HASTINGS CONVERSATIONS: A SERIES Although roughly 60% of adults in the United States have had at least one Covid vaccine shot, many Americans remain reluctant, or outright opposed, to getting vaccinated. This hesitancy poses a major hurdle to achieving herd immunity. Therefore, some experts reco...

A HASTINGS CENTER CONVERSATION WITH RHEA BOYD, MAYA GOLDENBERG, AND MILDRED SOLOMON The Hastings Center hosted “Vaccine Access, Vaccine Hesitancy: Challenges to Herd Immunity,” an online discussion of the ethical issues related to vaccine access and hesitancy in the United State...

If the United States is to achieve herd immunity, at least 75-85% of the population will need to be vaccinated, yet there are many different kinds of barriers to overcome. Some Americans are reluctant or wish to wait, because they distrust government or the safety of the vaccines or believe in wides...

Last month, with concerns over the supply and coordinated administration of coronavirus vaccines escalating, the Centers for Disease Control and Prevention conceded that “any available mRNA COVID-19 vaccine” may be used to complete vaccination in “exceptional situations” preventing multi-dose manufacturer matching. While presented solely as a last resort, this guidance reflects a dilemma currently sweeping across the medical and health policy worlds: given limited supply, should vaccination efforts—still only authorized for emergency use in this country—deviate from evidence-driven, studied regimens to maximize individuals reached?

A third Covid vaccine candidate moving closer to potential FDA authorization is less effective than the two Covid vaccines already authorized in the United States. Is it ethical to offer a vaccine with lower efficacy? Is it ethical not to offer it in a public health emergency?

Suppose you are young, healthy, employed in a health care system and that your line of work does not require leaving the low-risk comfort of your home. Now suppose that your employer offers you a vaccine. You know there are others in your community who are at greater risk of contracting and dying from Covid-19 than you. Should you accept the dose?

A Covid-19 vaccine developed by Pfizer and BioNTech has received emergency authorization in the United States and has been authorized in the countries, and a vaccine by Moderna is likely to be authorized soon. In spite of this good news, at least for the first couple of years, Covid-19 vaccines will be a scarce resource. Because low-income countries are likely to lose out in the scramble to get access to them, there have been calls for global solidarity. While equitable allocation of vaccines around the world would be ideal, it is unrealistic as a near-term goal.

Experts in infectious disease and public health warn that the Covid-19 pandemic will be with us until there is an effective vaccine, possibly 12 to 18 months in the future. This situation has given rise to calls for human challenge studies, in which healthy volunteers are injected with an experimental vaccine and then infected with the disease to test the vaccine’s efficacy. Is this ethically justifiable?