Bioethics of Access to COVID-19 Vaccines

At the height of the COVID-19 pandemic, it was evident that ending the scourge would not be feasible without the use of an efficacious preventive vaccine, resulting in an accelerated research and development of the vaccines given the seriousness of the disease. This resulted in at least seven COVID-19 vaccines being given globally, under emergency use authorization. Due to the large demand for COVID-19 vaccines, the pharmaceutical industry was not able to meet the global need for these vaccines. This resulted in distribution of these vaccines largely being based on the ability of each country to buy them. Thus, most COVID-19 vaccines were given in resource-rich countries vis-a-viz resource-limited ones. Was this ethical? Furthermore, even countries that could afford the vaccines faced shortages since the pharmaceutical companies were unable to manufacture them in sufficient quantities due to huge global demand. This necessitated rationing of the vaccines such that they were being given in a phased-out manner, only to certain groups first before expanding it to others. What was the ethical basis for this? Who should have been given priority over others in getting these vaccines, and why? Are there sound ethical principles that underpinned tiered access to the COVID-19 vaccines? In this chapter, the ethical basis for COVID-19 vaccine distribution both at the global and at the local ecosystem is examined.