If a worldwide pandemic occurs, the order in which people are deemed to be important enough to save or to whom experts submitted an ethical obligation is tricky and difficult. The protocol is revisited revised by the World Heath Organization and the United States government every two years. Prioritization is categorized by tiers, according to flu.gov the determination is based upon optimal survival projections and humanitarian considerations should a life threatening disease threaten the population.
So, whether it’s the flu, H1N1 or ebola, the following system of priority would be enacted, especially if vaccinations were extremely limited. Should you be beyond the priority tier, which is most of the population, there is a chance you could be relying on your own immunity and luck to save you.
Tier 1: The following are the first to be inoculated — deployed military on the front lines, front line physicians and nurses, EMS, fire, police, pregnant women, infants and toddlers
Tier 2: The following would be the second in line to be inoculated — border patrol, military support, national guard, key U.S. intelligence personnel, funeral directors and morticians, pharmacists, key utility personnel, critical government employees, those who have regular contact with infants and high risk children
Tier 3: The following are the third in line to be inoculated — all remaining military, remaining healthcare workers, bankers, remaining government workers and healthy children
Tier 4: The following are fourth in line to be inoculated — high risk adults and all of the elderly
If anything is left, the remaining healthy adult population (age 19 and up, which accounts for nearly half of the United States population) would be inoculated if any vaccines were left over.
Tier 1 is always given priority no matter how severe an outbreak, but for a serious outbreak in which vaccines are extremely limited or experimental, each tier would be sub-prioritized within each group.
For example, during a severe or critical outbreak, tier one would prioritize by:
1. First line doctors and nurses
2. Deployed front line military second
3. Emergency responders
4. Outpatient healthcare staff
5. Fire and police
6. Pregnant women and infants
7. Vaccine personnel such as the manufacturing facility workers and babies and toddlers 1 – 3 years.
These tiers have been debated and changed over the years with input from scientists and ethicists. Not long ago, the elderly were well ahead of the line before a healthy 4 year old. After much debate, the priority groups were changed after some opposition argued that a 4-year-old still has their whole life ahead of them.