How should COVID-19 vaccines be distributed between the global north and south: a discrete choice experiment in six european countries
- Technical University of Munich, Germany
- University of Trento, Italy
Abstract
Background: The global distribution of COVID-19 vaccinations remains highly unequal. We examine public preferences in six European countries regarding the allocation of COVID-19 vaccines between the Global South and Global North.
Methods: We conducted online discrete choice experiments with adult participants in France (n=766), Germany (n=1964), Italy (n=767), Poland (n=670), Spain (n=925), and Sweden (n=938). Respondents were asked to decide which one of two candidates should receive the vaccine first. The candidates varied on four attributes: age, mortality risk, employment, and living in a low- or high-income country. We analysed the relevance of each attribute in allocation decisions using conditional logit regression.
Results: In all six countries, respondents prioritised candidates with a high mortality and infection risk, irrespective of whether the candidate lived in the respondent's own country. All else equal, respondents in Italy, France, Spain, and Sweden gave priority to a candidate from a low-income country, whereas German respondents were significantly more likely to choose the candidate from their own country. Female, younger, and more educated respondents were more favourable to an equitable vaccine distribution.
Conclusions: Given these preferences for global solidarity, European governments should promote vaccine transfers to poorer world regions.
Funding: Funding was provided by the European Union's Horizon H2020 research and innovation programme under grant agreement 101016233 (PERISCOPE).
Data availability
All data generated or analysed during this study are made publicly available via the Open Science Framework under the following link: https://osf.io/72jrq/
Article and author information
Author details
Funding
Horizon 2020 Framework Programme (No 101016233 (PERISCOPE))
- Janina I Steinert
- Giuseppe A Veltri
The funders had no role in study design, data collection and interpretation, or the decision to submit the work for publication.
Ethics
Human subjects: The study received approvals from the ethics committees of the medical faculty at the Technical University of Munich (TUM, IRB 227/20 S) and the ethics board at the University of Trento (Trento, IRB 2021-027). Participants were given an individual link to the survey, where they first received information about the study's purpose, data protection regulations, and voluntary participation. All participants provided written electronic consent to participate in the study prior to commencing the survey. Personally identifying information such as names and contact details were not collected and data is thus fully anonymised. After completing the survey, participants received a voucher worth three to five Euros, which was distributed by the survey company.
Copyright
© 2022, Steinert et al.
This article is distributed under the terms of the Creative Commons Attribution License permitting unrestricted use and redistribution provided that the original author and source are credited.
Metrics
-
- 875
- views
-
- 117
- downloads
-
- 5
- citations
Views, downloads and citations are aggregated across all versions of this paper published by eLife.
Download links
A two-part list of links to download the article, or parts of the article, in various formats.
Downloads (link to download the article as PDF)
Open citations (links to open the citations from this article in various online reference manager services)
Cite this article (links to download the citations from this article in formats compatible with various reference manager tools)
How should COVID-19 vaccines be distributed between the global north and south: a discrete choice experiment in six european countries
eLife 11:e79819.
https://doi.org/10.7554/eLife.79819
Further reading
-
- Epidemiology and Global Health
- Microbiology and Infectious Disease
Several areas of the world suffer a notably high incidence of Shiga toxin-producing Escherichia coli. To assess the impact of persistent cross-species transmission systems on the epidemiology of E. coli O157:H7 in Alberta, Canada, we sequenced and assembled E. coli O157:H7 isolates originating from collocated cattle and human populations, 2007–2015. We constructed a timed phylogeny using BEAST2 using a structured coalescent model. We then extended the tree with human isolates through 2019 to assess the long-term disease impact of locally persistent lineages. During 2007–2015, we estimated that 88.5% of human lineages arose from cattle lineages. We identified 11 persistent lineages local to Alberta, which were associated with 38.0% (95% CI 29.3%, 47.3%) of human isolates. During the later period, six locally persistent lineages continued to be associated with human illness, including 74.7% (95% CI 68.3%, 80.3%) of reported cases in 2018 and 2019. Our study identified multiple locally evolving lineages transmitted between cattle and humans persistently associated with E. coli O157:H7 illnesses for up to 13 y. Locally persistent lineages may be a principal cause of the high incidence of E. coli O157:H7 in locations such as Alberta and provide opportunities for focused control efforts.
-
- Epidemiology and Global Health
Background: The role of circulating metabolites on child development is understudied. We investigated associations between children's serum metabolome and early childhood development (ECD).
Methods: Untargeted metabolomics was performed on serum samples of 5,004 children aged 6-59 months, a subset of participants from the Brazilian National Survey on Child Nutrition (ENANI-2019). ECD was assessed using the Survey of Well-being of Young Children's milestones questionnaire. The graded response model was used to estimate developmental age. Developmental quotient (DQ) was calculated as the developmental age divided by chronological age. Partial least square regression selected metabolites with a variable importance projection ≥ 1. The interaction between significant metabolites and the child's age was tested.
Results: Twenty-eight top-ranked metabolites were included in linear regression models adjusted for the child's nutritional status, diet quality, and infant age. Cresol sulfate (β = -0.07; adjusted-p < 0.001), hippuric acid (β = -0.06; adjusted-p < 0.001), phenylacetylglutamine (β = -0.06; adjusted-p < 0.001), and trimethylamine-N-oxide (β = -0.05; adjusted-p = 0.002) showed inverse associations with DQ. We observed opposite directions in the association of DQ for creatinine (for children aged -1 SD: β = -0.05; p =0.01; +1 SD: β = 0.05; p =0.02) and methylhistidine (-1 SD: β = - 0.04; p =0.04; +1 SD: β = 0.04; p =0.03).
Conclusion: Serum biomarkers, including dietary and microbial-derived metabolites involved in the gut-brain axis, may potentially be used to track children at risk for developmental delays.
Funding: Supported by the Brazilian Ministry of Health and the Brazilian National Research Council.
