How Will We Ration the COVID-19 Vaccine?

A COVID vaccine has the potential to save a great many lives. This is not a resource we can afford to limit only to those who can pay for it: Unvaccinated individuals can contribute to the viral spread, so it will be essential to vaccinate as much of the population as possible.
What will nationwide distribution entail, and who will supervise it? Who will fund the vaccines, and who will get those precious first doses? It will take time to manufacture and distribute adequate supplies before the vaccine is widely available.
The Centers for Disease Control and Prevention (CDC) and the National Institutes of Health (NIH) understand the need for a vaccine allocation plan to ensure that sufficient quantities are available by the time one or more vaccines are approved.
Both the NIH and CDC tasked the National Academies of Sciences, Engineering, and Medicine (NASEM) to assemble a committee of respected scientists, ethicists, physicians, epidemiologists, and public health experts to provide recommendations regarding the most effective and equitable way to distribute doses.
Formed in July 2020, the committee released its final report, Framework for Equitable Allocation of COVID-19 Vaccine, on October 2, 2020. The Committee’s recommendations set out four phases for COVID-19 vaccination, briefly summarized in the chart below.
Visit the NASEM website for a summary and the full report.
Committee members explained that when one household member qualifies for vaccination during a distribution phase, all family members should be vaccinated at that time to protect the at-risk individual and to maximize the efficiency of distribution.
Other recommendations include:
The Deptartment of Health & Human Services (HHS) should coordinate the necessary agencies to ensure that there will be no out-of-pocket costs to those who are vaccinated. 
The HHS and CDC should create community information and engagement programs to encourage widespread vaccination.
The U.S. should work with the Global Alliance for Vaccines and Immunization and the World Health Organization to assist in vaccination worldwide.
Though multiple federal agencies have yet to effectively adopt these recommendations, we may take solace in the renowned scientists and physicians guiding distribution when vaccines are available.
For daily virus counts and statistics, check out the daily updated dashboard at the Johns Hopkins University & Medicine Coronavirus Resource Center.

National Academies of Sciences, Engineering, and Medicine (2020). Framework for Equitable Allocation of COVID-19 Vaccine. Washington, DC: The National Academies Press (from Figure S-2, A phased approach to vaccine allocation for COVID-19).

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