There’s been lively discussion about whether people will be willing to take a vaccine for COVID-19 when it becomes available. It’s a question each of us will have to answer for ourselves sooner or later. But the debate obscures a more complex reality: when an effective and safe vaccine finally arrives, it will initially be in scarce supply. No country or business has the manufacturing capacity to quickly provide enough doses for an entire population.
The big question we should be considering, therefore, is who should get vaccinated first, and who should be next in line thereafter? Do certain groups within the population deserve priority over others? And if so, what considerations should influence these decisions?
This is not the first time we’ve been faced with this type of “allocation problem.” Typically, vaccine allocation decisions are made with a view toward maximizing the overall health benefit: to achieve the greatest