With promising preliminary results from companies like Pfizer, Moderna and AstraZeneca, many countries have started emergency use authorizations for COVID-19 vaccines in attempt to flatten the curve.
But as pharmaceutical companies around the world race their vaccines to market, questions about ethical distribution are beginning to spark controversy.
The situation is similar to vaccine development for the Ebola epidemic, according to Jacob Shelley, assistant law professor and co-director of the Health Ethics, Law and Policy Lab at Western University, who specializes in proper ethics and role of law in promoting public health.
Sporadic Ebola outbreaks occurred predominantly in African nations, including Guinea, Liberia and Sierra Leone from 2013 to 2016, and claimed over 11,300 lives. The epidemic pushed health officials to quickly manufacture and distribute an unlicensed vaccine, making the Ebola vaccine the fastest fully developed vaccine to date.
According to a study, multiple factors prior to the vaccine’s administration were assessed, including the likelihood of future outbreaks in specific populations, the availability of resources and which populations were most at-risk — things that health officials will also need to consider with an emergency coronavirus vaccine.
However, COVID-19 has caught the attention of the entire world.
“What’s strikingly different between the coronavirus vaccine development and the Ebola vaccine is that [COVID-19] is a worldwide issue and every country is racing to produce a vaccine simultaneously,” said Shelley. “No country wants to be the country that didn't approve a vaccine and then falls behind in inoculating its population.”
The Ebola outbreak did not have the same global attention as the coronavirus pandemic, so vaccine development was slower and more cautious. But according to Shelley, the effect COVID-19 has on our society is similar to the Ebola outbreak in Africa. He said rushing to produce a vaccine could be harmful, and that simple protocols are not being followed to prevent outbreaks effectively.
“[COVID-19] has exacerbated the vulnerabilities within our system,” explained Shelley. “There's a reason why disease has a disproportionate impact on racialized groups, those of lower socioeconomic status and women within certain employment situations.”
Ethical distribution of vaccines ensures they are distributed across countries with high case counts, administered for at-risk groups such as health workers and those with pre-existing conditions first and that the public is properly informed on vaccine development.
Shelley said the best way to ensure ethical distribution of vaccines is transparency — the ability to see the actions and steps involved in vaccine development. According to Shelley, transparency looks like informing citizens of the status of clinical trials and discussions between stakeholders, foreign countries and politicians.
Most African countries were transparent with their citizens during the Ebola outbreak, providing them with data regarding quality, safety and performance of the novel vaccine, which many scholars believe was key to popular acceptance of the vaccine. Shelley hopes countries will follow this example for COVID-19 vaccinations.
“Transparency doesn't always mean that the outcome will be favourable,” Shelley said. “But with so much misinformation and distrust in certain pharmaceutical companies, the best thing the government can do is provide necessary information to the public before distributing a vaccine."
As the Ontario government continues to roll out their three-phase distribution plan, some vulnerable and high-risk people have already received the vaccine, but others, particularly those in low-risk groups, continue to wait.
“Even when the vaccine becomes available and distributed in Canada, it won’t change much globally, because people still won’t be travelling wherever they want," said Shelley.
“What’s surprising is how impatient people are to receive the vaccine. We’ve gotten it manufactured and distributed in under a year, which is unheard of. Many of us are not in frontline or a vulnerable position, so we’re at least looking until the summer before we will even be considered eligible."