COVID-19 Vaccine: Distributional and Paternalistic Methods

In Sarah Zhang’s article, “A COVID-19 Vaccine Reality Check” in The Atlantic, she addresses the false hopes that the coronavirus vaccine is providing for America. She argues her case by stating America’s H1N1 vaccine procedures and how the coronavirus differs immensely. For example, the dosage is a two-step process and the uncertainty revolving around the coronavirus has yet to slow down. However, there are key similarities that, with ethical modification, America should implement. It is crystal clear that distribution will be an extremely complicated, particular process. America, as a whole, failed to address resource scarcity in the early stages of the pandemic, running out of masks and ventilators within weeks. While our focus must now shift towards a vaccine, keeping Zhang’s article and resource scarcity in mind, questions of what ethical practices that are justifiable must be put into place. I believe that America should take a modified, general utilitarian approach to distribution and heavily consider mandating the vaccine to a certain extent.

By taking the utilitarian approach to distribution, the allocation of resources will be properly addressed while respecting ethical practice. Zhang mentions the prioritization of certain groups of people as a successful procedure used during the 2009 H1N1 virus. This could be swiftly and effectively replicated for the coronavirus vaccine. The first group of people to be vaccinated and have priority should be healthcare workers, researchers, and officials on the frontlines of this pandemic. By vaccinating this group of people, we are adhering to the utilitarian perspective: a maximization of benefit and “good” produced in our society. These healthcare warriors could then devote their time and effort to save patients with great health, which is proven to increase productivity by economist Robert Fogel, and not have the preconditioned danger of receiving the virus. Furthermore, this group is fairly small with humongous value. With this method, we are still keeping in mind the scarcity of the vaccine. 

To streamline the process of distribution along, the people most vulnerable to the virus should receive vaccinations after healthcare workers. This would mainly include those with underlying health conditions and older adults in America: those who can truly not function “normally” due to the virus in their lives. Once again, we are adhering to the utilitarian perspective by decreasing the danger and effectiveness of the virus by protecting those most vulnerable. Thus, producing the most good and benefit by decreasing the threat that the COVID-19 virus possesses in America. This is also fairly similar to the normal function philosopher Norman Daniels stated while addressing the right to healthcare. However, this method becomes problematic after the first two prioritized groups: as it is extremely difficult to determine whose lives have been affected the most by this virus. 

Alongside questioning distribution methods, paternalism through the law (mandating the vaccine) could be justifiable to a certain extent and must be discussed. For example, if a healthcare worker or person with underlying health issues were, to hypothetically, deny the vaccine, should they still be able to work? Should we respect their autonomous decision? A golden rule when referring to paternalism in medicine is that overriding and/or restricting one’s autonomy is just if it is necessary to protect others in society. Refusing the vaccine is not only putting yourself in danger but putting others at risk that may be tremendously vulnerable to the coronavirus. To protect some autonomy, vaccines should be mandated to return to education at schools, the workplace, and other essential places. What is deemed to be an “essential place” is yet another complication to the hundreds of other logistical practices that must be addressed to successfully deliver the vaccine to the people.

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