The Coronavirus Immunisation Programme Advice on priority groups for coronavirus vaccination in Norway Expert group in ethics and priority setting 15 November 2020
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Executive Summary The Norwegian Ministry of Health and Care Services has commissioned the Norwegian Institute of Public Health to organise the national coronavirus immunisationation programme. As a partial delivery of the assignment, the Norwegian Institute of Public Health has established an external expert group in ethics and prioritisation (henceforth: the ethics advisory group). This ethics advisory report describes the external group's working process and conclusions concerning the order of priority of the vaccines in the first phase of the Norwegian Coronavirus Immunisation Programme. The overall objective of this ethics advisory report has been to establish clear goals for what the Coronavirus Immunisation Programme should achieve, as well as to make recommendations for which groups should be given priority in the first phase of the programme. The advisory group has proceeded from values, to goals and lastly to priority categories. The following five values were adopted as the core values to guide prioritisation: equal respect, welfare, equity, trust and legitimacy. Five goals were then proposed and ranked in order of their importance: 1) Reduce the risk of death. 2) Reduce the risk of severe illness. 3) Maintain essential services and critical infrastructure. 4) Protect employment and the economy. 5) re-open society. Based on these values and goals, three categories for prioritisation were established: risk factors for severe illness and death, the infectious situation and occupation. The ethics advisory group has suggested dynamic health priorities based on the Norwegian Government's long-term scenario for the course of the pandemic and recommended that I. risk groups and II. healthcare personnel should be prioritised in pandemic scenarios 1–2a, and that in the event of widespread infection (scenario 2b–), the priority order should instead be I. healthcare personnel, II. risk groups and III. critical societal functions. These three priority groups are in accordance with the values, goals and priority categories proposed by the ethics advisory group in this document. These are preliminary recommendations for the order of priority for coronavirus vaccines in Norway, and the ethics advisory group has taken into account that the recommendations may need to be revised if there are significant changes to the empirical evidence.