COVID-19 Vaccines: Allocation – WHO SAGE

WHO SAGE values framework for the allocation and prioritization of COVID-19 vaccination, 14 September 2020
World Health Organization
14 September 2020 :: 13 pages
PDF: WHO-2019-nCoV-SAGE_Framework-Allocation_and_prioritization-2020.1-eng.pdf
Executive Summary
This Values Framework offers guidance globally on the allocation of COVID-19 vaccines between countries, and to offer guidance nationally on the prioritization of groups for vaccination within countries while supply is limited. The Framework is intended to be helpful to policy makers and expert advisors at the global, regional and national level as they make allocation and prioritization decisions about COVID-19 vaccines. This document has been endorsed by the Strategic Advisory Group of Experts on Immunization (SAGE).

The Framework articulates the overall goal of COVID-19 vaccine deployment, provides six core principles that should guide distribution and twelve objectives that further specify the six principles (Table 1). To provide recommendations for allocating vaccines between countries and prioritizing groups for vaccination within each country, the Values Framework needs to be complemented with information about specific characteristics of available vaccine or vaccines, the benefit-risk assessment for different population groups, the amount and pace of vaccine supply, and the current state of the epidemiology, clinical management, and economic and social impact of the pandemic. Hence, the final vaccination strategy will be defined by the characteristics of vaccine products as they become available.

SAGE is currently engaged in the process of applying the Values Framework to emerging evidence on specific vaccines, and the evolving epidemiology and economic impact of the pandemic. The first stage of this process was the identification of populations and sub-populations which would be appropriate target groups for prioritization under the various values-based objectives in the Framework (Table 2), before data on Phase 3 vaccine performance are not yet available. Specific priority group recommendations for specific vaccines will be made as vaccine products become authorized for use; initial vaccine specific policy recommendations are expected in the final quarter of 2020 or early 2021, depending on timing of and findings from phase 3 vaccine trials.

The Framework also complements the principles on equitable access and fair allocation of COVID-19 health products developed for the ACT Accelerator COVAX facility.

Framework Goals and Principles at a Glance
Overarching goal
COVID-19 vaccines must be a global public good. The overarching goal is for COVID-19 vaccines to contribute significantly to the equitable protection and promotion of human well-being among all people of the world.

Principles
Human Well-Being
Protect and promote human well-being including health, social and economic security, human rights and civil liberties, and child development.
Equal Respect
Recognize and treat all human beings as having equal moral status and their interests as deserving of equal moral consideration.
Global Equity
Ensure equity in vaccine access and benefit globally among people living in all countries, particularly those living in low-and middle-income countries.
National Equity
Ensure equity in vaccine access and benefit within countries for groups experiencing greater burdens from the COVID-19 pandemic.
Reciprocity
Honor obligations of reciprocity to those individuals and groups within countries who bear significant additional risks and burdens of COVID-19 response for the benefit of society.
Legitimacy
Make global decisions about vaccine allocation and national decisions about vaccine prioritization through transparent processes that are based on shared values, best available scientific evidence, and appropriate representation and input by affected parties.