Table 1

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

PrincipleReasoningPoint system
Ability to provide careWithout the capacity to treat critically ill patients, a vaccine is the only potential intervention for patients in low-income countries; they should receive priorityHigh (well-developed ICU resources)Medium (limited ICU care or respiratory resources)Low (no ICU care)
Ability to implementVaccines should not be allocated if they cannot be used. Efforts should be made to support low-income countries for distribution and implementationWould need significant external resources to implement.Can acquire supplies and train personnel to implement, but not immediately readyHas necessary supplies and personnel to implementHas necessary supplies and personnel to implement, shares resources with other countries
ReciprocityA country and its people should be rewarded for their participation in develop and testing vaccines.Hindered global efforts or attempted to obtain exclusive accessDid not participate in vaccine development processIndicated desire to participate but was unable due to resources or abilityParticipated in clinical trials, aided in surveillance efforts, donated viral samples
  • ICU, intensive care unit.