Ethical Allocation of COVID-19 Vaccine in the United States: An Evaluation of Competing Frameworks for the Current Pandemic and Future Events

The COVID-19 pandemic, caused by the SARS-CoV-2 virus, created the need for aneffective vaccine. Questions arose about allocating the initial limited supplies in theUnited States. We present four allocation models and compare their characteristics forethically meeting the health needs of the population. The literature shares broadagreement on guiding ethical principles with those of the four proposed models forvaccine allocation, featuring the concepts of utilitarianism, prioritarianism, equity, andreciprocity. We conclude that the “Interim Framework for COVID-19 Vaccine Allocationand Distribution in the United States” from the Johns Hopkins Bloomberg School ofPublic Health is the most comprehensive and ethically sound. We recommendgovernment officials and policymakers at all levels consider the principles andobjectives in this model as U.S. COVID-19 vaccination distribution efforts continue.This model may serve as an effective framework for initial vaccine distribution effortsduring future epidemic and pandemic events.