Ethical Considerations in Vaccine Allocation and Vaccine Certification - Policy and Strategy to Address the COVID-19 Pandemic

A special issue of Vaccines (ISSN 2076-393X). This special issue belongs to the section "Human Vaccines and Public Health".

Deadline for manuscript submissions: closed (28 February 2023) | Viewed by 16435

Special Issue Editor


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Department of Anatomical, Histological, Forensic Medicine and Orthopedic Science, Sapienza University of Rome, I-00185 Rome, Italy
Interests: aas; anabolic androgenic steroid; personalized medicine; forensic sciences; theragnostic; molecular autopsy; genomics; transcriptomics; proteomics; pharmacogenomics; metabolomics; sudden death

Special Issue Information

Dear Colleagues,

The ethical issues raised by the COVID-19 pandemic are now evident and being reported from all over the world. Resource allocation has been one of the most significant and burning conflicts in the ethical debate during the epidemiological peak of the pandemic. In this pandemic context, vaccination is still constantly giving rise to doubts, fears and conflicts concerning its acceptance, the criteria for making it compulsory and for which categories, and its safety. Vaccine hesitancy has been interpreted and experienced in various ways, with varying consequences in the social context of the various countries, and pragmatic solutions have been sought, as well as ways of communicating and accepting it, especially for different categories of workers. The efforts of anti-vaccinationists have had disruptive and costly effects, including damage to individual and community wellbeing through outbreaks of previously controlled diseases, the withdrawal of vaccine manufacturers from the market, the compromising of national security, and lost productivity. The role of the government is to inform, educate, recommend, and even provide incentives for immunization but not to require acceptance without exclusion from the civilian population. The publication of high-quality studies, to in-deep investigate the characteristics of these thematic, may be important and productive of a confrontation with diversified proposals and ethical-regulatory approaches of undoubted usefulness.

Prof. Dr. Paola Frati
Guest Editor

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Keywords

  • covid-19 vaccination
  • adverse events
  • no-fault compensation
  • consent form
  • information
  • availability
  • ethical issues
  • liability

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Published Papers (6 papers)

