When the Covid-19 vaccine is ready, it would be interesting to see how it is distributed. One expects that the vaccine would reach citizens in the country of development first, in the rich countries next, and in the poorest countries last.

Within a country, political and administrative leaders, the ultra rich, healthcare workers, and the police force would probably receive the vaccine first, and poor and marginalized citizens would receive it last. The vaccine would also be distributed in urban areas before it reaches the rural population.

Should the elderly and those with multiple medical comorbidities be prioritized because they are at highest risk of death or should the young and healthy be prioritized so that they do not spread the disease? Chances are that this ethical cum epidemiological poser will not be answered because, in between the extreme categories of vaccine access, delivery of the vaccine will be haphazard and subject to the vagaries of the administrative bureaucracy.

Some questions will perhaps be answered only long after vaccine delivery, such as the safety and efficacy of the vaccine in pregnancy, in immunocompromised persons, and in other special populations.

A final question is whether universal vaccination will be mandated by law, and how persons who are opposed to vaccination (for whatever reason), will face the situation.


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