A research team from the JU Interdisciplinary Centre for Ethics has analysed vaccination schedules published by 29 states, including members of the European Union, Great Britain and Israel, with respect to the order in which they provided vaccination for different groups of citizens. The results of their research were published in the latest issue of the Journal of Law and Biosciences.
The common element of all vaccination policies was to prioritise health care workers as well as the staff and residents of nursing care facilities. Only 10 countries have also singled out teachers as a group to be prioritised when it came to COVID-19 vaccination, and an even lesser number have decided to do the same with employees of grocery stores (Austria, Germany, Ireland, Latvia, Romania and Slovenia).
There were also only 6 states which followed the recommendation of the World Health Organisation in providing migrants, refugees and prisoners staying in crowded conditions with a priority access to vaccination (Cyprus, Germany, Greece, Ireland, Latvia and Romania).
Researchers working on the project mapped out the differences in vaccination schedules. The main one was related to the criteria on which various countries based policies. In Great Britain, for example, the schedule was based solely on the age of citizens, while other countries took into account various other factors contributing to an increased risk of death from COVID-19. A few states also included increased risk of infection as a factor.
Karolina Wiśniowska from the JU Interdisciplinary Centre for Ethics, a PhD student at the JU Doctoral School in the Humanities, observed that there is no consensus among the experts as to how preventive measures should be distributed, and that there is no data on how this process looks like in reality.
The researchers point out that governments adopted different strategies when it came to designing policies for vaccination schedules and treating patients already infected with COVID-19.
In March and April 2020,several foreign medical associations published a set of recommendations on how to distribute medical equipment and drugs in situations where resources are scarce. In particular, they mentioned access to ventilators and beds in intensive care units.
‘Some of those recommendations were very controversial, as in the case of access to ventilators. Some posited we take into account the probability of survival of certain patients, while others suggested assessing their predicted lifespan going forward. This could lead to the exclusion of the elderly or patients with comorbidities’, said Prof. Tomasz Żuradzki, head of INCET.
The situation was different when it came to vaccination schedules. All of them prioritised groups with increased risk of death, such as the elderly and, sometimes, patients with comorbidities.
High chance of infection was taken into account much more rarely, with the exception of law enforcement and emergency services employees as well as social workers.
Vaccination and treatment schedules for different social groups are in stark contrast with the regulations concerning transplants, where it is not only important to save as many people from death, but it is also necessary to assess a procedure’s viability based on various factors, such as the expected lifespan and quality of life of the patient. In most countries, these regulations are very similar.
‘The moral judgements underlying vaccination schedules cannot be unequivocally interpreted within the light of dominant ethical frameworks. However, this ambiguity may be seen as their strong point’, said Dr hab. Wojciech Ciszewski from the JU Chair in Legal Theory. ‘Since the public opinion and experts represent various ethical standpoints, and broad support is necessary for successful vaccination strategies, the ability to defend these strategies on various moral grounds may increase their social legitimacy’, he added.
The paper is available under the following link: https://academic.oup.com/jlb/article/9/2/lsac026/6711428?login=false