Experts issue recommendations for equitable distribution of COVID-19 vaccine

November 19, 2020

Philadelphia, November 19, 2020 --A group of vaccine experts led by Children's Hospital of Philadelphia (CHOP) has published recommendations to ensure equitable distribution of a COVID-19 vaccine when it becomes available. The framework, published today in Heath Affairs, focuses on five principles the authors believe would strengthen the current immunization delivery system to ensure equitable access to everyone for whom vaccination is recommended.

"It is critical for the federal government to set policy and provide coordinated guidance and resources to states and localities for meaningful, rapid implementation of a vaccine strategy, so that areas may begin immunizing prioritized populations as soon as they receive vaccine doses," said lead author Angela K. Shen, ScD, MPH, a visiting research scientist at CHOP's Vaccine Education Center.

The paper outlines five main principles by which policymakers can implement an equitable COVID-19 vaccine distribution strategy:

1. Recruit diverse populations to participate in clinical trials for a COVID-19 vaccine to ensure the data reflect the racial, ethnic, age and gender diversity of the US.
2. Require transparency when it comes to reviewing safety and efficacy data, with approval discussions taking place in the public eye, particularly in the event of an Emergency Use Authorization.
3. Follow guidance from the Advisory Committee on Immunization Practices (ACIP) and the National Academy of Sciences, Engineering, and Medicine (NASEM) working groups as they identify priority groups and develop recommendations for vaccinating the civilian population.
4. Ensure access to vaccinations for all individuals, regardless of their ability to pay.
5. Engage state-level task forces and working groups in discussions about how to distribute vaccines effectively to recommended populations, with a focus on communication strategies and ensuring proper representation of minority voices.

The authors also recommend establishing benchmarks by which policymakers can measure progress on these recommendations in order to support the goals of equitable vaccine distribution. Additionally, the researchers also specify that the federal government, through the National Vaccine Plan, National Pandemic Preparedness Strategy and other strategic, coordinated efforts, should remain accountable for the outcomes of these vaccine and vaccination efforts.

"As a country, we must guarantee diverse representation at every stage of medical and policy development, resolve financial barriers, and strengthen our immunization infrastructure, which is long overdue," Shen said. "We can only end deadly pandemics and eliminate morbidity and mortality from other vaccine-preventable diseases when we can ensure everyone has equal access to life-saving vaccines regardless of their geographic location, systemic limitations to health care, or ability to afford vaccines."
Shen et al. "Ensuring Equitable Access to Novel COVID-19 Vaccines in the United States: An Overview of the Current System, Challenges, and Opportunities," Health Affairs, Nov. 19, 2020,

About Children's Hospital of Philadelphia: Children's Hospital of Philadelphia was founded in 1855 as the nation's first pediatric hospital. Through its long-standing commitment to providing exceptional patient care, training new generations of pediatric healthcare professionals, and pioneering major research initiatives, Children's Hospital has fostered many discoveries that have benefited children worldwide. Its pediatric research program is among the largest in the country. In addition, its unique family-centered care and public service programs have brought the 595-bed hospital recognition as a leading advocate for children and adolescents. For more information, visit

Children's Hospital of Philadelphia

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