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Politics, Policy & Law

Academics propose ‘fair priority model’ to allocate COVID-19 vaccines

Sep 4, 2020 | 12:02 AM GMT

A team of academics has published a framework, dubbed the Fair Priority Model, for global COVID-19 vaccine allocation that it contends is more “ethically defensible and practical” than distribution schemes proposed by the WHO. 

Amid concerns regarding vaccine nationalism, various initiatives have launched to ensure equitable global distribution. For example, in June, the COVID-19 Vaccine Global Access (COVAX) Facility and the Gavi COVAX Advance Market Commitment purchased guarantees for more than 15 billion doses of COVID-19 vaccines over six years (see “Global Health Funders Plan to Buy 15 Billion COVID-19 Vaccine Doses”“Global Access to COVID-19 Vaccines”). 

In a Science paper published Thursday, an academic group led by Ezekiel Emanuel, vice provost for global initiatives and chair of the department of medical ethics and health policy at the University of Pennsylvania’s Perelman School of Medicine, outlined three phases of vaccine distribution that prioritize preventing more “urgent” harms earlier.

Phase I of the Fair Priority Model would allocate vaccines in order to reduce premature deaths caused by COVID-19 directly or indirectly; Phase II would aim to stem serious economic and social harms; and Phase III would seek to reduce and ultimately end community transmission. 

The authors also outlined metrics that international coalitions, vaccine developers and national governments could use to calculate and prioritize distribution.

In June, the WHO presented a framework in which countries would receive doses proportional to their respective populations. According to the authors, COVAX “currently accepts this proposal, which is undergoing revision.” 

However, the authors stated that this model “mistakenly assumes that equality requires treating differently situated countries identically rather than equitably responding to their different needs.”

A second WHO proposal would distribute vaccines to countries according to the number of front-line healthcare workers, the proportion of the population over 65 and the number of people with co-morbidities. “It is an empirical question whether this prioritization optimally reduces death, let alone premature death or serious economic harms,” the authors wrote. 

Meanwhile, the governments of the U.S., EU, U.K. and Canada have collectively procured more than 1.5 billion vaccine doses directly from vaccine developers (see “Mapping Dose Commitments”). 

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