To address the issue of scarcity and vulnerable populations, you will be asked to imagine yourself as the director of a mobile healthcare unit providing primary care in an underserved community that includes several vulnerable populations. Please read the following scenario carefully and answer each question.

You have received enough of the Johnson & Johnson vaccine to give one vaccination (only one shot is required) to two hundred people after immunizing your workers. Your total patient population is 555 clients. You are the director of four care teams that specialize in offering free services to the following groups of vulnerable people:

Preexisting conditions for the patients served include:

Asthma and other respiratory illnesses

HIV and other sexually transmitted diseases

Severe mental illness including schizophrenia

Opioid Addictions

Hypertension and other cardiovascular illnesses

These patients do not have other sources of health care. Patients receive a variety of primary care services including screening and preventive health care by the 4 teams of workers. Each team leader has advocated for the first vaccinations to be given to as many of their clients as possible because of their vulnerability. To keep good relations with your team leaders you must be able to justify your choice of who get vaccinated. The State has required that you justify who receives the vaccine for you to be eligible to continue to provide vaccines through your program.

Teams

Active substance abusers (200 registered clients, average age 36)

Homeless mentally ill (125 walk in clients per month, average age 58)

Recently released former prison inmates (55 registered clients, average age 23)

Sex workers (175 walk-in clients per month, average age 17)

For this Case Analysis, you must determine how to distribute the limited number of vaccines. Your decision must be ethically sound and based on the following:

promoting the health of the population,

fairness relative to need in the distribution of risks and benefits of care provision in society, and

impact on your healthcare workers considering risks to their own health

Please note your answers should not be justified by your opinion about any group.

Answer each of these questions:

How will you distribute the vaccines among the teams (which team, and how much)? You must explain and justify for decisions for distribution.

What ethical principles are raised in this case study?