Stacy Weiner, Association of American Medical Colleges (AAMC); Is it ever okay to jump to the front of the vaccine line? An ethics expert weighs in
When a good is scarce, people sometimes behave badly to get it. Renowned bioethicist Arthur Caplan, PhD, offers advice on how to make the COVID-19 vaccine rollout more equitable, ethical, and trustworthy.
"What went wrong with applying ethical principles to vaccine distribution?
First, it became hard to roll out the vaccines to the priority groups, particularly the elderly. It turns out it’s not a great idea to ask them to make appointments on the internet [since they often lack access]. Also, some of them were homebound, so they couldn't get to vaccination sites.
As for health care workers, that term was never clearly defined. I think people had in mind front-line workers, but some hospitals and health systems were vaccinating everybody, including people who did psychotherapy remotely, even bioethicists and the board of trustees. So it looked to the public as though the rich were getting advantages. It looked like minority people weren't getting anything much — and they often weren’t.
If people think you're prejudiced, the sense of fairness falls apart, and then fewer people are willing to follow the rules.
In addition, once you opened Moderna and Pfizer [vials of] vaccines, you had to finish them. [Moderna has 10 doses per vial, and Pfizer has five or six.] But nobody issued any guidance about how to redistribute vaccines that are about to go bad. That destroyed trust because people said, “Well, you're just giving it to anybody who's nearby or somebody who waits in line for six hours.” All of that made better sense than throwing it away — but none of that was following any agreed-upon rules.
The rollout has been unfair, inefficient, and frustrating. It’s made the public angry, and it’s made them not trust in government.""
