Table 6

Comparison of ethical frameworks for distribution of COVID-19 vaccines

Priority to frontline and essential workers?Priority to high risk of severe disease/ death?Priority to high risk of infection?Priority to saving the most lives?Other criteria?
Global allocation criteria
 Jecker, Wightman, DiekemaYesYesYesYesNarrow social utility, help the needy, reduce health disparities, show equal respect, build trust
 WHOYesNoNoNoProportional to population
YesQualifiedQualifiedQualifiedOpening economies
 Emanuel, Persad, Kern, et al YesNoNoNoSEYLL, priority to the disadvantaged, reduce risk of transmission
Domestic allocation criteria
 NASEMYesYesYesYesReduce risk of transmission, equality
 Johns Hopkins UniversityYesYesQualifiedYesReduce risk of transmission, reciprocity, trust, opening economies
 ACIPYesYesNoYesMaximise benefits/minimise harms, equity
  • ACIP, Advisory Committee on Immunization Practices; NASEM, National Academies of Sciences, Engineering and Medicine; SAGE, Strategic Advisory Group of Experts; SEYLL, standard expected years of life lost.