The American College of Physicians (ACP) released a statement supporting an “immediate ramping up of supply for distribution of COVID-19 vaccines equitably among and within countries in need,” citing not only an ethical but practical imperative to do so due to the fact that the pandemic will continue to spread without a coordinated global response.
As the ACP noted, more than 85% of the world’s population lives in low- and middle-income countries, which poses additional challenges to vaccine access. Currently, the COVID-19 pandemic is disproportionately affecting Brazil and India, where only 9% and 3% of the populations, respectively, are fully vaccinated. While the aims of the COVID-19 Vaccines Global Access initiative (COVAX) are of an unprecedented scope and scale, the current pacing cannot meet the ongoing need of communities around the world.
The ACP stated that they support vaccine distribution plans within countries based on medical criteria (eg, morbidity and mortality risk and COVID-19 transmission risk). They recommended using the following principles to guide vaccine allocation: first, maximize benefit to individuals by saving the most lives and caring for those most in need; and second, maximize benefit to public health by preventing infection and transmission.
Further, continual innovation and pipelines may be needed for different modes of vaccine administration as well as development and manufacturing techniques. For example, single-dose vaccines that are easier to store and transport could assist with rapid global distribution. Strategies are greatly needed for improved infrastructure, sharing of vaccine stockpiles, and more sustainable vaccine pricing and purchasing.
The ACP recognized that special efforts may be necessary to deliver vaccines to marginalized and underserved populations to promote equity. They also cautioned against using approaches that “systematically disadvantage certain groups of patients, including the ‘life years’ approach, which is biased against older individuals or those living with disabilities … the goal should be to maximize lives saved, using a science-based data-driven approach.”
The ACP statement also acknowledged the work that physicians may need to do to address “historical distrust of medicine in general or vaccines in particular” by promoting accurate health information.
“Plans should be developed through transparent and inclusive processes, consistently applied, and include accountability mechanisms to ensure they are followed,” the authors of the report stated.
American College of Physicians. ACP statement on global COVID-19 vaccine distribution and allocation: on being ethical and practical. Approved on June 8, 2021. Accessed June 15, 2021. https://www.acponline.org/acp_policy/policies/acp_statement_on_global_covid-19_vaccine_distribution_and_allocation_on_being_ethical_and_practical_2021.pdf