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Justice in COVID-19 vaccine prioritisation: rethinking the approach
  1. Rosamond Rhodes
  1. Medical Education, Mount Sinai School of Medicine, New York, New York, USA
  1. Correspondence to Dr Rosamond Rhodes, Medical Education, Mount Sinai School of Medicine, New York, New York, USA; Rosamond.Rhodes{at}


Policies for the allocation of COVID-19 vaccine were implemented in early 2021 as soon as vaccine became available. Those responsible for the planning and execution of COVID-19 vaccination had to make choices about who received vaccination first while numerous authors offered their own recommendations. This paper provides an account of how such decisions should be made by focusing on the specifics of the situation at hand. In that light, I offer an argument for prioritising those who are likely vectors of the disease and a criticism of the victim-focused priority proposals put forward by the US Centers for Disease Control and Prevention, the National Academies of Sciences, Engineering, and Medicine, the UK National Health Service, and others. I also offer thoughts on how those authors may have gone astray.

  • COVID-19
  • public policy
  • resource allocation
  • distributive justice
  • ethics

This article is made freely available for use in accordance with BMJ’s website terms and conditions for the duration of the covid-19 pandemic or until otherwise determined by BMJ. You may use, download and print the article for any lawful, non-commercial purpose (including text and data mining) provided that all copyright notices and trade marks are retained.

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  • Presented at The material for this paper was presented on the following panels: ASBH, 'Justice at Stake: Distributing a COVID-19 Vaccine', 18 October 2020; 'What Did Bioethics Contribute to the COVID-19 Pandemic Response? A Retrospective', Wiley Press Symposium, 17 March 2021; and 'Equity and Justice in the COVID-19 Emergency', Fondazione Bruno Kessler, Trento, Italy, 18 May 2021.

  • Correction notice This paper has been updated since first published to correct author details in footnote xi.

  • Contributors RR is the sole author of this paper.

  • 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.