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Vaccine ethics: an ethical framework for global distribution of COVID-19 vaccines
  1. Nancy S Jecker1,
  2. Aaron G Wightman2,
  3. Douglas S Diekema2
  1. 1 University of Washington School of Medicine, Department of Bioethics and Humanities, Seattle, Washington, USA
  2. 2 Seattle Children's Hospital and Research Institute, Treuman Katz Center for Pediatric BIoethics, Seattle, Washington, USA
  1. Correspondence to Dr Nancy S Jecker, Department of Bioethics & Humanities, University of Washington, Seattle, WA 91895, USA; nsjecker{at}


This paper addresses the just distribution of vaccines against the SARS-CoV-2 virus and sets forth an ethical framework that prioritises frontline and essential workers, people at high risk of severe disease or death, and people at high risk of infection. Section I makes the case that vaccine distribution should occur at a global level in order to accelerate development and fair, efficient vaccine allocation. Section II puts forth ethical values to guide vaccine distribution including helping people with the greatest need, reducing health disparity, saving the most lives and promoting narrow social utility. It also responds to objections which claim that earlier years have more value than later years. Section III puts forth a practical ethical framework to aid decision-makers and compares it with alternatives.

  • allocation of healthcare resources
  • distributive justice
  • ethics
  • public health ethics
  • COVID-19

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  • Contributors All authors contributed to developing ideas and arguments contained in the paper, researching and writing the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.