Wiśniowska, Karolina and Żuradzki, Tomasz and Ciszewski, Wojciech
(2022)
Value choices in European COVID-19 vaccination schedules:
how vaccination prioritisation differs from other forms of priority-setting.
Journal of Law and the Biosciences, 9 (2).
pp. 1-32.
ISSN 2053-9711
Abstract
With the limited initial availability of COVID-19 vaccines in the first months of 2021, decision makers had to determine the order in which different groups were prioritised. Our aim was to find out what normative approaches to the allocation of scarce preventive resources were embedded in the national COVID-19 vaccination schedules. We systematically reviewed and compared COVID-19 vaccination prioritisation regulations in 29 countries: 27 members of the European Union, the United Kingdom, and Israel. We differentiated between two main types of priority categories: groups that have increased an infection fatality rate (IFR) compared to the average for the general population and groups chosen because their members experience increased risk of being infected (ROI). Our main findings show a clear trend: all researched schedules prioritised criteria referring to individual IFR (in particular being over 65 years old and coexisting health conditions) over the ROI criteria (e.g. occupation and housing conditions). This is surprising since, in the context of treatment, it is rather common and justifiable to adopt very different allocation principles (e.g., introducing a saving more life-years approach or prioritising younger patients). We discuss how utilitarian, prioritarian, and egalitarian principles can be applied to interpret these normative differences between the allocation of curative and preventive interventions.
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