Rationing could also be affected by where the vaccine was tested. In the case of AIDS, experimental treatments were assessed in Africa, where testing was cheaper, but the treatments then went to developed countries. Severely affected African countries had to pay prohibitive prices as the disease took hold.
Africa could become a Covid-19 test site if regulators do not permit human challenge tests elsewhere. If large-scale testing does happen there, justice will demand that early supplies of the vaccine are made available to Africans, even at the expense of people in the researchers’ home country.
How to Roll It Out?
Vaccinations work best when everyone receives them, since germs that can’t infect people tend to wither away.
But all vaccines come with risks. That creates a “free-rider” problem. The best option from a self-interested point of view is that everybody else has the shot (eliminating your personal risk of catching Covid-19) – but that you don’t (avoiding any personal risk of side-effects). Taxes have the same problem. Taxes are compulsory. Does that mean vaccination should be compulsory, too?
The public-health case for compulsion is strong. But libertarians have a problem with forcing a potentially harmful vaccine on someone without the “informed consent” that’s hard to procure in societies skeptical of experts and low on social trust.
How can the vaccine reach a critical mass without compulsion? Caplan suggests leaving compulsion to private entities. An employer might demand vaccination as a condition of reporting for work. A university might impose the same requirement on faculty and students. A vaccine might be dangled as a golden ticket to return to theaters, cinemas, night clubs or sports events. Governments or foundations could even pay people to receive a shot.
By this thinking, those who assert their right not to be vaccinated would be free to work from home and home-school. They would be voluntarily narrowing their own freedom of movement and assembly.
Yet societies would pay a price. The virus has divided humans in countless ways already. If many citizens opt to stay unvaccinated, the virus and the messy ethics of compelling vaccination will have helped to create another permanent division.
This opinion piece was written by John Authers, a senior editor for markets at Bloomberg.