TABLE 1. Essential questions for COVID-19 vaccine allocation planning related to ethical principles — United States, 2020.

Ethical principle	Essential question
Maximize benefits and minimize harms	What groups are at highest risk for SARS-CoV-2 infection, COVID-19 disease, hospitalization, and death?
	What groups are essential to the COVID-19 response?
	What groups are essential to maintaining critical functions of society?
	What are the important characteristics of these groups (e.g., size or geographic distribution) that might inform the magnitude of benefit based on the amount of vaccine available or its characteristics?
Promote justice	Does the allocation plan result in fair and equitable access of the vaccine for all groups?
	How do characteristics of the vaccine and logistical considerations affect fair access for all persons?
	Does allocation planning include input from groups who are disproportionately affected by COVID-19 or face health inequities resulting from social determinants of health, such as income and health care access?
Mitigate health inequities	Does the plan identify and address barriers to vaccination among any groups who are disproportionately affected by COVID-19 or who face health inequities resulting from social determinants of health, such as income and health care access?
	Does the allocation plan contribute to a reduction in health disparities in COVID-19 disease and death?
	What health inequities might inadvertently result from the allocation plan, and what interventions could remove or reduce them?
	Is there a mechanism for timely assessment of vaccination coverage among groups experiencing disadvantage and the possibility for course correction if inequities are identified?
Promote transparency	How does development of the allocation plan include diverse input, and if possible, public engagement?
	Are the allocation plan and evidence-based methods publicly available?
	Is the allocation plan clear about what is known and unknown and about the quality of available evidence?
	What is the process for revision of allocation plans based on new information?
	Is there a mechanism to report demographic data elements for vaccine recipients (e.g., age, race/ethnicity, and occupation) to support equitable vaccination coverage?

Abbreviation: COVID-19 = coronavirus disease 2019.