Is It Ever OK To Jump Ahead In the Vaccine Line?

In the beginning of this year, countries started the vaccination of their citizens. The vaccination drives were conducted according to the vulnerability of various groups of citizens. The first targeted were the frontline workers, medical staff, then people above 60 were vaccinated. Currently, India is in the process of vaccinating all its people above 45 years of age.

• Various Indian states like Maharashtra and Odisha have reported the shortage of COVID -19 vaccines, as they have ramped up the vaccination drive.
• Due to this scarcity, many people who want the shots can't get them yet, either because they're not yet eligible, according to priorities set by their state, or because there aren't any available appointments.
• Thus, people have come up with different ways to get vaccinated as early as possible. This raises the concern where providing a vaccine to the most vulnerable becomes a difficult task.
• In this article we shall look into details of various ethical issues involved in how the country should procure vaccines and an individual's decision of getting vaccinated when there is a shortage of COVID-19 vaccines worldwide.

Why COVID-19 Vaccine scarcity increased?

• Inability to meet Production targets:
  • Two vaccine producers in India have raised concerns about their ability to meet their production targets.
  • The largest of these, SII - which produces Novavax and AstraZeneca vaccines - has warned of raw material shortages affecting production.
  • Its chief executive, Mr. Poonawalla, attributed this to US export bans on specific items needed to make vaccines, such as specialised bags and filters.
• Hoarding by Rich Countries:
  • When the pandemic began, rich countries went on a buying spree. Some have even called it "panic buying." This has led to the scarcity of Vaccines in poor countries.

• The objectives of vaccination are 2-fold.
  • One is the direct protection of the vaccinated individual against future infection and its associated health consequences.
  • The other is the indirect protection of the population at large by reducing overall viral transmission (herd immunity) and, thereby, the risk of infection, even for those who have not been vaccinated.

• For Wealthy countries, scarcity is a reality which they believe can be avoided by providing enough money.
• But scarcity also brings the question of ‘Who should get the vaccine first’?
• Covid response has prioritized saving lives and thus a planned approach to providing vaccination was implemented throughout the World.
• But as countries take care of their own citizens, practices like hoarding have made many poor countries in dire need of Vaccines. This can be seen from current status, where many countries do not have even a single fully vaccinated person.
• The head of WHO has warned that the world faces a "catastrophic moral failure" because of unequal Covid vaccine policies. He said over 39 million vaccine doses had been given in 49 richer states - but one poor nation had only 25 doses.
• Thus, countries while incorporating the values of equity, empathy and the idea of saving maximum lives, in their own countries should also incorporate these values at a global level.
  • The WHO global vaccine sharing scheme COVAX, is a step in the right direction and should be supported.
  • India has supplied 20 million doses under the scheme to low and middle income countries.

• First and foremost, it deprives the people who are in most need of the vaccine their right.
• This is a scenario of Conflict of Interest, where personal interests become more important than those of the society.
• Since vaccination decisions affect not only the individuals who get vaccinated, but also people around them in the community, vaccination decisions and policies are also ethical decisions.
• From a utilitarian perspective, policies should be in place to ensure that the vaccines are going to those who need them most to allow the vaccine to do the most good.
• This means people who cannot pay should still be allowed to get the vaccine if they are at-risk. This goes against the principles of the free-market.

• What should one do, if Vaccines are getting wasted?
  • In such a situation, a person should take the vaccine even if s/he is not eligible.
  • But more ethical would be to direct eligible and more vulnerable people in the neighborhood to take the vaccination.
• Should one travel to another country, where they are eligible for vaccination, to take vaccines?
  • Each country procures vaccines based on the number of people it is planning to vaccinate.
  • Such practices can deprive people of that country, their right to get vaccinated. Thus, the practice becomes unethical.
• Should one get vaccinated if he/she is eligible but is otherwise healthy and fit?
  • Countries plan their vaccination drive not only for the benefits of individuals who are getting vaccinated, but also for a greater public good.
  • Even if one is healthy and has less chances of severe illness due to Covid, he/she should follow government protocol and get vaccinated.
  • In this way, they are not only making themselves safer, but also helping the community around them.

COVID-19 pandemic is still ongoing and the death toll due to the disease is still rising. In such a scenario, distribution of vaccines to the most vulnerable, which can save maximum lives is need of the hour. Thus, both at national and individual level, following the ethically right path will help to control the pandemic in a swift and efficient manner, which will be beneficial to all.