Question: What ethical consideration should governments or vaccine manufacturers take to ensure a fair distribution of vaccines

Answer passage (source: WHO):
page_title: Q&A: Ethics and COVID-19: resource allocation and priority setting
section_headers: What conclusions can we draw about the fair allocation of scarce resources within countries during the COVID-19 outbreak?
section_content: 
Health care workers (caring for patients) and first responders can justifiably be prioritized when allocating some resources because of their contribution to the health and well-being of the community. Their health helps preserve the health of others.
Participants of research aimed at developing vaccines, therapies or other critical resources should receive some priority in receiving those resources because they have also helped save others by their participation. This is not an absolute priority – for example, it should not take precedence over giving priority to those most at risk in the case of resources such as vaccines.
While the principle of first come, first served is often applied when allocating resources in health care settings, it is rarely appropriate in an emergency. In practice, it is very likely to favour certain groups, such as those closest to a distribution centre, those with access to better information, or those who are most well-off.
Younger populations appear to be at lower risk in the COVID-19 context. Consequently, the principle of youngest first should have low priority for vaccine, but perhaps may have more weight if they do become sick and need critical care resources.
The allocation of different resources may find ethical justification in different principles or values. For instance, if a novel vaccine is found to be safe and effective, a lottery-based allocation may be justified among those as highest risk, the old and those with co-morbidities, if they outnumber available vaccines.
Maximizing utility should be balanced with the principle of priority to the worst-off: centralizing the availability of resources in larger centres may extend their benefits to more people, but may exclude isolated populations and challenge our concern for those at highest risk.


Reviewer feedback on this answer:
Detailed list of how vaccines should be distributed to different groups. Fully answers question.
The answer goes into a great amount of detail concerning who should have priority for the vaccine. There is a detailed list with that information. This is a direct answer to the question.

Reviewer ratings:
Excellent
Excellent

Answer passage (source: WHO):
page_title: Q&A: Ethics and COVID-19: resource allocation and priority setting
section_headers: What are the key ethical considerations that governments, vaccine manufacturers and funders should take into account to ensure a fair distribution of vaccines globally?
section_content: Countries are equally vulnerable to COVID-19 and have a shared responsibility,
grounded in solidarity, to collaborate globally to mitigate the outbreak. Each
government has special obligations to its own citizens, but the fair
allocation of vaccines globally requires us not to simply appeal to self-
interest, claims of resource ownership and the prioritization of compatriots.
Vaccines should be allocated in a way that prioritizes those who fall into the
categories presented in the below table. (Where individuals or populations
fall into multiple categories, they should receive even higher priority.)
Priority populations, and rationale for prioritization
Priority population|  Rationale for prioritization
---|---  
Those at greatest risk of becoming infected and seriously ill
| Maximize benefit of vaccine  
Those who, if vaccinated, would prevent the greatest spread of the virus
| Maximize benefit of vaccine  
Those who have volunteered to participate in research aimed at developing the
vaccine
|
Reciprocal obligation to those who were voluntarily put at risk to aid in this
effort  
Those falling into each category may change over time.

Reviewer feedback on this answer:
Lays out rationale for how a vaccine should be distributed once it is found.
The answer addresses the idea of prioritizing vaccines, but it doesn't give any information concerning how it should be prioritized, and who should get priority. It's very general and vague.

Reviewer ratings:
Excellent
Could be Improved

Answer passage (source: WHO):
page_title: Q&A: Ethics and COVID-19: resource allocation and priority setting
section_headers: Are the ethical considerations the same for all medical countermeasures, including therapeutics, vaccines and personal protective equipment (PPE)?
section_content: Generally, the considerations may be different. The allocation of different
resources may find ethical justifications in different principles or values.
For instance, once a novel vaccine is found to be safe and effective, to
prioritize those at highest risk, as well as populations like health care
workers who may be more likely to serve as vectors for transmission, is
justified.
Within those subgroups, some suggest that a lottery-based (i.e., random)
allocation may be justified, given that resources will be limited and we can
assume nearly equal benefits will be derived from any recipient within that
group. This is not the case, however, for other resources such as ventilators,
where some individuals may derive significantly more benefit than others.  

Reviewer feedback on this answer:
Describes ethical considerations when distributing vaccines. Fully on-topic.
The question wants to know about distributing vaccines fairly. The answer goes into pretty good detail about how the vaccine should be distributed, including prioritizing health care workers and high risk individuals.

Reviewer ratings:
Excellent
Excellent