Department of Public Health and Healthcare Management, Tashkent Institute of Postgraduate Medical Education, Parkent str. 51, Tashkent, 100007, Uzbekistan.
Department of Global Health and Population, Harvard School of Public Health, 677 Huntington Avenue, Boston, MA, 02115, USA.
BMC Med Ethics. 2022 Mar 9;23(1):21. doi: 10.1186/s12910-022-00764-1.
In the pandemic time, many low- and middle-income countries are experiencing restricted access to COVID-19 vaccines. Access to imported vaccines or ways to produce them locally became the principal source of hope for these countries. But developing a strategy for success in obtaining and allocating vaccines was not easy task. The governments in those countries have faced the difficult decision whether to accept or reject offers of vaccine diplomacy, weighing the price and availability of COVID-19 vaccines against the concerns over their efficacy and safety. We aimed to analyze public opinion regarding the governmental strategies to obtain COVID-19 vaccines in three Central Asian countries, focusing particularly on possible ethical issues.
We searched for opinions expressed either in Russian or in the respective national languages. We provided data on the debate within three countries, drawn from social media postings and other sources. The opinion data was not restricted by source and time. This allowed collecting a wide range of possible opinions that could be expressed regarding COVID-19 vaccine supply and human participation in the vaccine trial. We recognized ethical issues and possible questions concerning different ethical frameworks. We also considered scientific data and other information, in the process of reasoning.
As a result, public views on their respective government policies on COVID-19 vaccine supply ranged from strongly negative to slightly positive. We extracted the most important issues from public debates, for our analysis. The first issue involved trade-offs between quantity, speed, price, freedom, efficacy, and safety in the vaccines. The second set of issues arose in connection with the request to site a randomized trial in one of the countries (Uzbekistan). After considering additional evidence, we weighed individual and public risks against the benefits to make specific judgements concerning every issue.
We believe that our analysis would be a helpful example of solving ethical issues that can arise concerning COVID-19 vaccine supply around the world. The public view can be highly critical, helping to spot such issues. An ignoring this view can lead to major problems, which in turn, can become a serious obstacle for the vaccine coverage and epidemics' control in the countries and regions.
在大流行时期，许多中低收入国家面临着 COVID-19 疫苗获取受限的问题。获取进口疫苗或在当地生产疫苗成为这些国家的主要希望来源。但制定成功获取和分配疫苗的策略并非易事。这些国家的政府面临着接受还是拒绝疫苗外交提议的艰难决定，权衡 COVID-19 疫苗的价格和可及性与对其疗效和安全性的担忧。我们旨在分析三个中亚国家政府获取 COVID-19 疫苗的策略的公众意见，特别关注可能存在的伦理问题。
我们搜索了俄语或各自国家语言中表达的意见。我们提供了来自社交媒体帖子和其他来源的关于三个国家内部辩论的数据。该意见数据不受来源和时间的限制。这使得我们能够收集到广泛的可能意见，这些意见可能涉及 COVID-19 疫苗供应和人类参与疫苗试验。我们认识到不同伦理框架下可能存在的伦理问题和疑问。我们还在推理过程中考虑了科学数据和其他信息。
结果，公众对其各自政府在 COVID-19 疫苗供应方面的政策的看法从强烈反对到略有赞成不等。我们从公众辩论中提取了最重要的问题进行分析。第一个问题涉及疫苗数量、速度、价格、自由、疗效和安全性之间的权衡。第二个问题与在其中一个国家（乌兹别克斯坦）要求进行随机试验有关。在考虑了其他证据后，我们权衡了个人和公共风险与收益，对每个问题做出了具体判断。
我们相信，我们的分析将为解决全球 COVID-19 疫苗供应可能出现的伦理问题提供一个有益的范例。公众的意见可能极具批判性，有助于发现此类问题。忽略这一观点可能会导致重大问题，从而成为这些国家和地区疫苗接种和传染病控制的严重障碍。
