Ethical allocation of scarce vaccine doses: The Priority-Equality protocol

Area of Science:

• Mathematical social sciences
• Public health ethics
• Epidemiology

Background:

• Vaccine demand often outstrips supply during pandemics, necessitating ethical rationing protocols.
• Existing protocols must balance individual equity with the prioritization of at-risk and essential populations.
• COVID-19 vaccination allocation faced ethical challenges due to its territory-based and localized prioritization methods.

Purpose of the Study:

• To investigate ethical desiderata for vaccine allocation methods using a formal-analytical approach.
• To identify and algorithmically formulate methods that satisfy ethical principles of equity and prioritization.
• To evaluate existing allocation procedures against established ethical standards.

Main Methods:

• Employed a formal-analytical framework from mathematical social sciences.
• Investigated the algorithmic formulation of allocation methods satisfying ethical criteria.
• Assessed whether known and unknown allocation methods meet combined ethical desiderata.

Main Results:

• Identified a unique algorithm that equally treats individuals while prioritizing the worst-off.
• Demonstrated the algorithm's implementability and desirable properties.
• Showed that COVID-19 pandemic allocation procedures violated key ethical principles.

Conclusions:

• Developed a readily applicable algorithm that improves upon existing methods for vaccine distribution.
• Concluded that ethical principles mandate the adoption of this algorithm for pandemic vaccination campaigns.
• Highlighted the algorithm's superiority in ensuring both equal treatment and prioritization of vulnerable groups.