The third consideration that mitigates some of the fair chances and best outcomes conflict in the case of vaccine development is that the diseases for which vaccines are sought are frequently not, at least usually, life threatening to most people who experience them, but often instead only have some impact on individuals’ health status, and often for only a limited period of time. In these cases, the difference in impact on individuals who avoid a disease because a vaccine was developed and individuals who contract a disease for which no vaccine was developed is much less, and so the possible concern about fairness is less compelling.
The committee emphasizes that the aim in this chapter has been to identify some of the principal ethical issues involved in developing and using the model presented in this report to help set priorities for vaccine development. The use of a quantitative analytic model for determining those priorities can help focus those ethical issues, just as it helps focus the various empirical considerations that bear on the recommendation for priorities. The committee has tried to say enough about these ethical issues to give readers a sense of the nature of the controversies. In some cases, the committee has given reasons for the ethical position our quantitative model and recommendations take on the issues, but in others the aim was only to focus the issue for policymakers who will make use of this report.