Editor’s note: This full story is an online exclusive. A portion of the story can be found on page five in Issue 13 of The Beacon.

On March 9, the Honors Program held an ethics seminar, discussing who should receive the COVID-19 vaccine first and the decision-making process. 

Interim Director Dr. Jonathan Kuiken and Assistant Jennifer McLaughlin were joined by Associate Professor and Chair of Pharmaceutical Sciences Dr. Marie A. Roke Thomas and Associate Professor of Pharmaceutical Sciences Dr. Mary F. McManus to speak on the topic. 

To start the lecture, McManus shared a list of seven hypothetical examples of recipients who would need the vaccine and posed a difficult question to attendees: Who should get it first? 

McManus explained that many factors go into answering this, and who receives the vaccine first will be the most important decision made in 2021. For example, there are the elderly who die at a much higher rate than others, the front line workers who come into contact with those infected and those with pre-existing conditions. 

When it comes to making these types of ethical decisions, it is important to ensure that the least served group benefits. This can take a negative turn depending upon how it is viewed.

“Our least served individuals in our community seemed to be hit the hardest,” said Thomas. “So, do we give the vaccine by race or ethnicity? Should we look at social vulnerability? The CDC developed a plan to roll it out based on social vulnerability. But, what happens then is that the first population you are giving this vaccine to are all people who are really vulnerable — are you just testing it out of them?”

Even to put aside who gets the vaccine first, there is then to consider whether or not to worry about people dying or simply the long-term effects: how do we monitor,  what about those who do not want it, should it be made mandatory? 

In order for every American to receive the vaccine right now, 300 million doses would need to be deployed. But even then, how does it get administered? The decisions continue to grow, but there is hope that everyone should have the vaccine by the end of May. 

McManus then went on to explain who is making these ethical decisions. 

“Under the Center for Disease Control, there is a committee, the Advisory Committee on Immunization Practices making these decisions,” said McManus. “They’ve been doing this for years — they are not brand new at this. They are the committee that makes the recommendations for the CDC in terms of all immunizations. So, what they did was set up a workgroup and that is where the ethical principles are being applied for allocating initial supplies of the COVID-19 vaccine.”

ACIP consists of four fundamental ethical principles that aid them in their decision-making: maximize benefits and minimize harm, promote justice, mitigate health inequities (reduce and address all barriers and achieve health and wellbeing for all) and promote transparency. 

The floor was then opened to questions, in which Kuiken started by looking to both the past and future. 

“Even if we do want to help these underserved communities, sometimes the infrastructure does not exist and sometimes the communication abilities do not exist,” said Kuiken. “So, even if our plan today is perfect, we might still suffer from some of those inequities. Do you think that there are ways for us to overcome that now? Or, is this something we have to deal with long-term?” 

Both McManus and Thomas agreed that it is both. There are constantly hold-ups in the allocation of the vaccine despite their best efforts to provide to communities. And when that happens so frequently, people start to lose trust. 

It is a frustrating learning process but a learning process nonetheless.