Grossman School of Medicine, NYU Langone Health, New York, New York, USA
Division of Medical Ethics, Grossman School of Medicine, NYU Langone Health, New York, New York, USA.
J Med Ethics. 2022 Aug;48(8):510-511. doi: 10.1136/medethics-2021-107247. Epub 2021 Apr 7.
Coronavirus vaccines have made their debut. Now, allocation practices have stepped into the spotlight. Following Centers for Disease Control and Prevention guidelines, states and healthcare institutions initially prioritised healthcare personnel and elderly residents of congregant facilities; other groups at elevated risk for severe complications are now becoming eligible through locally administered programmes. The question remains, however: who should be prioritised for immunisation? Here, we call attention to individuals institutionalised with severe mental illnesses and/or developmental or intellectual disabilities-a group highly susceptible to the damages of COVID-19, recent research shows, and critical to consider for priority vaccination. The language describing both federal-level and state-level intentions for this population remains largely vague, despite the population's diversity across age, diagnosis, functional status and living arrangement. Such absence of specificity, in turn, leaves room for confusion and even neglect of various subgroups. We review data stressing this group's vulnerability, as well as select state plans for priority vaccination, highlighting the importance of clarity when describing intentions to vaccinate, or even generally care for, diverse populations composed of distinct subgroups in need.
冠状病毒疫苗已经问世。现在，分配实践已成为焦点。根据疾病控制与预防中心的指导方针，各州和医疗机构最初优先考虑医疗保健人员和群居设施中的老年人；其他有严重并发症高风险的群体现在通过当地管理的计划获得资格。然而，问题仍然存在：谁应该优先接种疫苗？在这里，我们提请注意患有严重精神疾病和/或发育或智力残疾的被监禁者，最近的研究表明，这一群体极易受到 COVID-19 的损害，对于优先接种疫苗至关重要。尽管该人群在年龄、诊断、功能状态和生活安排方面存在多样性，但描述这一人群的联邦和州级意图的语言仍然很大程度上模糊不清。这种缺乏特异性反过来又为混淆甚至忽视各个亚组留出了空间。我们回顾了强调该群体脆弱性的数据，以及优先接种疫苗的一些州计划，强调在描述接种疫苗或甚至一般照顾由有需要的不同亚组组成的不同人群的意图时，明确性的重要性。
