Is vaccination prioritization obsolete? Medical ethicist Norbert Paul does not want to throw the established order overboard yet – but work on refreshing it has to be done every day.
SWR Aktuell: The vaccination priority was created because initially there was extremely little vaccine and the aim was to ensure that the vulnerable over 80-year-olds were vaccinated first. Clear guidelines, clear implementation. This clarity is now missing in many places – is it time to throw the prioritization overboard or at least to refresh it?
Prof. Norbert Paul: For me as an ethicist, it is foreseeable that this will happen, but it is still too early. For one thing, because we don’t have enough vaccine yet. We still don’t know how much we will have in Rhineland-Palatinate at the end of May. On the other hand, we have a number of groups that have not yet been taken into account in order to maintain the community. Take pharmacists, for example – only those who test or work in the vaccination center are vaccinated. But everyone else is in contact with sick people every day. So there are still people whom we consistently protect and therefore have to vaccinate as a matter of priority.
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Prof. Norbert Paul heads the Rhineland-Palatinate ethics advisory board on corona vaccinations.
SWR
SWR Aktuell: Doesn’t vaccination prioritization press us into too rigid a corset? Example teachers: We absolutely want to leave the schools open. At the same time, teachers from secondary schools in Rhineland-Palatinate are still not vaccinated. Hessen has meanwhile prioritized this professional group higher, which leads to resentment in the staff room, where vaccinated and non-vaccinated people sit next to each other.
Discussion about corona vaccination for all teachers in Rhineland-Palatinate
Paul: Yes, at this point we have to enter into an open discourse and weigh up the prioritization depending on the situation. If our aim is to open schools and if you watch the hustle and bustle after school – that often looks like normal – then it certainly makes sense to protect teachers as well as kindergarten teachers. However, we observe that the schools have excellent hygiene concepts. The transmission process is clearly laid out there, thanks to the schools. But: You have to negotiate the prioritization all the time, every day, there is no avoiding it. And with teachers this is certainly still an open discussion – but it is made more difficult by the lack of vaccines.
SWR Aktuell: What would happen if you gave up vaccination prioritization?
Paul: It just needs a consensus at the state level and that depends on the amount of vaccine doses available. If the prioritization is abolished, each vaccinating unit would vaccinate according to its own priority – then it would be a matter of chance who is prioritized as long as there is not enough vaccine. We then come into a situation of inequality that is also unjust. Priorities have to be set deliberately, and each group has good, justified reasons for asking for prioritization. As an ethics committee, we wrestle with all of these decisions and have to give them good reasons.