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