Ethical decision to be made: A vaccine distribution plan must be developed where the number of needed vaccinations significantly exceeds the supply. 

Link to worksheet


  • You are the public health official for a country of approximately 360,000 people.
  • Due to personal privacy and census information limitations, there is uncertainty in the demographic information.
  • The chart below provides the most comprehensive overview until the next census. Recognize the limitation here that individual citizens may be counted in more than one category listed below.
  • Nevertheless you are responsible for developing an initial 6 month schedule to allocate vaccines to the citizens.
  • Only one pharmaceutical company has an approved vaccination.
  • Currently it can produce 100 vials of vaccine per day.
  • It will take greater than 12 months before another vaccine production facility comes online to manufacturer the vaccination.
  • The country's public health department provided you the following information and bar chart of key demographic values that you will use to allocate the vaccine.
  • People over the age of 70 years old are twice as likely to die from the virus.
  • Financially poor people are at high risk of contracting the virus due to living conditions.
  • Agricultural workers are needed to provide food to the population.
  • Medical professionals and Emergency workers are needed to care for both pandemic and non-pandemic patients.
  • Military personnel are critical to protect against aggressive neighboring countries.

Analysis questions:

  • If 100 vials of vaccine are produced each day, how many vials are available each month?
  • How many months are required to vaccinate the entire population?


Ethical decision-making process:

  • What are the ethical issues? What does not feel right?
  • What are the relevant facts? Is anything missing or distorted?
  • Who are the stakeholders? What are their influence on the situation?
  • What are the situational factors?
  • What are the values in conflict?
  • How do the ethical frameworks apply? Is anyone/any group not acting with virtue? Are any ethical rules being violated? How would the most benefit to the largest number of people be achieved? Should only people be considered?
  • What are possible solutions? What are the consequences? What must be monitored in the future?
  • What was your final solution and justification?
  • As  you think through this, make a note of the unanswered questions you would like to receive answers to.
  • Make a note of any demographic details you would recommend the country begin collecting in order to aid in responding to future public health emergencies?


Implement your solution:

  • Complete the table below that will determine how to ration the vaccine to the citizens.
6 month vaccination implementation schedule
Demographic overview (*individuals may be counted in multiple categories) Population 1 2 3 4 5 6 6 month total
Poor 180,000
Older than 70 yrs old 72,000
Historically discriminated 79,200
Agricultural workers 3,600
Medical professionals 7,200
Emergency responders 5,400
Military 12,600
Total 360,000





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