Table 1

A multivalue ethical framework for the global allocation of a severe acute respiratory syndrome coronavirus 2 vaccine

Principle	Reasoning	Point system
Principle	Reasoning	0	1	2	3
Ability to provide care	Without the capacity to treat critically ill patients, a vaccine is the only potential intervention for patients in low-income countries; they should receive priority	–	High (well-developed ICU resources)	Medium (limited ICU care or respiratory resources)	Low (no ICU care)
Ability to implement	Vaccines should not be allocated if they cannot be used. Efforts should be made to support low-income countries for distribution and implementation	Would need significant external resources to implement.	Can acquire supplies and train personnel to implement, but not immediately ready	Has necessary supplies and personnel to implement	Has necessary supplies and personnel to implement, shares resources with other countries
Reciprocity	A country and its people should be rewarded for their participation in develop and testing vaccines.	Hindered global efforts or attempted to obtain exclusive access	Did not participate in vaccine development process	Indicated desire to participate but was unable due to resources or ability	Participated in clinical trials, aided in surveillance efforts, donated viral samples