As some of you know, I have been doing some work on the question of vaccine prioritization before the current swine flu outbreak. The question of who would get vaccine first in the case of a pandemic has been discussed extensively in and out the public health community in the past few years.

The prioritization scheme for the allocation of pandemic vaccine developed by the US government has taken a particular form. The logic informing it is largely, but not exclusively, a logic of – what a surprise! – security. This is particularly true for a severe pandemic, less though for a moderate pandemic; i.e. they developed three different prioritization schemes for three different types of pandemics (severe, moderate, less severe). Although it appears to make sense at first sight to differentiate between diffferent types of pandemics, this move actually comes with its own problems, if you keep in mind that pandemics tend to come in waves. So a moderate wave may be followed by a severe wave. Which scheme are you going to implement?  What if the moderate pandemic suddenly becomes a severe one?

The prioritization scheme with its three distinctive types of pathological events is based on the idea of a pandemic as the realization of a possible rather than the actualization of a virtual event, to use the Deleuzian distinction.

The logic of security at work in the prioritization scheme means basically that if you are not working for the police, the military, homeland security, the fire department, or some other “essential service,” you will most likely not be among the group that will get pandemic vaccine first. Maybe time to change your job!

Of course, it will be interesting to see if there will be any resistance to the prioritization scheme should it ever be implemented. An “ethical prophylaxis,” to use Sarah Franklin’s term, has already been built into the scheme, so contestation will certainly be difficult.