Show an ad over header. AMP

Vaccine ethics have created an unambiguous tradeoff between economics and public health

All lives are equally valuable. That's the strong consensus emerging from the many different countries and organizations that have struggled with the question of who should get first access to the COVID-19 vaccine.

Why it matters: The current scarcity of the vaccine looks like an economics problem — too much demand, and not enough supply. But no one is seriously proposing a market-based solution, where the vaccine goes first to those willing and able to pay to jump to the front of the line.


The big picture: The National Academies of Sciences, Engineering and Medicine have constructed an ethical framework based on three considerations.

  • Maximum Benefit means that the vaccine rollout should be designed to save the most lives, care first for those most in need, and prevent new infections. It does not include any economic considerations.
  • Equal Concern is the principle that "every person has equal dignity, worth, and value." This principle makes it impossible to look at economic concepts like "life-years," which, as the American College of Physicians points out, are "inherently biased against the elderly and the disabled."
  • Mitigation of Health Inequities means that populations experiencing the greatest burden from the disease should receive priority.

Details: No vaccination program will manage to abide perfectly by these ethical standards. If individual states receive vaccine allocations according to their overall population, for instance, that would violate the third principle. Maine's population is much older than Utah's, and Montana's population is much whiter than Mississippi's. But age and race are highly correlated with vulnerability to COVID-19.

  • There is universal agreement, however, that health workers and people in nursing homes should get the vaccine first, and that there should be no formal mechanism whereby individuals can buy early access to the vaccine.

What to watch: Rich people will get early access to the vaccine, just as they are currently getting access to antibody therapies. By the time the World Economic Forum holds its annual meeting in Singapore in May, it's a safe bet that many delegates will have managed to get themselves vaccinated somehow. (Which will surely come as a relief to Singapore's public-health agencies.)

  • Such vaccinations will probably be accompanied by sheepishness, however, since they will clearly be unfair.

Between the lines: Ethical considerations seemingly stop at national borders. Vaccine allocation according to ability to pay is shameful within countries — but has already largely determined vaccine distribution between countries.

  • Of note: The opportunity cost — measured in dollars — of taking the ethical path is impossible to calculate with specificity, but is certainly enormous. A GDP-maximizing algorithm would give large early allocations to healthy high-earners and would place little comparative value on the lives of the elderly.

The bottom line: We've finally reached a point at which there is an unambiguous tradeoff between economic activity and public health. To our credit, we've chosen the latter.

Biden administration seeks to allow separated migrant families to reunite in the U.S.

Secretary of the Department of Homeland Security Alejandro Mayorkas announced Monday that the Biden administration will explore "lawful pathways" to allow migrant families separated under the Trump administration to reunite in the U.S.

Why it matters: Biden has pledged to reunite the hundreds of families still separated as a result of the Trump administration's "zero tolerance" policy, and signed an executive order last month creating a family separation task force chaired by Mayorkas.

Keep reading... Show less

CDC director warns "now is not the time" to lift COVID restrictions, citing stalled progress

CDC Director Rochelle Walensky warned states on Monday that "now is not the time" to lift public health restrictions, as the recent dramatic declines in coronavirus cases and deaths "appear to be stalling."

Why it matters: While the average of 70,000 new infections and 2,000 daily deaths is nowhere near the extremely high levels recorded at the start of 2021, the figures are still a poor baseline to "stop a potential fourth surge" — especially with the threat posed by more contagious new variants, Walensky warned.

Keep reading... Show less

Sen. Elizabeth Warren introduces "ultra-millionaire" wealth tax bill

Sen. Elizabeth Warren (D-Mass.) on Monday introduced a bill in the Senate that would impose a new tax on the assets of America's wealthiest individuals.

Why it matters: The plan, which Warren introduced along with Reps. Pramila Jayapal (D-Wash.) and Brendan Boyle (D-Pa.) is similar to a proposal that was the centerpiece of Warren's campaign for the presidency in 2020.

Keep reading... Show less

Private equity firms dodge cost-cutting and aim for revenue growth

Private equity is mimicking venture capital, banking on revenue growth instead of cost-cutting.

Why it matters: PE firms may struggle to maintain historical returns, particularly if the bull market slows its rampage and they're stuck with overpriced and overleveraged portfolios.

Keep reading... Show less

Former French President Sarkozy sentenced to jail for corruption

A court in Paris on Monday sentenced former French President Nicolas Sarkozy to one year in prison and a two-year suspended sentence, after he was found guilty of trying to bribe a magistrate, the AP reports.

Driving the news: Sarkozy, who was president from 2007 to 2012, is the first president in France’s modern history to have gone on trial for corruption, per AP. He was charged with corruption and influence-peddling.

Keep reading... Show less

Canceled NFL Scouting Combine puts 40-yard dashes on the backburner

Top NFL prospects would normally be gathering in Indianapolis this week for the annual Scouting Combine. But due to the pandemic, this year's event has been canceled.

What they're saying: No combine means no 40-yard dash times making headlines. Former scout and current NFL Network analyst Daniel Jeremiah thinks that could be a glimpse of the future:

Keep reading... Show less

J&J CEO "absolutely" confident in vaccine distribution goal of 100 million doses by June

Johnson & Johnson CEO Alex Gorsky said Monday that he is "absolutely" confident that the company will be able to meet its distribution goals, which include 100 million doses by June and up to a billion by the end of 2021.

Driving the news: J&J is already in the process of shipping 3.9 million doses this week, just days after the FDA issued an emergency use authorization for the one-shot vaccine. Gorsky said he expects vaccines to be administered to Americans "literally within the next 24 to 48 hours."

Keep reading... Show less

The spike in global bond yields is setting up a clash between the world's top central bankers

While Fed chair Jerome Powell is brushing off the seismic rise in government bond yields and a corresponding decline in stock prices, a group of central bankers in the Pacific are starting to take action.

Driving the news: Bank of Japan governor Haruhiko Kuroda told parliament on Friday the BOJ would not allow yields on government debt to continue rising further above the BOJ's 0% target.

Keep reading... Show less

Insights

mail-copy

Get Goodhumans in your inbox

Most Read

More Stories