Thinking Citizen Blog — How should vaccines be rationed? Who should decide? How?

John Muresianu
3 min readFeb 11, 2021


Thinking Citizen Blog — Thursday is Health, Health Care and Global Health Policy Day

Today’s Topic: How should vaccines be rationed? Who should decide? How?

The CDC has guidelines for states, but these are not legally binding. And different states are making different choices. Does this make sense? Doesn’t it make more sense to have a centralized system like in the UK where the roll-out is proceeding at a much faster pace than in the US? But, of course, if the central authority gets its priorities wrong, not so good. Well, in this instance does the CDC get it right? What is an alternative? Which would you vote for? Experts — please chime in. Correct, elaborate, elucidate.

THE CDC’S THREE STATED GOALS — the right ones? in what order? too open to interpretation?

1. “Decrease death and serious disease as much as possible”

2. “Preserve functioning of society”

3. “Reduce the extra burden COVID-19 is having on people already facing disparities.


1. Phase 1a: Health care workers and residents of long term care facilities

2. Phase 1b: “Frontline essential worker such as fire fighters, police officers, corrections officers, food and agricultural workers, United States Postal Service workers, manufacturing workers, grocery store workers, public transit workers, and those who work in the educational sector (teachers, support staff, and daycare workers.)

3. Phase 1b: “People aged 75 years and older because they are at high risk of hospitalization, illness, and death from COVID-19.”

ALTERNATIVE IDEAS — which states or countries get it most “right”?

1. Use age alone. Much simpler. More “scientific.” But then again does it make sense for centenarians be first in line?

2. What about inmates? Some states give them high priority others not. CDC is silent, so far as I can tell.

3. Who is “essential”? Who is “frontline”? What about teachers and child-care workers? Shouldn’t kids always come first? How do you weigh long term risks versus short term risks?

NB: Who is “at risk” is also subject to debate. Should the obese get preference over the non-obese? the morbidly obese preference over the obese?

Fragmented, decentralized health system plagues vaccine rollout across US, Mass. — The Boston Globe

The High-Risk Group Left Out of New York’s Vaccine Rollout

Prison, jail inmates are starting to receive COVID-19 vaccines. Some are passing on the offer — The Boston Globe

Opinion | How to Ration Vaccines


1. Is there no right answer? Is there no best answer?

2. Is the greatest risk dithering?

3. Best article you have read on the subject?

For the last three years of posts organized by theme:

PDF with headlines — Google Drive


Please share the most interesting thing you learned in the last week related to health, health care or health care policy — the ethics, economics, politics, history…. Or the coolest, most important thing you learned in your life related to health are or health care policy that the rest of us may have missed. Or just some random health-related fact that blew you away.

This is your chance to make some one’s day. Or to cement in your mind something really important you might otherwise forget. Or to think more deeply than you otherwise would about something that matters.



John Muresianu

Passionate about education, thinking citizenship, art, and passing bits on of wisdom of a long lifetime.