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Research

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11 pages, 473 KiB  
Article
Vaccines Administration in the Perspective of Patient Safety and Quality of Healthcare: Lesson from the Experience of an Italian Teaching Hospital for Pandemic Preparedness
by Francesco De Micco, Anna De Benedictis, Lorenzo Sommella, Andrea Di Mattia, Laura Leondina Campanozzi, Rossana Alloni and Vittoradolfo Tambone
Vaccines 2022, 10(9), 1495; https://doi.org/10.3390/vaccines10091495 - 8 Sep 2022
Cited by 4 | Viewed by 2054
Abstract
The development and administration of vaccines against COVID-19 was a key element in the fight against the pandemic, as it protected health systems and helped restore global economies. National implementation plans and vaccination strategies for COVID-19 vaccines ensured the immunization of large segments [...] Read more.
The development and administration of vaccines against COVID-19 was a key element in the fight against the pandemic, as it protected health systems and helped restore global economies. National implementation plans and vaccination strategies for COVID-19 vaccines ensured the immunization of large segments of the population in the shortest time. However, even before the start of the vaccination campaign, it was clear to decision-makers that the usual methods of vaccination were not suitable. The aim of this report is to share the experience of an Italian teaching hospital in the organisation of spaces and activities of healthcare workers to realise a safe vaccination campaign. An in-depth analysis of how the vaccination campaign was organised could be useful to understand strengths and weaknesses learnt from this experience and plan an effective, efficient, and resilient response to future pandemics right away. The adoption of a systemic clinical risk management (SCRM) could guarantee healthcare organizations a more adequate and resilient response in an ethics of a job well done perspective, allowing them to maintain high patient safety standards regardless of the contingent situation for which safety first should be the motto of a disaster response plan. Full article
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20 pages, 280 KiB  
Article
The Race for COVID-19 Vaccines: Accelerating Innovation, Fair Allocation and Distribution
by Rutger Daems and Edith Maes
Vaccines 2022, 10(9), 1450; https://doi.org/10.3390/vaccines10091450 - 2 Sep 2022
Cited by 5 | Viewed by 2409
Abstract
Racing to develop and distribute a vaccine against COVID-19 has proven to be a challenging endeavor. Not only has there been the enormous scientific-technical challenge of developing the world’s first vaccines against a coronavirus, the subsequent ethical issues involved in vaccine allocation have [...] Read more.
Racing to develop and distribute a vaccine against COVID-19 has proven to be a challenging endeavor. Not only has there been the enormous scientific-technical challenge of developing the world’s first vaccines against a coronavirus, the subsequent ethical issues involved in vaccine allocation have been equally complex. This contribution focuses on the policy and strategic aspects of accelerating innovation, fair allocation, and distribution. We take a holistic approach to describing the various tasks and how they are interconnected. Through comparative analysis we explore the issues through the lens of multiple stakeholders: i.e., public health authorities, governments of industrialized and developing countries, and industry. At each step of the consecutive process—from vaccine development to delivery—common ground has to be found between global community stakeholders, to move the project to the next stage, until completion: (1) accelerated innovation, (2) centralized purchasing, (3) selecting suppliers, (4) equitable allocation, (5) global access and affordability, (6) compulsory vs. voluntary licensing, and (7) a universal pandemic treaty. Conclusions: Public–private partnership is essential with regards to inventing and allocating new vaccines to fight infectious disease pandemics. The nature of pandemics requires collaboration at both the national and international levels. Seven important lessons have been identified that we can learn from based on the experience gathered during the COVID-19 pandemic. We trust that these findings will be helpful in drafting preparedness guidelines and a global pandemic treaty to manage future pandemics. Full article
15 pages, 870 KiB  
Article
Promoting Vaccination in India through Videos: The Role of Humor, Collectivistic Appeal and Gender
by Amelia M. Jamison, Rajiv N. Rimal, Rohini Ganjoo, Julia Burleson, Neil Alperstein, Ananya Bhaktaram, Paola Pascual-Ferra, Satyanarayan Mohanty, Manoj Parida, Sidharth Rath, Eleanor Kluegel, Peter Z. Orton and Daniel J. Barnett
Vaccines 2022, 10(7), 1110; https://doi.org/10.3390/vaccines10071110 - 12 Jul 2022
Cited by 1 | Viewed by 2482
Abstract
Vaccination hesitancy is a barrier to India’s efforts to control the COVID-19 pandemic. Considerable resources have been spent to promote COVID-19 vaccination, but evaluations of such efforts are sparse. Our objective was to determine how vaccine videos that manipulate message appeal (collectivistic versus [...] Read more.
Vaccination hesitancy is a barrier to India’s efforts to control the COVID-19 pandemic. Considerable resources have been spent to promote COVID-19 vaccination, but evaluations of such efforts are sparse. Our objective was to determine how vaccine videos that manipulate message appeal (collectivistic versus individualistic), tone (humorous versus serious), and source (male versus female protagonist) toward vaccines and vaccination. We developed eight videos that manipulated the type of appeal (collectivistic or individualistic), tone of the message (humor or serious), and gender of the vaccine promoter (male or female) in a 2 × 2 × 2 between-subjects experiment. Participants (N = 2349) were randomly assigned to watch one of eight videos in an online experiment. Beliefs about vaccines and those about vaccination were obtained before and after viewing the video. Manipulation checks demonstrated that each of the three independent variables was manipulated successfully. After exposure to the video, beliefs about vaccines became more negative, while beliefs about vaccination became more positive. Humor reduced negative beliefs about vaccines. Collectivism and protagonist gender did not affect beliefs about vaccines or vaccination. Those able to remember the protagonist’s gender (a measure of attention) were likely to develop favorable beliefs if they had also seen the humorous videos. These findings suggest that people distinguish beliefs about vaccines, which deteriorated after exposure to the videos, from beliefs about vaccination, which improved. We recommend using humor when appropriate and focusing on the outcomes of vaccination, rather than on the vaccines themselves. Full article
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17 pages, 737 KiB  
Article
Vaccinating to Protect Others: The Role of Self-Persuasion and Empathy among Young Adults
by Dariusz Drążkowski, Radosław Trepanowski and Valerie Fointiat
Vaccines 2022, 10(4), 553; https://doi.org/10.3390/vaccines10040553 - 2 Apr 2022
Cited by 10 | Viewed by 2962
Abstract
Direct persuasion is usually less effective than self-persuasion. As research shows that most young adults are unafraid of COVID-19, this study aimed to investigate the effectiveness of self-persuasion targeted at protecting the health of others to encourage young adults to be vaccinated against [...] Read more.
Direct persuasion is usually less effective than self-persuasion. As research shows that most young adults are unafraid of COVID-19, this study aimed to investigate the effectiveness of self-persuasion targeted at protecting the health of others to encourage young adults to be vaccinated against COVID-19 and examined the link between empathy and vaccination intention. We conducted two studies: Study 1 (n = 352) compared the effectiveness of self-persuasion targeted at others’ health versus personal health and direct persuasion in encouraging COVID-19 vaccination intention; Study 2 (n = 375) investigated the applicability of self-persuasion through a poster framed as an open-ended question. The theory of planned behavior-based tools were used in both studies, and structural equation modeling was conducted. Study 1 found that self-persuasion targeted at others’ health (compared to other forms of persuasion) indirectly affects vaccination intention through utility and social norm beliefs. Higher empathy, utility, social norms, and control beliefs are associated with a greater vaccination intention. Study 2 found that the poster with self-persuasion targeted at others’ health enhanced vaccination intention compared with a direct persuasion poster. Our findings demonstrate that self-persuasion targeted at others’ health can potentially increase COVID-19 vaccination uptake among young adults. Full article
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10 pages, 1391 KiB  
Article
SARS-CoV2 Vaccination Adverse Events Trend in Italy: A Retrospective Interpretation of the Last Year (December 2020–September 2021)
by Nicola Di Fazio, Giuseppe Delogu, Giuseppe Bertozzi, Vittorio Fineschi and Paola Frati
Vaccines 2022, 10(2), 216; https://doi.org/10.3390/vaccines10020216 - 30 Jan 2022
Cited by 16 | Viewed by 2940
Abstract
At the end of 2020, a vaccination campaign against COVID-19 was launched. In 2021, legal obligations for health workers, as well as specific regulations for all workers, were introduced. The global SARS-CoV-2 pandemic was followed by epochal changes in life, school, and work [...] Read more.
At the end of 2020, a vaccination campaign against COVID-19 was launched. In 2021, legal obligations for health workers, as well as specific regulations for all workers, were introduced. The global SARS-CoV-2 pandemic was followed by epochal changes in life, school, and work habits in Italy. Therefore, the pharmacovigilance work currently being conducted in Italy by the AIFA concerning the recording and analysing of adverse reactions related to the use of vaccines has proved to be very important. The latest report, including a period of 10 months from December 2020 to September 2021, has allowed us to combine the results received so far, and to compare the safety of all vaccines currently available in Italy. The results of this analysis are highly encouraging and reveal the statistical reliability of the safety of the COVID-19 vaccines currently used in Italy. The dissemination of these findings could increase the public’s awareness of vaccines and their ability to make free and informed choices concerning vaccination. The potential increase in the Italian population’s adherence to the vaccination campaign could ultimately be a decisive factor in achieving herd immunity and the final resolution of the pandemic. Full article
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Review

