Public opinion on global distribution of COVID-19 vaccines: evidence from two nationally representative surveys in Germany and the United States
Abstract
Background
Despite ongoing calls for more equity in the global distribution of COVID-19 vaccines, there remains a great disparity between high- and low- or middle-income countries. Based on the principles of distributive justice, we assessed the public opinion on this issue in the United States and Germany as examples for high-income countries with a high potential for redistribution.
Methods
We conducted representative surveys among the adult population in the United States ( N =1,000) and Germany ( N =1,003) in June 2021 using two instances of an analytic hierarchy process (AHP) to elicit how the public weighs different principles and criteria according to which the vaccines should be allocated as well as discrete choice experiments to split a limited supply of vaccine doses between a hypothetical high-income and low-income country.
Findings
In the first AHP, respondents in the United States and Germany gave weight to “medical urgency” by 37·4% (37·2-37·5) and 49·4% (49·2-49·5), “equal access for all” 32·7% (32·6-32·8) and 25·4% (25·2-25·5), “production contribution” 13·7% (13·6-13·8) and 13·3% (13·2-13·4), and “free market rules” 16·3% (16·2-16·4) and 12·0% (11·9-12·1), respectively. In the discrete choice experiment responds in the United States split available vaccine doses such that the low-income country on average received 53·9 percent (95% CI: 52·6-55·1). For Germany this number was 57·5 percent (95% CI: 56·3-58·7). The low-income country had three times as many inhabitants as the high-income country. When facing the dilemma where a vulnerable family member was waiting for a vaccine as opposed to when there was no clear self-interest, 20·7% (18·2-23·3) of respondents in the United States and 18·2% (15·8-20·6) in Germany reduced the amount they allocated to the low-income country
Interpretations
The public in the United States and Germany favours utilitarian and egalitarian distribution principles of vaccines for COVID-19 over the currently prevailing libertarian or meritocratic principles. This implies that political approaches and decision favouring higher levels of redistribution would be supported by the public opinion in these two countries.
Funding
German Research Foundation DFG RTG 1723.
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