Good news BUT the next Surgeon General already had excuses why he can't meet the April timeframe for distributing the vaccine to the general public per Operation Warp Speed. Remember when the media said it would be a miracle to have a covid19 vaccine by years end. Well the miracle happened.... But no more.

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Excerpt from CDC Advisory Committee
A major ethical issue in front of the committee has been how it's considered racial and ethnic minorities, groups that have been disproportionately affected by Covid-19. But according to data presented at the ACIP meeting, front-line essential workers first in line, in Phase 1B, are more likely to be white Americans, while there is significant representation of minority groups in other essential workers, in Phase 1C.

Altogether, Phase 1C totals about 129 million people. The recommendations may need to be adapted over the coming months as the vaccine supplies fluctuate.

Dr. Nancy Messonnier, who leads the CDC's work on vaccines for Covid-19, explained during the meeting Sunday that her staff has tried to "walk a careful line" by offering explanations for the agency's recommendations, while leaving some room for "those on the front lines of jurisdictions that actually have to translate this into implementable guidance." States will ultimately make those final decisions.

One measure that can be used in distribution of a scarce resource is its effect on Years of Potential Lives Lost YPLL. YPLL calculates how many years of living the victim of a disease or accident lost as a result of that disease or accident.

An action taken to save a 10 year old has a much greater effect on YPLL than that same action taken to save an 85 year old. Similarly you can consider cost benefit. A person disabled by Covid and living for 5 years costs far less than someone getting the same level of disability and living for 40 years. Morbidity alone is not the only factor that can ethically be used in decision making.

While my death from Covid might be more likely to be prevented by a vaccine than my child's death, I and likely all of you if there were only one dose left to be given and you could get it or give it to your child - would pass it on.

If that is an easy choice because you love your child, I'd simply point out that your choice was based on an ethical construct, what is best for your family. Women and children first into the lifeboat... ethical choice. Is all of society our family? Does love your neighbor mean anything in this context?

If you leave race out of it, an ethical justification can be found for protecting essential young workers, especially those with children over elderly persons with limited YPLL benefits and no one dependent on them. If it turns out that those young essential workers are much more likely to be not white than the elderly at risk group, it is fair to mention that fact and not be accused of making a racist statement.

The calculation of benefit is not as simple as who is more likely to die if not vaccinated. It is the job of an ethicist to bring differing options and approaches to the discussion. The Children's hospital where I attended had ethicists. They came into difficult decision making situations not to tell the families or doctors what to do, rather to present all the factors which could ethically be used in making one of many reasonable choices.

That's the "let grandma die" strategy of Utility Theory with a constant, equal marginal utility per year for everyone. But suppose grandma has a PhD in microbology and still works in her profession. Shouldn't her marginal utility be higher than a child who has a low IQ ? Shouldn't grandma get the vaccine?

I agree that rationing scarce resources invo!ves an ethical decision but ascertaining the correct uti!ity functions is more complex than appears at first glance.

Geronticide, Senilicide, Senicide? Pretty drastic and scary.

Senicide - Wikipedia

Facing Senilicide | Psychology Today

This looks pretty reasonable to me. https://www.cdc.gov/vaccines/acip/me...ID-Dooling.pdf