Raskin Nele, Hiligsmann Mickaël, Luyten Jeroen, Tubeuf Sandy, Grigoriev Alexander, Kessels Roselinde
Department of Health Services Research (HSR) of the Faculty of Health, Medicine and Life Sciences (FHML), Care and Public Health Research Institute (CAPHRI), Maastricht University, P.O. Box 616, 6200 MD Maastricht, The Netherlands; Department of Data Analytics and Digitalization of the School of Business and Economics, Maastricht University, P.O. Box 616, 6200 MD Maastricht, The Netherlands.
Department of Health Services Research (HSR) of the Faculty of Health, Medicine and Life Sciences (FHML), Care and Public Health Research Institute (CAPHRI), Maastricht University, P.O. Box 616, 6200 MD Maastricht, The Netherlands.
Vaccine. 2025 May 10;55:126997. doi: 10.1016/j.vaccine.2025.126997. Epub 2025 Mar 19.
The COVID-19 pandemic, particularly the period when safe and protective vaccines became available, presented an excellent opportunity to investigate public preferences regarding how to ration a scarce, life-saving resource. It is important to understand which distributive strategies are preferred but, as this is an inherently normative matter, also to which extent different socio-demographic groups hold different opinions. This study assesses the impact of socio-demographic characteristics on preferences for vaccine prioritization during the early stages of the COVID-19 pandemic at the moment when vaccines were not available yet. A representative sample of 2060 Belgians were asked to rank eight prioritization strategies. Based on the rankings, we clustered the eight strategies into five overarching groups. Then, we estimated the potential impact of respondents' socio-demographic characteristics on their preferences towards these five strategies. The ranking exercise shows that the vulnerability strategy (i.e. chronically ill and elderly) is preferred most often (N = 1815) and the market strategy (i.e. individuals who come first or pay the most) by the fewest respondents (N = 116). Preferences for vaccine distribution vary among population subgroups. Women, older or retired individuals, residents of Flanders, those with a positive attitude towards vaccination efforts and/or high vaccination willingness, and those who prefer the government or scientists to decide upon prioritization were more likely to prefer a designated priority strategy (i.e. vulnerability strategy, workers strategy or spreaders). Furthermore, younger respondents, residents of Wallonia, and those previously infected by COVID-19 tended to favour a risk-independent prioritization strategy (i.e. lottery or market strategy) more than others. This study validates the appropriateness of the implemented rationing approaches, by supporting a phased approach in which first vulnerables were vaccinated. However, it also demonstrates that different subgroups had substantially different preferences and the population was in disagreement about what constitutes a fair rationing policy for a scarce, potentially lifesaving resource.
新冠疫情，尤其是在安全有效的疫苗问世之后的这段时期，为研究公众在稀缺救命资源分配方式上的偏好提供了绝佳机会。了解哪种分配策略更受青睐固然重要，但鉴于这本质上是一个规范性问题，同时了解不同社会人口群体在多大程度上持有不同观点也很重要。本研究评估了社会人口特征对新冠疫情早期疫苗尚未可得时疫苗优先级偏好的影响。我们让2060名具有代表性的比利时人对八种优先级策略进行排序。基于这些排序，我们将这八种策略归为五个总体类别。然后，我们估计了受访者的社会人口特征对其对这五种策略偏好的潜在影响。排序结果显示，最常被首选的是脆弱性策略（即慢性病患者和老年人）（N = 1815），而最少受访者选择的是市场策略（即先来者或付费最多者）（N = 116）。不同人群亚组对疫苗分配的偏好各不相同。女性、年龄较大或已退休的个人、弗拉芒地区的居民、对疫苗接种工作持积极态度和/或接种意愿较高的人，以及那些希望由政府或科学家决定优先级的人，更有可能倾向于指定优先级策略（即脆弱性策略、工作人群策略或传播者策略）。此外，年轻受访者、瓦隆地区的居民以及曾感染过新冠病毒的人，比其他人更倾向于风险无关的优先级策略（即抽签或市场策略）。本研究通过支持先为弱势群体接种疫苗的分阶段方法，验证了所实施的分配方法的适当性。然而，研究也表明不同亚组的偏好存在显著差异，而且对于稀缺的、可能救命的资源而言，何种分配政策才算公平，民众并未达成一致意见。
