Rationing Vaccine During An Avian Influenza Pandemic: Why It Won’t Be Easy John D. Arras Department of Philosophy, University of Virginia, Charlottesville, Virginia
The specter of an avian influenza pandemic poses enormous technical and logistical challenges. For example, how can such a looming catastrophe be avoided? If we cannot prevent it, how can we best mobilize our medical and social resources to effectively blunt its impact? How can we quickly mobilize production of sufficient quantities of effective vaccines and antiviral agents to either prevent infection or mitigate the burden of illness in the infected?
While we hope and trust that our scientists and public health officials will do their best to prevent a pandemic, it would be foolhardy to assume they will succeed against such a formidable foe, especially when many of our most distinguished and knowledgeable influenza experts warn that the operative question isn’t whether, but rather when, a pandemic will strike. And while virologists in both the public and private sectors are no doubt searching feverishly for new ways to hasten production of effective vaccines, a full-blown pandemic will most likely overwhelm their best efforts. Thus, in addition to posing scientific, technical, and logistical problems, the threat of an avian influenza pandemic poses equally important ethical problems, the most vexing of which is the age-old question, “Who shall live when not all can live?” In short, how should influenza vaccine and antivirals be rationed in the context of a global pandemic?