Vaccine Rationing and the Urgency of Social Justice in the Covid-19 Response

Hastings Cent Rep. 2020 May;50(3):46-49. doi: 10.1002/hast.1113. Epub 2020 May 28.


The Covid-19 pandemic needs to be considered from two perspectives simultaneously. First, there are questions about which policies are most effective and fair in the here and now, as the pandemic unfolds. These polices concern, for example, who should receive priority in being tested, how to implement contact tracing, or how to decide who should get ventilators or vaccines when not all can. Second, it is imperative to anticipate the medium- and longer-term consequences that these policies have. The case of vaccine rationing is particularly instructive. Ethical, epidemiological, and economic reasons demand that rationing approaches give priority to groups who have been structurally and historically disadvantaged, even if this means that overall life years gained may be lower.

Keywords: Covid-19; health disparities; public health ethics; public health policies; social justice; vaccine rationing.

MeSH terms

  • Age Factors
  • Betacoronavirus
  • COVID-19
  • Communicable Disease Control / organization & administration
  • Comorbidity
  • Contact Tracing / ethics
  • Contact Tracing / methods
  • Continental Population Groups
  • Coronavirus Infections / epidemiology*
  • Coronavirus Infections / ethnology
  • Coronavirus Infections / prevention & control*
  • Health Care Rationing / ethics*
  • Health Status
  • Health Status Disparities
  • Humans
  • Pandemics / prevention & control*
  • Pneumonia, Viral / epidemiology*
  • Pneumonia, Viral / ethnology
  • Pneumonia, Viral / prevention & control*
  • SARS-CoV-2
  • Social Justice
  • Socioeconomic Factors
  • Vaccines / supply & distribution*
  • Ventilators, Mechanical / supply & distribution


  • Vaccines