Learning Objectives for this Presentation:
By the end of the presentation, participants will be able to describe the egalitarian and utilitarian approaches to rationing and apply them to influenza vaccine, analyze the current federal influenza pandemic vaccine rationing scheme, and discuss the impact on vaccine rationing schemes of varying pandemic mortality patterns (e.g., the “W” pattern of childhood, young adult, and elderly deaths seen 1918 in contrast to the more typical “U” shaped curve)

Background:
Rationing of scarce vaccine supplies will likely be required when the next pandemic occurs, raising the questions about how to ration and upon what principles. Because influenza pandemics have differing mortality pattern, such as the 1918 pandemic's “W” shaped curve that effected healthy young adults, the particular pattern should inform rationing. Competing ethical principles for vaccine rationing are utilitarianism and egalitarianism.

Setting:
Pandemic and a shortage of influenza vaccine

Population:
US population, including healthy persons, high risk persons, and health care workesr

Project Description:
A. Overview, Winslow's Triage and Justice
B. Influenza Epidemiology , Transmissibility, Complications, Pandemic Mortality Patterns, and Inactivated Vaccines
C. Utilitarianism as applied to rationing
D. Egalitarianism as applied to rationing
E. Combining multiple principles, 1976 swine influenza campaign and Guillian-Barre syndrome, and the current federal rationing scheme


Results/Lessons Learned:
Vaccine manufacturers and essential health care workers can be justified with either principle. Utilitarian principles of choosing based on social worth or those in whom vaccination is most likely to medically succeed raise substantial justice issues. Egalitarian principles of medical neediness and random chance avoid justice concerns and are proposed.