Distributing Vaccine Fairly During Influenza Pandemics – A Case Study from Berlin

  • Jasper Littmann
Part of the Public Health Ethics Analysis book series (PHES, volume 1)


At the beginning of an influenza pandemic, scarcity of vaccine is unavoidable. This raises questions about fair distribution and prioritisation of particular groups. During the H1N1 pandemic in 2009 and 2010, the prioritisation of patient groups for the vaccination against influenza raised a series of ethical concerns. These related to the problems of uncertainty about outcomes at the onset of a pandemic, the difficulty of defining a clear goal of vaccination campaigns, and the practical problems brought about by the intense challenges that health care systems are faced with in a pandemic. In this paper, Berlin is used as a case study to show that at least some of these problems are related to a failure to integrate pandemic policy between different organisational levels. This failure proved problematic in two instances, first where policies overlapped and contradicted each other, and second where the minutiae of vaccine provision created problems for more abstract assumptions about fair allocation of scarce resources. It will be shown that some aspects of these problems may be remediable by applying principles of procedural justice. However, in order to properly integrate the micro and the macro scale, bioethicists will have to work alongside those with clinical expertise, and deploy models of thinking both from conventional doctor-patient bioethics and more population-level public health ethics.


Health Care Worker Procedural Justice Distributive Justice Influenza Pandemic Vaccination Campaign 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


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Copyright information

© Springer Science+Business Media Dordrecht 2013

Authors and Affiliations

  1. 1.Division of MedicineUniversity College LondonLondonUK

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