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16 pages, 617 KiB  
Review
A Lesson from the Green Pass Experience in Italy: A Narrative Review
by Laura Leondina Campanozzi, Vittoradolfo Tambone and Massimo Ciccozzi
Vaccines 2022, 10(9), 1483; https://doi.org/10.3390/vaccines10091483 - 6 Sep 2022
Cited by 9 | Viewed by 2134
Abstract
The COVID-19 outbreak has raised several global challenges related to disease management while highlighting the need to embrace a multidimensional approach in dealing with events such as. Due to the singular features of SARS-CoV-2, an appropriate medical response was required to develop new [...] Read more.
The COVID-19 outbreak has raised several global challenges related to disease management while highlighting the need to embrace a multidimensional approach in dealing with events such as. Due to the singular features of SARS-CoV-2, an appropriate medical response was required to develop new vaccines able to tackle it effectively. Mass vaccination plans were thus promptly launched around the world. However, vaccine uptake has been coupled with growing concerns that have affected people’s willingness to get vaccinated. To promote compliance with vaccination campaigns, many governments introduced the use of vaccination certificates and immunization passports. Studies have discussed some benefits and cons coupled with the rollout of vaccine passports or certificates. This paper takes up and extends this discussion by showing the results of a mini- narrative review we undertook with the aim of critically summarizing the existing scholarly research on the Green Pass in Italy. In analyzing the 12 included records, we explored the scientific viability of this measure, as well as the concerns and criticisms it has raised and the recommendations that have been proposed to address them, as a starting point to consider how the lesson learned in the Italian context can contribute to informing future reflections and strategies in view ofanother pandemic event. Full article
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