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Value choices in European COVID-19 vaccination schedules: how vaccination prioritisation differs from other forms of priority-setting

Wiśniowska, Karolina and Żuradzki, Tomasz and Ciszewski, Wojciech (2022) Value choices in European COVID-19 vaccination schedules: how vaccination prioritisation differs from other forms of priority-setting. Journal of Law and the Biosciences, 9 (2). pp. 1-32. ISSN 2053-9711

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Abstract

With the limited initial availability of COVID-19 vaccines in the first months of 2021, decision makers had to determine the order in which different groups were prioritised. Our aim was to find out what normative approaches to the allocation of scarce preventive resources were embedded in the national COVID-19 vaccination schedules. We systematically reviewed and compared COVID-19 vaccination prioritisation regulations in 29 countries: 27 members of the European Union, the United Kingdom, and Israel. We differentiated between two main types of priority categories: groups that have increased an infection fatality rate (IFR) compared to the average for the general population and groups chosen because their members experience increased risk of being infected (ROI). Our main findings show a clear trend: all researched schedules prioritised criteria referring to individual IFR (in particular being over 65 years old and coexisting health conditions) over the ROI criteria (e.g. occupation and housing conditions). This is surprising since, in the context of treatment, it is rather common and justifiable to adopt very different allocation principles (e.g., introducing a saving more life-years approach or prioritising younger patients). We discuss how utilitarian, prioritarian, and egalitarian principles can be applied to interpret these normative differences between the allocation of curative and preventive interventions.


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Item Type: Published Article or Volume
Creators:
CreatorsEmailORCID
Wiśniowska, Karolinakarolina.wisniowska@uj.edu.pl0000-0002-0848-9723
Żuradzki, Tomaszt.zuradzki@uj.edu.pl0000-0001-6749-2124
Ciszewski, Wojciechwojciech.ciszewski@uj.edu.pl
Keywords: COVID-19, health care ethics, prevention, prioritarianism, vaccination, vulnerability
Subjects: Specific Sciences > Medicine > Biomedical Ethics
General Issues > Ethical Issues
Specific Sciences > Medicine > Health and Disease
General Issues > Science and Policy
General Issues > Theory/Observation
Depositing User: Ms. Karolina Wiśniowska
Date Deposited: 30 Dec 2022 08:17
Last Modified: 30 Dec 2022 08:17
Item ID: 21594
Journal or Publication Title: Journal of Law and the Biosciences
Publisher: Oxford University Press
Official URL: https://academic.oup.com/jlb/article/9/2/lsac026/6...
DOI or Unique Handle: https://doi.org/10.1093/jlb/lsac026
Subjects: Specific Sciences > Medicine > Biomedical Ethics
General Issues > Ethical Issues
Specific Sciences > Medicine > Health and Disease
General Issues > Science and Policy
General Issues > Theory/Observation
Date: 2022
Page Range: pp. 1-32
Volume: 9
Number: 2
ISSN: 2053-9711
URI: https://philsci-archive-dev.library.pitt.edu/id/eprint/21594

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