COVID-19 Vaccine Distribution: An Ethical Approach

America is and has been ethically and structurally unprepared for the Coronavirus pandemic. Practical shortcomings became clearly evident in the early days of the pandemic, on issues such as mask production. But as we move into the ‘late’ stages of the pandemic and everything is allocated to the possibility of a vaccine, even more infrastructural concerns are arising. Some of these are identified clearly in Sarah Zang’s article A Covid-19 Vaccine Reality Check: the complications relating to the vaccine are even more threatening. The complicated nature of the disease and the potential two-step nature of the vaccine threaten to throw the US healthcare distribution process into complete disarray. I believe that to organize this incredibly important ethical healthcare issue, we can apply ideals we have studied in this class- mainly, a combination of general Utilitarianism and Norman Daniel’s Normal Function models.

The utilitarian distributive approach– Sarah Zhang identifies in her article the method of ‘prioritization’ of distribution, where healthcare officials meet to decide which groups are a priority and therefore should receive the vaccine first. Zhang says this has been used before- in the 2009 H1N1 pandemic, a prioritization system was put in place with considerable success. However, I believe that this system needs to be modified to fit with the Covid crisis, and Utilitarianism theory can help. Utilitarianism, as we know, advocates maximum well-being for the maximum amount of people. Under this theory, I would strongly advocate priority immunization of groups who are actively fighting the pandemic, such as healthcare workers and researchers. This would result in them being able to devote maximum effort and time to caring for the sick and researching a vaccine without the fear of the disease itself. Therefore, by increasing their productivity, they in turn would produce the most good for society as a whole. They may not be the most numerous group, but their professions and actions will undoubtedly have the largest possible positive repercussions for our society in this pandemic. After these high-priority, society-affecting groups have been immunized, the distributive approach undoubtedly needs to focus on providing vaccination to those at risk. Yet as Zhang argues, there is endless discourse and speculation about ‘at-risk’ populations and who truly deserves the vaccine. It is because of this situation that I propose the use of the Normal Function model.

The Normal Function approach– To provide a quick summary of the normal function approach: Health philosopher Norman Daniels advocates that healthcare should be provided first to those who are not able to function ‘normally’ and achieve their goals (operating in a ‘red’ rather than normal ‘green’ zone). This could be almost flawlessly applied to this Covid vaccine distribution crisis. After the healthcare workers/other groups I identified above was immunized, the distributive professionals should use this model to identify groups that are operating out of their normal function range because of Covid. An example would be someone with a compromised immune system who cannot attend work and achieve goals because of fear of catching and dying from Covid. This person is operating out of their ‘green’ zone, and therefore that group needs to be designated as a priority. Do not prioritize groups that are not being directly pushed out of their green zone by Covid-19. Rinse and repeat. We have extensive knowledge of how Covid and similar viral diseases affect patients with pre-existing conditions that we didn’t have in the past. We need to use that knowledge to designate priority groups with the normal function model; streamlining the distributive process.

Although I believe this process would work, I do leave some questions after writing it. I wonder how officials would agree on the defining value zones that are critical to the normal-function theory? I also (sadly) wonder how we could balance utilitarianism with the ever-present diaspora of financial and lobbyist influence in the US, especially in the healthcare industry. 

In conclusion, the Covid vaccine distribution process is undeniably technically and ethically complicated. The US administration was not adequately prepared for the structural difficulty of this complicated Covid crisis. However, in the lens of ethical distribution, I believe that by applying utilitarianism and the Normal function model to society, the distributive process would be immediately streamlined, allowing society to focus more on refining the technical aspects of the pandemic.

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