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Ethics of vaccination: measures used to inform SARS-CoV-2 vaccination priorities
  • Mike Millar,
  • Yannis Gourtsoyannis,
  • Angelina jayakumar
Mike Millar
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Yannis Gourtsoyannis
Barts Health NHS Trust
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Angelina jayakumar
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Abstract

Proposals for SARS-CoV-2 virus vaccination priorities in the UK and in many other countries are heavily influenced by epidemiological models, which use outcome measures such as deaths or hospitalisation. Limiting the values under consideration to those attributable to the direct effects of infection has the advantage of simplifying the models and the process of decision-making. However, the consequences of the pandemic extend beyond outcomes directly attributable to SARS-CoV-2 infection. The alternative to vaccination (in addition the threat of illness and death) is restrictions on educational and work opportunities, access to services, recreational activities, affiliations and relationships with others, freedom of movement (including escaping abusive relationships), and other determinants of human experience. Capability theory gives emphasis to the freedoms that individuals have to express themselves (in doings and beings). Restrictions on freedoms restrict our capabilities. Capability theory has been used to provide a framework for the evaluation and comparison of international development approaches and in the evaluation of public health policy. There is a clustering of disadvantages associated with this pandemic that adds to pre-existing inequalities. Much of the disadvantage engendered in the SARS-CoV-2 pandemic is left out when public health policy is based on a limited range of metrics. Acknowledging the impact of policy across the range of human freedoms at both a national and international level has the potential to improve policy, facilitate the mitigation of direct and indirect adverse consequences, and improve public confidence in vaccine deployment strategies.

Peer review status:ACCEPTED

29 Jan 2021Submitted to British Journal of Clinical Pharmacology
01 Feb 2021Submission Checks Completed
01 Feb 2021Assigned to Editor
28 Feb 2021Reviewer(s) Assigned
18 Mar 2021Review(s) Completed, Editorial Evaluation Pending
19 Mar 2021Editorial Decision: Revise Major
12 Apr 20211st Revision Received
13 Apr 2021Submission Checks Completed
13 Apr 2021Assigned to Editor
13 Apr 2021Review(s) Completed, Editorial Evaluation Pending
15 Apr 2021Editorial Decision: Accept