ETHICS OF THE COVID-19 VACCINE

THE DIFFICULTIES OF DISTRIBUTION

ETHICS OF THE COVID-19 VACCINE

By Rachel Zhang Sophia Carino

In the past year, the COVID-19 pandemic has brought immeasurable loss, suffering, and isolation to hundreds of millions of people across the globe. As the virus and its new variants exhibit detrimental effects, the world has poured copious funding into the development and research of vaccines. Under normal circumstances, the production and distribution of a vaccine involve extensive funding for research, reviews, and clinical trials in a process which can take several decades. Given the urgency of COVID-19, these results were accelerated to reach approval within just 12 months. As the virus continues its way into 2021, several of these vaccines have been approved and are readily available.

In the United States, Pfizer-Biotech and Moderna are two mRNA vaccines which were approved in late December 2020. The mRNA injected through the upper arm provides the body’s immune system, particularly the memory T and B cells with key information regarding how to fight the virus given an actual encounter. Pfizer-Biotech administers a two-shot vaccine with a 21-day difference, whereas Moderna has a longer, 28-day difference between the first and second shot.

As of February 2021, Johnson & Johnson applied for emergency FDA approval for a different, one-shot vaccination. This vaccine modifies an adenovirus, which stores instructions to fight COVID-19 in DNA rather than mRNA.

Nevertheless, as these vaccines develop and phases of distribution begin, there remain several complex issues regarding which countries and which people should be receiving this finite number of vaccines first.

distribution in countries

Evidently, the development of a vaccine with sufficient funding has disproportionately occurred in wealthier countries which can afford such urgent acceleration.

As these vaccines roll out, many wealthier governments pre-order a large percentage of produced vaccines, to the extent that there are few left for lower-income countries. Due to high global demand, lower-income countries are unable to purchase as many vaccines and must pay a higher price for the same number of vaccines. As of February 4th, 68 countries and territories worldwide have begun vaccine distribution, but only four of these countries are from Africa. South Africa, a region hit hard by the virus and the new variant, paid $5.25 per dose when compared to the $3.00 per dose deal secured by the African Union just two weeks before. With 1.5 million cases and 45,000 deaths, South Africa requires these vaccines just as much, if not more than other lower-paying countries do.

And yet, while wealthy countries increase their vaccine distributions and buy up the finite supplies which exist, there also comes the realization that an improved economy and safe world can only be achieved through equal distribution to lower-income countries as well. In the US, the Pfizer and Moderna vaccines require refrigeration at colder temperatures, and these conditions cannot be maintained in many parts of the world. To deliver two separate shots in a given timeframe, there must be modes of transportation and tracking, which is also not globally plausible. More vaccines and more distributable vaccines must be extended to lower-income countries or the world is incapable of returning to any former sense of normalcy.

distribution in populAtions

Within each country, there are additional issues in deciding which people within the population receive the vaccine first. Should it be healthcare workers? Elderly? Teachers? Politicians? What about prisoners? The general public? Should the vaccine be distributed at random?

There are many conflicting views about the prioritized demographics in vaccine distribution, and there are many conflicting reasons in favor of different people. While primary distribution to healthcare workers is a given, the situation gets more complicated immediately afterwards. When it comes to the elderly versus younger generations, vaccinating older adults averts less deaths, whereas vaccinating younger adults averts more infections. Prisons have become COVID-19 breeding grounds, as communal living in confined spaces facilitates spread. When it comes to in-person educational instruction, teachers also need the vaccine for this to be a safe experience. Different countries and groups of people have considered these prioritizations in different ways, as there is no concrete answer for the distribution of finite vaccines amongst a sea of people who wish to receive it.

In the US, the Centers for Disease Control and Prevention

has announced their distribution phases (left image).

The City of Chicago follows a similar order of distribution phases (right image).

tAKing the vAccine

While the development of COVID-19 vaccines decreases the risk and severity of COVID19, there are several reasons why a person may avoid taking the vaccine.

The CDC recommends against taking the mRNA vaccine for anyone who has had either anaphylaxis (severe allergic reaction) or an immediate allergic reaction to polyethylene glycol (PEG), polysorbate, or any other potential allergen in an mRNA COVID-19 vaccine. Many people express concern about safety due to the speed at which the vaccine was produced, and many believe the misconception that the vaccine could alter one’s DNA. Many are also concerned regarding the longterm effects of the vaccine.

Despite these concerns, a majority of the population must take the vaccine in order to return to some resemblance of normal life. Roughly 70-90% of the population must either be vaccinated or have antibodies against the virus to achieve herd immunity, assuming that COVID-19 variants do not make this entirely impossible. Lingering concerns and refusing people will make this process rather difficult.

to conclude

The COVID-19 pandemic presents itself to the world as a difficult, unfamiliar situation through which inequities and dysfunctional systems are brought to light. The distribution of COVID-19 poses several ethical and reasonable questions regarding how the United States, and also the entire world, should respond to the difficulties provided by a global health crisis. As the virus spreads further and new variants arise, only time will tell the extent to which our vaccines are effective and if the world is able to combat the COVID-19 pandemic on a united front in favor of a return to normalcy.

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