Ethical Framework for Prioritizing Healthcare Workers to Receive Vaccine

Centers for Disease Control and Prevention advisors cited ethical reasons for selecting healthcare workers (HCWs) as first to receive a COVID-19 vaccine, including these:

Maximize benefits

• HCWs are essential for response.
• Vaccine may help decrease transmission to patients, co-workers, and community.
• It may decrease COVID-19 morbidity and mortality in some HCWs, as approximately 40% have high-risk conditions or are older than age 65 years.
• HCWs may hold positions where absenteeism may compromise/stop care.

Equity

• There is overrepresentation of some racial or ethnic minority groups and lower-income earners in the healthcare field.
• Seroprevalence of SARS-CoV-2 is higher among Hispanic and non-Hispanic Black HCWs.
• Long-term care facility staff largely comprise female and non-Hispanic Black persons, and are disproportionately lower-wage workers.

Justice

• HCWs recommended for early vaccination have an equal opportunity to access vaccine.
• Definition of HCW includes “paid and unpaid persons serving in healthcare settings.”

Fairness

• The vaccine can help reduce disparities in health outcomes.
• HCWs are at increased risk of COVID-19 exposure.