Who Should Get a Flu Shot When There’s Not Enough For Everyone?

In response to the threat of a bird flu pandemic, two possible vaccines have been made in the USA, but neither has been tested in the field, yet. It’s become clear that there won’t be enough vaccine to protect everyone, although the debate about rationing the supplies started some months ago.

Two eminent ethicists have now written in Science that the sick and the elderly should be last in line. There are arguments on their side – apart from the obvious one of ‘expendability’. It seems that pandemic outbreaks of flu (e.g. the 1918 epidemic) hit those between 20 and 40 hardest; this is different from the annual flu attacks, which affect children and the elderly most. This makes their priorities roughly:

1. health-care and vaccine workers

2. those aged 13 to 40 (the group hard hit in the 1918 epidemic), with priority given to key decision-makers, utility workers, police officers, and other essential workers.

3. neighboring age groups: 7 to 12 and 41 to 50

4. the sick and elderly

As a healthy elder, I can’t argue with this listing. I can’t see a good reason to give priority to those most likely to die – the sick and elderly – when the overall disaster will make living difficult enough . . . Besides, in 1918 the elderly did just as well, if not better, than the youngsters, without any flu vaccine. And I’m glad that the ethicists removed the planned priority given to ‘minor government officials and undertakers’.