The COVID-19 pandemic has highlighted a number of ethical issues that typically have not been addressed openly in public debate. The argument 'protect the vulnerable' has been a mantra to motivate all sorts of measures, many of them not scientifically motivated. In this article, the concept of 'vulnerability' is analyzed, and a model is suggested to distinguish layers of vulnerability that may or may not result in poor outcomes, depending on how many layers are present and how they interact. Ethical aspects also need to be considered at the global level, where the issue of vaccine distribution illustrates that stronger obligations and responsibilities need to be taken to fulfil wishes and declarations on the fair distribution of resources.
© The Author(s) 2021. Published by Oxford University Press on behalf of the European Public Health Association.