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ACP issues new policy statement on the ethics of global COVID-19 vaccine distribution and allocation

PHILADELPHIA, June 9, 2021 – The American College of Physicians (ACP) today released a new policy statement that supports finding innovative and practical solutions for distributing COVID-19 vaccines equitably among and within countries in need. In ACP Statement on Global COVID-19 Vaccine Distribution and Allocation: On being Ethical and Practical, ACP says physicians have an ethical obligation to advocate for the health and well-being of patients and communities locally and globally.

The ACP Ethics Manual notes that physicians have an important role to play in promoting health and human rights and addressing social inequities. That role recognizes the ethical responsibility to assist others in minimizing mortality and morbidity from COVID-19.

Ethical and equitable allocation of COVID-19 vaccines has been a challenge in both the U.S. and the rest of the world. More than 85 percent of the world’s population lives in low- and middle-income countries which presents challenges to vaccine access. The COVID-19 Vaccines Global Access Initiative (COVAX) hopes to secure and deliver 2 billion vaccine doses by the end of 2021 although pricing variations could create challenges and some countries will need assistance.

“The ethical, equitable and efficient distribution of vaccines is critical to ending the global pandemic,” said George M. Abraham, MD, MPH, FACP, President, ACP. “As a society, we must do all we can to ensure that that equity is paramount in a coordinated effort to allocate vaccines in a practical and ethical way.”

ACP recommends a coordinated global response including a rapid scale up of efficient, safe, and effective vaccines; support for infrastructure development; and cooperation among national regulatory authorities and vaccine manufacturers globally.

Additionally, to ensure equitable vaccine distribution, ACP supports:

  • Vaccine distribution plans within countries that are based on medical criteria (i.e., risk of morbidity/mortality and risk of COVID-19 transmission). Plans should be developed through transparent and inclusive processes.
  • Vaccine allocation based in principles of nonmaleficence, beneficence, and justice. Allocations should first, maximize benefit to individuals: save the most lives, care for those most in need and then, maximize benefit to public health: prevent infection and transmission to others.
  • Special efforts that may be necessary to promote equity and to deliver vaccines to marginalized and underserved populations (recognizing that how these populations are defined is local context-specific).
  • Goals that should be to maximize lives saved, using a science-based data-driven approach. ACP cautions against approaches that systematically disadvantage certain groups of patients (e.g., the “life years” approach, which is biased against older individuals or those living with disabilities, or approaches based on perceived social worth or economic value).

“Physicians and the medical community have a responsibility to speak out about the need for equity in administering vaccines and in health care at large,” added Dr. Abraham. “While the distribution efforts to administer the COVID-19 vaccines are constantly changing, our commitment to ensuring the health and well-being of all patients, is unwavering.”

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About the American College of Physicians
The American College of Physicians is the largest medical specialty organization in the United States with members in more than 145 countries worldwide. ACP membership includes 163,000 internal medicine physicians (internists), related subspecialists, and medical students. Internal medicine physicians are specialists who apply scientific knowledge and clinical expertise to the diagnosis, treatment, and compassionate care of adults across the spectrum from health to complex illness. Follow ACP on TwitterFacebook and Instagram.

ACP Media Contact: Andrew Hachadorian, (215) 351-2514, AHachadorian@acponline.org