COVID-19 vaccine distribution is a chance for social equity, medical ethicists say

“The vaccine is not going to get to the places where it’s most needed unless we actually really make an effort to do that.”

As the country gears up for a massive deployment of overnight delivery trucks filled with the Pfizer Biontech vaccine for COVID-19 on dry ice, medical personnel are getting ready to vaccinate thousands of frontline workers and the elderly.

That formula is being considered by medical ethicists and social justice medicine, who wonder if the vaccines will get to enough of the right people to stop the worldwide spread.

“This is a chance to save the world,” said Dr. Rachel Pearson, a UT Health assistant professor of pediatrics and a Ford Foundation global equity fellow. She agrees with the National Academy of Sciences, Engineering, and Medicine, which wants the government to set aside 10% of available vaccines for the disadvantaged.

“The hope is that some extra portion is reserved to send to those places where people are most likely to get sick and die from the coronavirus,” she explained. “It’s about equity, but it’s equity in service of saving the most lives.”

For example, on the 0-1 scale on the CDC’s Social Vulnerability Index, Bexar County is considered at risk at 0.8. But along the border in Duvall County, the population registers at the top of the scale at .998. Medical ethicists believe that makes Duvall County’s residents harder to reach, harder to treat, and therefore more likely to spread the virus.

“The vaccine is not going to get to the places where it’s most needed unless we actually really make an effort to do that,” said Pearson.

Dr. Jason Morrow, a palliative care physician and clinical ethicist at UT Health, agrees that there is a higher danger to those without transportation and resources to get in line for the vaccine.

“They could end up last in line for access to resources by virtue of their existing disenfranchisement, so it becomes a vicious cycle because they’re always on the outside looking in,” he said.

And that sentiment is not just about Texas border towns, but also worldwide spread. Since those living in impoverished countries are not as likely to have a state-of-the-art vaccination distribution program like the U.S., or the latest advances in health care at the ready, they become the riskiest in the world of the Covid-19 pandemic. That’s where the lack of a worldwide coordinated vaccine distribution system could ensure that Covid 19 continues to flare up again and again.

The U.S. has chosen not to join Covac Global, a coalition of countries making vaccines available worldwide, something Dr. Pearson and other ethicists find wrong.

“This is a global pandemic, not just a pandemic here in the US. If we want to stop it, we’ve got to stop it everywhere,” said Dr. Pearson.

To look at the CDC’s Social Vulnerability Index, click here. To read the report from the National Academies of Medicine on vaccine distribution and equity, follow this link.

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