Socio-demographic differences in citizen' preferences for distributing a scarce, lifesaving resource: A case study using COVID-19 vaccine distribution in Belgium

• DOI: 10.1016/j.vaccine.2025.126997
• Publication Date: 2025-03-19T13:36:54Z
• Authors: Nele Raskin; Mickaël Hiligsmann; Jeroen Luyten; Sandy Tubeuf; Alexander Grigoriev; Roselinde Kessels
• Keywords: 2019-20 coronavirus outbreak; Resource distribution; Pandemic; Scarcity

The COVID-19 pandemic, particularly the period when safe and protective vaccines became available, presented an excellent opportunity to investigate public preferences regarding how ration a scarce, life-saving resource. It is important understand which distributive strategies are preferred but, as this inherently normative matter, also extent different socio-demographic groups hold opinions. This study assesses impact of characteristics on for vaccine prioritization during early stages pandemic at moment were not available yet. A representative sample 2060 Belgians asked rank eight strategies. Based rankings, we clustered into five overarching groups. Then, estimated potential respondents' their towards these ranking exercise shows that vulnerability strategy (i.e. chronically ill elderly) most often (N = 1815) market individuals who come first or pay most) by fewest respondents 116). Preferences distribution vary among population subgroups. Women, older retired individuals, residents Flanders, those with positive attitude vaccination efforts and/or high willingness, prefer government scientists decide upon more likely designated priority strategy, workers spreaders). Furthermore, younger respondents, Wallonia, previously infected tended favour risk-independent lottery strategy) than others. validates appropriateness implemented rationing approaches, supporting phased approach in vulnerables vaccinated. However, it demonstrates subgroups had substantially was disagreement about what constitutes fair policy potentially lifesaving