Considerations Underlying Prioritisation of COVID-19 Vaccine Recipients

The scale and rampant spread of COVID-19 has generated a huge challenge for the world. While vaccine candidates are racing through the trial process, countries are gearing up to administer the early vaccines to their populace. It is obvious that initially no country will have enough vaccine supply to vaccinate everyone. In India, we will require about 2 billion doses to vaccinate the more than 1.3 billion people. No freshly approved vaccine will be available in that supply and manufacture can only be ramped up over time to cater to this demand. Thus, initially vaccine demand is going to outstrip supply, necessitating a mechanism of prioritising vaccine recipients.

Several methodologies have been proposed to prioritise vaccine recipients — such as frontline workers first or those with co-morbidities or over the age of 65 years to be vaccinated first. There is universal consensus that healthcare workers be prioritised within the first phase of vaccination. However, there are differing views on which group would accompany HCWs in this phase. Each methodology has its own set of pros and cons and will have champions and detractors. There is no universally correct or right method to prioritise and it will be up to our elected officials to make this hard decision. But a principled decision communicated transparently to the public can help alleviate public anxiety.