Ethical perspective for the COVID-19 vaccine prioritization in Chile

The SARS-CoV-2 pandemic has generated an important health and economic impact on the world. Vaccines emerge as an intervention that can contribute to the control of the pandemic. Vaccines were approved for emergency use in the United States, Europe, as well as in Chile, however, they will not be immediately available, creating the need to prioritize vaccine distribution. The World Health Organization (WHO) and other international agencies established ethical frameworks to guide the distribution of the COVID-19 vaccine globally. In Chile, the Advisory Council on Vaccines and Immunizations (CAVEI) and the COVID-19 Advisory Council of the Ministry of Health (MINSAL) recommended the groups to prioritize vaccination, based on the available evidence stating that this information could change over time. In this article, we propose a reference framework of ethical principles and values to support the decision-making of prioritization and distribution of vaccines in Chile. We propose three timeless values: maximizing benefits, prioritizing the most vulnerable, reciprocity, and two transversal bioethics principles: justice and transparency. This reference framework contributes to the vaccination plan communication, the decision-making by the authorities and supports the prioritization strategy ' s values framework. With an explicit values framework we can expect better communication or priorities, a greater acceptance of SARS-CoV-2 vaccination plan by the community and an increased vaccination coverage to protect the population.