Statistics from Altmetric.com
If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.
A number of countries are considering administering COVID-19 vaccines in ways that have not been informed by clinical trials, nor recommended by the manufacturers or authoritative international health bodies, in order to provide some protection for a greater number of people under conditions of vaccine scarcity, or for other reasons.
Proposals include delaying the second dose of two-dose vaccines beyond the period for which there is evidence from clinical trials, or foregoing it entirely, giving fractional doses, providing vaccines for individuals outside recommended age ranges, or providing different vaccines for the first and second, or booster, doses.
The WHO Strategic Advisory Group of Experts on Immunization Values Framework provides a valuable ethical background for considering the policy questions concerning choice of vaccine modalities, highlighting that vaccines are a global public good for the benefit of all, and drawing on values of human well-being, equal respect, global and national equity, reciprocity and legitimacy.
This paper considers the factors that we believe governments have an ethical duty to take into account in considering the vaccination modality they adopt.
In developing their policies, governments must take seriously the evolving scientific evidence base, as well as potential effects on public trust, the legitimate expectations and rights of those who have been begun the vaccination process, responsibility to the global community and equity, among others considersations, and to communicate their reasons for their decisions appropriately to the affected populations.
Any decision to adopt a modality that differs from those recommended by manufacturers must be accompanied by comprehensive and clear mechanisms to follow-up those in alternative modalities.
As a growing number of vaccines for COVID-19 gain emergency use designation, including emergency use authorisation and conditional marketing authorisation under different jurisdictions, the WHO Strategic Advisory Group of Experts on Immunization (SAGE)1 has issued a number of …