The allocation of preventive interventions : the case of COVID-19 vaccination schedules

In the early stage of the COVID-19 pandemic, many professional associations, healthcare institutions, and governmental bodies published or updated prioritization guidelines regarding the allocation of scarce medical resources, e.g., beds or artificial ventilation in intensive care units. Later, in the second half of 2020, many governments published detailed prioritization schedules for the distribution of COVID-19 vaccines, which were scarce goods at the turn of 2020 and 2021. Unlike guidelines on medical treatment (Hans‐Jörg et al., 2021), official schedules on the distribution of medical prevention have not yet been analyzed or compared in scholarly journals. Thus, our main aim is to provide the first systematic international comparison of the official prioritization schedules for vaccinations in 29 countries (EU, UK, and Israel) and to analyze the values and principles implicitly embedded in these documents. Although some scholars suggest that prioritization during the pandemic raises structurally similar dilemmas in the cases of diagnosis, treatment, and prevention (Emanuel et al. 2020), we highlight and analyze the specific nature of allocation decisions in the case of prevention. Our study shows that two groups were vaccinated first in almost all of the researched countries: frontline medical workers as well as personnel and residents of nursing homes. We assume that the reasons why they were prioritized are mixed: direct (protecting persons belonging to this group) and indirect (because of someone else’s interests).