The Big Decision of the World - Who Will Get the Covid-19 Vaccine First?
In theory, everyone in the world who wants it should eventually be able to get immunized. But for much of 2021, demand for the coronavirus vaccine will outstrip supply, presenting a massive dilemma for governments, which must decide who gets the vaccine first or early, and who must wait.
The U.S. federal government's world-leading "Operation Warp Speed" vaccine program plans to over 6 million doses within 24 hours of regulatory clearance. But even this initial effort to immunize front-line health-care workers risks wasted doses and that's just Step 1, in one country.Many disputes over prioritization will play out in the fine print of government plans. Is a hospital worker more at risk than a suburban pediatrician? Is a bus driver's super-spreading danger a greater priority than the risk faced by a 50-year old with diabetes?
"You want to target the highest risk, because this will get you the biggest benefit," said Tom Kenyon, a former director of CDC's Center for Global Health, who cited the example of bus drivers in Africa being identified as key spreaders of the virus.
Serious questions also arise around equity. "We will not have succeeded if a healthy 20-year old in US is getting vaccinated before a frontline health care worker in South Sudan," said senior vaccines policy adviser for Doctors Without Borders' Access Campaign.
With the vaccine likely to be administered outside hospitals in many instances — in pharmacies, from mobile van facilities — verifying that recipients have certain health conditions will rely on either huge databases or an honor system.
Many governments are keeping their options open until final details of vaccine efficacy and delivery timelines are available. Here are the most relevant elements of those...