ABSTRACT

Currently vaccines protecting from COVID-19 are a scarce resource. Prioritising vaccination for certain groups of society is placed in a context of uncertainty due to changing evidence on the available vaccines and changing infection dynamics. To meet accepted ethical standards of procedural justice and individual autonomy, vaccine allocation strategies need to state reasons for prioritisation explicitly while at the same time communicating the expected risks and benefits of vaccination at different times and with different vaccines transparently. In this article, we provide a concept summarising epidemiological considerations underlying current vaccine prioritisation strategies in an accessible way. We define six priority groups (vulnerable individuals, persons in close contact with the vulnerable, key workers with direct work-related contact with the public, key workers without direct work-related contact to the public, dependents of key workers and members of groups with high interpersonal contact rates) and state vaccine priorities for them. Additionally, prioritisation may follow non-epidemiological considerations including the aim to increase intra-societal justice and reducing inequality. While national prioritisation plans integrate many of these concepts, the international community has so far failed to guarantee equitable or procedurally just access to vaccines across settings with different levels of wealth.

摘要

目前，预防 COVID-19 的疫苗是一种稀缺资源。由于可用疫苗的证据不断变化和感染动态不断变化，优先考虑为某些社会群体接种疫苗是在不确定的背景下进行的。为了满足程序正义和个人自主权的公认道德标准，疫苗分配策略需要明确说明优先排序的原因，同时透明地传达不同时间和不同疫苗接种疫苗的预期风险和益处。在本文中，我们提供了一个概念，以一种易于理解的方式总结了当前疫苗优先战略的流行病学考虑。我们定义了六个优先群体（弱势群体、与弱势群体密切接触的人、与公众有直接工作相关接触的关键工作人员、与公众没有直接工作相关接触的关键工作人员、关键工作人员的家属和人际接触率高的群体成员）以及他们的国家疫苗优先事项。此外，优先排序可能遵循非流行病学考虑，包括旨在增加社会内部正义和减少不平等的目标。虽然国家优先计划整合了许多这些概念，但国际社会迄今未能保证在不同财富水平的环境中公平或程序公正地获得疫苗。优先排序可能遵循非流行病学考虑，包括旨在增加社会内部正义和减少不平等的目标。虽然国家优先计划整合了许多这些概念，但国际社会迄今未能保证在不同财富水平的环境中公平或程序公正地获得疫苗。优先排序可能遵循非流行病学考虑，包括旨在增加社会内部正义和减少不平等的目标。虽然国家优先计划整合了许多这些概念，但国际社会迄今未能保证在不同财富水平的环境中公平或程序公正地获得疫苗。