireland, Latvia, Romania , and Slovenia).

Only six countries have followed the recommendation of the World Health Organization (WHO) by granting migrants, refugees and prisoners living in overcrowded conditions priority access to vaccination (Cyprus, Germany, Greece, Ireland, Latvia and Romania ).

Researchers working on the project mapped the differences in vaccination schedules. The main one was related to the criteria on which the different countries based their policies. In Britain, for example, the calendar was based almost solely on the age of citizens, while other countries took into account various other factors contributing to an increased risk of death from COVID-19 (eg comorbidities ). A few countries have also included an increased risk of infection as a factor (eg Germany).

Karolina Wiśniowska of the Interdisciplinary Center for Ethics (INCET) observed that there is no consensus among experts on how preventive measures should be distributed and that the official timetables for the distribution of medical prevention in the case of COVID-19 have not yet been analyzed. or systematically compared.

The researchers point out that governments took very different strategies when it came to designing policies for vaccination schedules and when it came to designing policies to treat patients already infected with COVID-19.

In March and April 2020, several foreign medical associations published recommendations on how to distribute medical equipment and medicines in situations where resources are scarce. In particular, they mentioned access to ventilators and beds in intensive care units.

“Some of these recommendations were very controversial, such as in the case of access to ventilators. Some have suggested that we consider the likelihood of certain patients surviving, while others have suggested assessing their expected lifespan in the future. This could lead to the exclusion of elderly people or patients with comorbidities,” said Professor Tomasz Żuradzki, Director of INCET at Jagiellonian University.

The situation was different with respect to vaccination schedules. All prioritized groups at increased risk of death, such as the elderly and, in many cases, patients with comorbidities.

The high risk of infection was considered much more rarely, with the exception of law enforcement and emergency service employees as well as social workers.

Vaccination schedules for different social groups are in stark contrast to regulations regarding the allocation of scarce health resources in treatment cases (eg, transplants). In this second case, the objective is not to save as many people as possible from sudden death, but to assess the feasibility of the intervention according to various factors, such as the lifespan expected and the patient’s future quality of life. In most countries, these regulations on the distribution of vital healing resources are very similar.

“The moral judgments that underlie vaccination schedules cannot be unequivocally interpreted in light of prevailing ethical frameworks. However, this ambiguity can be considered their strong point,” said Dr. hab. Wojciech Ciszewski from the Jagiellonian University Chair of Legal Theory. “Because public opinion and experts represent diverse ethical viewpoints and broad support is necessary for successful vaccination strategies, the ability to defend these strategies on diverse moral grounds can increase their social legitimacy,” said he added.

This research has received funding from the European Research Council (ERC) under the European Union’s Horizon 2020 research and innovation program (grant agreement 805498). The document is available under the following link: https://academic.oup.com/jlb/article/9/2/lsac026/6711428