Vacunagate: Vaccines for all or privilege of the few?

Case overview/synopsis: The COVID-19 pandemic highlighted the profound limitations of the Peruvian health-care system. Despite its rapid economic growth in previous years, Peru faced the collapse of its health-care infrastructure in the face of the spread of the virus. In this context, the country was selected in 2020 to participate in a Phase III clinical trial of the Sinopharm vaccine, led by the Universidad Peruana Cayetano Heredia (UPCH). The research team, under the direction of Dr Germán Málaga, administered 12,000 doses in a randomized, controlled study, seeking to validate the safety and efficacy of the vaccine. However, the arrival of an additional batch of 3,200 doses, not included in the official trial, opened an ethical crossroads. As hospitals collapsed and the country suffered one of the highest mortality rates in the region, senior officials pushed to receive these additional doses in secret, prioritizing their personal use over the most vulnerable groups. Should Dr Malaga: Apply the extra vaccines to personnel outside the health system in the clinical trial? Or follow strict protocols and reserve the doses only for those directly involved in the research? This case exposes not only the ethical challenges, but also the need to make decisions in high-pressure environments. Complexity academic level: The Vacunagate case is designed for students of undergraduate programs, in subjects related to health sciences and medicine, such as bioethics, health administration and hospital management. Also, in subjects related to administration and business, such as business ethics, crisis management, leadership and decision-making. In summary, the case allows students to explore issues such as the impact of individual decisions, the management of public trust and the evaluation of ethical responsibility in the management of resources in a health-care context. Supplementary material: Teaching notes are available for educators only. Subject code: CSS10: Public Sector Management.