Mobile Vaccination Teams in Long-Term Care Homes for the Elderly in Germany During the COVID-19 Pandemic

Abstract In Germany, residents in long-term care homes for the elderly were among the highest priority to receive the first COVID-19 vaccine. To reach this vulnerable population efficiently and without exposing them to further risk of contagion, mobile vaccination teams were assembled. This chapter provides a case study of these teams, reflects upon their implementation and operation, raises both contextual and general ethical questions about them, and addresses the topic of proportionality as distinct from field experience while paying attention to practical problems in times of emergency that are relevant for moral evaluation. More precisely, the population benefit of background and herd immunity is juxtaposed with several moral principles that were overridden or, at least, infringed upon by the teams’ operation. Among these principles are the protection of privacy, respect for autonomy, and the maintenance of public trust. In addition to considering distributive and procedural justice, the avoidance and removal of harms, and nonmaleficence and beneficence, this chapter presents an assessment of the case study that provides two insights into the role of proportionality in health crisis management. First, it demonstrates that there is no general answer to the question of whether the benefits of the field vaccination outweighed the costs. Second, the assessment points to an ethical pandemic exceptionalism that was at work during the 2020–2021 vaccination campaign. Hence, it not only contributes to the reappraisal of past events but also points the way to the development of holistic pandemic preparedness that must include moral considerations.