As production of all three approved COVID-19 vaccines accelerates, the availability of those vaccines in destination countries is regressing toward a critical bottleneck. Governments and public health authorities are facing a number of complex decisions on how to distribute vaccines once they’re produced, including which groups to prioritize first and which communities should receive vaccines in the second phase of the rollout.
To make these decisions, the KFF team has developed a model incorporating epidemiological parameters estimated from actual disease progress and vaccination coverage data during the COVID-19 pandemic. The model’s Tier Global and Tier Domestic scenario sets allow for comparisons of vaccine distribution strategies. The Tier Domestic set includes sub-scenarios defining the allocation of vaccines (from producing countries) within destination countries by age group and industrial sectors.
Our analysis shows that prioritising groups with high daily person-to-person interactions leads to significant reductions in total fatalities, particularly at fast rolling out rates and when children are eligible for vaccination. However, when rollout rates are slower and overall vaccination coverage is high, focusing on vaccinating elders appears to be a better strategy, with up to 11% fewer fatalities.
This approach is consistent with the recommendation of WHO’s Strategic Advisory Group of Experts that frontline health and care workers, and older adults, should be vaccinated early. It also reflects the health utility benefits of reducing the likelihood of hospitalisation and death by vaccinating the elderly before extending vaccine access to other populations. This approach would, however, be difficult to sustain if incidence levels reached 20-50 cases per 100,000 people, given that hospitals and other health care systems could be overwhelmed with demand.
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