| Home > Events > Disease, Disaster, and Democracy, 2006 > Conference Speakers > Roundtable 1 Roundtable I: Who Receives the Limited Doses of Pandemic Flu Vaccine?
An Exercise in Shared Decision-Making Background | Issues and participants | Transcript | Summary | Audio Purpose, Scenario, and Agenda
Purpose
To explore the feasibility and benefits of actively engaging citizens in pandemic influenza planning, in anticipation of the ethical dilemmas posed by a scarcity of life-saving medical resources such as vaccines, anti-virals, antibiotics, and hospital beds. Scenario
In September, the novel H5N1 strain begins to spread rapidly in several Asian countries with increased and sustained person-to-person transmission. Because of this, the World Health Organization officially declares the onset of an influenza pandemic on September 20, 2006. In late September, CDC informs state health departments that H5N1 vaccine will not be available until March 2007, despite emergency efforts to produce vaccine against the novel strain. CDC will distribute vaccine through the Strategic National Stockpile to state health departments in batches as it is produced and according to the state’s population. State health agencies expect to receive enough doses to vaccinate 20% of their populations initially, with comparable portions coming each month thereafter.* With this knowledge, your city’s health agency begins to review and update its own distribution plans for the first and subsequent batches of the vaccine. At the health officer’s briefing on flu vaccine planning, the Mayor wonders aloud which 20% of the city’s residents get to stand in line first for the flu vaccine shipment and how everyone else will be able to live with that decision. The health officer explains that broad federal guidelines do outline priority categories, but she estimates that the city residents who populate the top priority groups far exceed the first allotment of vaccine. Discussion Agenda – 1:30 to 2:45 pm
5 min Introductory Remarks (Peter Singer, Moderator)
20 min Role-Playing by Roundtable Participants The moderator will engage each of the participants in turn regarding their real-world role as it plays out in the above “scarcity” situation – whether as an official responsible for allocating the vaccine, someone on the receiving end of the vaccine, or someone reporting on the public policy decisions. Panelists will also be asked to reflect on how they think the final rationing decisions should be made and how different city residents will judge those decisions. 20 min Brainstorming on Applications of Public Involvement The conversation will shift from role playing in the hypothetical crisis period to generating ideas about real steps that can be taken, now, pre-crisis to develop sound, dynamic decision-making frameworks for allocating scarce medical resources. Participants will discuss how different techniques of citizen engagement – as described in the morning sessions – might be applied to rationing policy decisions, with the twin goals of broad social acceptability and enhanced public health outcomes. 25 min Q&A with audience members
5 min Summary Remarks (Moderator) * Scenario adapted and modified from the University of Minnesota Center for Infectious Disease Research and Policy. | 
