Ethical Vaccine Distribution Planning for Pandemic Influenza: Prioritizing Homeless and Hard-to-Reach Populations

Buccieri, Kristy; Gaetz, Stephen

doi:10.1093/phe/pht005

Cited by 36 publications

(28 citation statements)

References 33 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The most commonly justified group given priority was healthcare workers (HCW) [14][15][16][17][18][19][20][21][22][23][24][25], though the parameters around the nature and size of this group varied based on professional status and proximity to pandemicaffected patients. Other occupational groups for priority access included vaccine manufacturers, emergency services workers, and those working in basic infrastructure such as utility, transport, policing, food manufacturing and distribution, and communications [15,16,18,19,21,23,25,26].…”

Section: Who Matters: a Large Number Of Diverse Priority Groupings Hamentioning

confidence: 99%

“…Stage of life arguments were also made. Children were prioritised by some [14,[22][23][24][27][28][29], either as a means to minimise infection in the community or because they had the longest lives ahead of them. A number of papers argued for priority access for an age cohort running from adolescence to pre-middle aged adults for a number of different reasons (e.g.…”

Section: Who Matters: a Large Number Of Diverse Priority Groupings Hamentioning

confidence: 99%

“…Some made the case for the sickest or the most medically vulnerable to receive priority vaccination [15,16,23,25,26,[32][33][34], usually framed in terms of 'high risk' of harm, although they differed on whether medical need was about susceptibility to pandemic infection or poor baseline health. Others justified priorities based on social vulnerability [3,14,35] and included, variously, homeless people, 'hard to reach' groups, and socially stigmatised groups such as prisoners and obese people. It is worth noting here that the concept of vulnerability was used frequently, often as a catch-all, but regularly not defined or explained.…”

Section: Who Matters: a Large Number Of Diverse Priority Groupings Hamentioning

confidence: 99%

See 2 more Smart Citations

Prioritising access to pandemic influenza vaccine: a review of the ethics literature

Williams

Dawson

2020

BMC Med Ethics

View full text Add to dashboard Cite

Background: The world is threatened by future pandemics. Vaccines can play a key role in preventing harm, but there will inevitably be shortages because there is no possibility of advance stockpiling. We therefore need some method of prioritising access.Main text: This paper reports a critical interpretative review of the published literature that discusses ethical arguments used to justify how we could prioritise vaccine during an influenza pandemic. We found that the focus of the literature was often on proposing different groups as priorities (e.g. those with pre-existing health conditions, the young, the old, health care workers etc.). Different reasons were often suggested as a means of justifying such priority groupings (e.g. appeal to best overall outcomes, fairness, belonging to a vulnerable or 'at risk' group etc.). We suggest that much of the literature, wrongly, assumes that we are able to plan priority groups prior to the time of a particular pandemic and development of a particular vaccine. We also point out the surprising absence of various issues from the literature (e.g. how vaccines fit within overall pandemic planning, a lack of specificity about place, issues of global justice etc.). Conclusions: The literature proposes a wide range of ways to prioritise vaccines, focusing on different groups and 'principles'. Any plan to use pandemic vaccine must provide justifications for its prioritisation. The focus of this review was influenza pandemic vaccines, but lessons can be learnt for future allocations of coronavirus vaccine, if one becomes available.

show abstract

Section: Who Matters: a Large Number Of Diverse Priority Groupings Hamentioning

confidence: 99%

Section: Who Matters: a Large Number Of Diverse Priority Groupings Hamentioning

confidence: 99%

Section: Who Matters: a Large Number Of Diverse Priority Groupings Hamentioning

confidence: 99%

See 1 more Smart Citation

Prioritising access to pandemic influenza vaccine: a review of the ethics literature

Williams

Dawson

2020

BMC Med Ethics

View full text Add to dashboard Cite

show abstract

“…Without this trust, feelings of embarrassment and shame have been found to prevent homeless individuals from seeking out medical information, particularly around sexual health issues for young female and transgender youth [26]. The pressing physical and mental health needs of homeless individuals, combined with their low help-seeking behavior, lends support to the placement of accessible services, like public health clinics, in community-based shelters and drop-in centres [27]. However, while many homeless individuals report accessing some form of services [28], research has also found that the institutional cycling of clients through different agencies can contribute to the spread of disease among service users [29,30].…”

Section: Homelessness Health and Integrated Care In Canadamentioning

confidence: 99%

Integrated Social Housing and Health Care for Homeless and Marginally-Housed Individuals: A Study of the Housing and Homelessness Steering Committee in Ontario, Canada

Buccieri

2016

Social Sciences

View full text Add to dashboard Cite

Abstract:Homelessness is a complex social issue that requires a coordinated systems approach. In recent years, Canada has seen an emergence of integrated care, the joining of health care and social care, to address the needs of homeless persons. This article documents the findings of open-ended interviews with eleven members of the central east Ontario Housing and Homelessness Framework Steering Committee, comprised of service managers and the Local Health Integration Network. As the system planners for social housing and health care, respectively, members of the group work together to align system approaches for homeless persons. Research by this group identified three challenges of collaborating-their different histories and legislation, varied accountability structures, and differing roles and responsibilities within the central east region of Ontario. The study findings indicate that developing a joint document to guide the work was a process through which members began to work through these differences.

show abstract

“…There have been very few studies that focused on the fairness of distribution strategies, and the criteria for prioritizing the most important individuals are subjective. Specifically, researchers have suggested four kinds of fairness: treating people equally, favoring the worst-off, maximizing total benefits, and promoting and rewarding social usefulness [4, 5, 6]. Given that these analyses in the literature are totally based on qualitative analysis, researchers lack a general methodology to quantitatively measure the degree of fairness of each distribution rule, and objectively assess the tradeoff between the efficiency and fairness.…”

Section: Introductionmentioning

confidence: 99%

Fairness versus Efficiency of Vaccine Allocation Strategies

Marathe

2015

Value in Health

View full text Add to dashboard Cite

Objectives This research develops a framework to objectively measure the degree of fairness of any allocation rule aimed at distributing a limited stockpile of vaccines to contain the spread of Influenza. Methods The trade-off between the efficiency and the fairness of allocation strategies is demonstrated through an illustrative simulation study of an Influenza epidemic in Southwestern Virginia. A Susceptible-Exposed-Infectious-Recovered (SEIR) model is used to represent the disease progression within the host. Results Our findings show that among all the criteria considered here, the household size (largest first) combined with age (youngest first) based strategy leads to the best outcome. At 80% fairness, highest efficiency can be achieved but in order to be 100% fair, disease prevalence will have to rise by ≈1.5%. Conclusions This research provides a framework to objectively determine the degree of fairness of vaccine allocation strategies.

show abstract

Ethical Vaccine Distribution Planning for Pandemic Influenza: Prioritizing Homeless and Hard-to-Reach Populations

Cited by 36 publications

References 33 publications

Prioritising access to pandemic influenza vaccine: a review of the ethics literature

Prioritising access to pandemic influenza vaccine: a review of the ethics literature

Integrated Social Housing and Health Care for Homeless and Marginally-Housed Individuals: A Study of the Housing and Homelessness Steering Committee in Ontario, Canada

Fairness versus Efficiency of Vaccine Allocation Strategies

Contact Info

Product

Resources

About