Department of Community Medicine, Vardhman Mahavir Medical College & Safdarjung Hospital, New Delhi, India.
Diabetes Metab Syndr. 2021 Nov-Dec;15(6):102314. doi: 10.1016/j.dsx.2021.102314. Epub 2021 Oct 15.
COVID-19 had put world to a standstill with enormous morbidity and mortality. Vaccines' development against this provided a beacon of hope. India approved different vaccines under emergency use authorization but distribution of vaccines and vaccination of huge population was a challenging task. We attempted to review the vaccination program from an ethics perspective.
The core ethical principles of healthcare and other tenets put forth in discussion papers on addressing ethical issues in pandemic influenza planning, ethical considerations in developing a public health response to pandemic influenza and World Health Organization (WHO) Scientific Advisory Group for Emergencies values framework for the allocation and prioritization of COVID-19 vaccination were used to identify the ethical concerns in the vaccination program of the country. Relevant ministry guidelines, documents, websites etc., were accessed.
The program tried addressing many of the ethical principles laid out in various international documents. Approving indigenously produced vaccines upheld the principle of utility while prioritizing health care workers for vaccination was an example of reciprocity. However, vaccine approval without availability of trial results in public domain raised apprehensions and lacked transparency. Lack of well-defined mechanism to facilitate vaccination for socially disadvantaged groups compromises equity.
Overall, the program fared well on most aspects of ethical principles, but there were few gaps which still exist. These should be taken care of as the country advances further into vaccination program to garner enhanced public trust in the scientific, regulatory and administrative authorities.
COVID-19 导致全球停摆，造成巨大的发病率和死亡率。针对该疾病的疫苗开发带来了一线希望。印度在紧急使用授权下批准了不同的疫苗，但疫苗的分发和对庞大人口的接种是一项具有挑战性的任务。我们试图从伦理角度审查疫苗接种计划。
使用医疗保健的核心伦理原则和其他在讨论文件中提出的原则，这些讨论文件涉及解决大流行性流感规划中的伦理问题、在大流行性流感公共卫生应对方面的伦理考虑以及世界卫生组织（世卫组织）紧急情况科学咨询小组的 COVID-19 疫苗分配和优先排序价值框架，以确定该国疫苗接种计划中的伦理问题。查阅了相关部委指南、文件、网站等。
该计划试图解决各种国际文件中列出的许多伦理原则。批准国产疫苗符合效用原则，而优先为医护人员接种疫苗则是互惠原则的一个例子。然而，在公共领域缺乏试验结果的情况下批准疫苗接种引起了人们的担忧，缺乏透明度。缺乏明确的机制来促进社会弱势群体的疫苗接种，这损害了公平性。
总体而言，该计划在伦理原则的大多数方面表现良好，但仍存在一些差距。随着国家进一步推进疫苗接种计划，以增强公众对科学、监管和行政当局的信任，应注意这些差距。
