During the COVID-19 pandemic, many countries have prioritised individuals for vaccination primarily on the basis of (intrinsic) risk factors such as older age and presence of comorbidities. Such a prioritisation strategy ignores risk of exposure to the virus and harm from non-pharmaceutical interventions. In this paper, we develop an account of fair allocation of vaccines. First, we argue fairness requires maximal proportional satisfaction of claims. Second, we argue what grounds people’s claim to vaccines is that they are at risk of harm, and fairness requires people are prioritised for vaccination in proportion to the risks they face. Third, we defend an expansive understanding of relevant harms; when allocating vaccines, governments should, in principle, include all pandemic-related risk of harm. Finally, we consider several ways in which different harms could be traded off against each other and defend giving priority to mitigating direct risk of harm from an infectious agent. Our account also provides a principled reason for compensating people who suffer disproportionally from indirect risks of harm (e.g., harms from non-pharmaceutical interventions).
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