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A healthcare professional holds a bottle labelled 'Vaccine Covid-19' and a syringe
The first effective vaccines against Covid are expected for late 2020 or early 2021. Photograph: Dado Ruvić/Reuters
The first effective vaccines against Covid are expected for late 2020 or early 2021. Photograph: Dado Ruvić/Reuters

Covid-19 vaccine: who are countries prioritising for first doses?

This article is more than 3 years old

The WHO put out guidelines but different countries are setting their own vaccination priority criteria

Hope that the first effective vaccines against Covid-19 could begin being distributed late this year or early in 2021 has led countries, including the UK, to announce who will be vaccinated first.

While the World Health Organization has set out general guidelines for vaccination priority, different countries have set their own criteria.

That includes the United States, where the Centers for Disease Control’s Vaccination Program interim playbook, issued at the end of last month, identified minority ethnic groups – who have been shown to be more susceptible as a potential “critical population” – for priority consideration along with care homes, prisons and psychiatric facilities residents and workers, health workers and the over-65s and those with pre-existing conditions.

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In Europe countries are at different levels of planning, with some already providing detailed guidance of who and how the first round of vaccines may be delivered, while others are promising more details in the weeks to come.

So what stage are countries at?

Germany

The government has acknowledged that it is unlikely it will have sufficient doses for everyone at first. The health minister, Jens Spahn, suggested it would take months to vaccinate the population with a target of 55-65% to reach herd immunity.

A committee from the German Ethics Council, the Leopoldina (national academy of sciences) and the permanent vaccination commission at the official public health agency, the Robert Koch Institute, has been asked to draw up guidelines for “fair and orderly access” with about 30-40% of the population in higher-risk groups by age or health. That includes 23 million Germans over 60.

Germany has said it intends to reduce pressure on intensive care beds by prioritising people with a significantly higher risk, with distribution at first at bespoke vaccination centres and then through GPs.

The next tier for priority will be those working in key public services, including healthcare and care home staff, and the emergency services.

“At the forefront are of course nurses, doctors and also people who belong to a risk group. However, that is already quite a large number in our country,” the chancellor, Angela Merkel, said recently.

France

Like Germany, France relies on a group of advisory committees which have been issuing draft guidelines for vaccination priority and a widespread public consultation campaign aimed at countering vaccine hesitancy in a country with a history of resistance.

France estimates that 6.8 million of its citizens are at especially high risk, including 1.8 million healthcare professionals and carers. In addition, about 23 million people could be considered vulnerable because of either age or chronic health conditions.

Although the WHO has advised considering higher-risk occupations in inoculation strategy, France has extended this category to workers outside healthcare, emergency services and care homes.

With chauffeurs and taxi drivers suffering higher death rates than healthcare workers in France’s first wave of infections, they have been prioritised for vaccination. Five million other professionals would also be included because of their contact with the general public including retail workers, school staff, plus people working in abattoirs and in construction.

The next priority groups for France would be those living in overseas territories lacking sufficient intensive care beds and workers in settings such as prisons or in the military, and emergency services.

Spain

Spain hopes to receive about 20m initial vaccine doses under a deal struck by the EU, with the first consignment expected by late this year orearly next year, enough to give 10 million people the required two shots.

While detailed criteria are expected to be released in the coming weeks, the country’s health minister, Salvador Illa, has suggested that healthcare workers and the elderly should get priority – although in terms of numbers, the two groups, at about 10 million, account for almost all of the initially available doses.

It is understood that – as in other countries – vaccinations will largely take place in local healthcare settings to avoid having vulnerable individuals go to hospitals.

Italy

Walter Ricciardi, a senior scientific adviser to Italy’s minister of health, told the newspaper La Repubblica that his country’s priority for vaccination would be health workers, elderly people and people with conditions that make them vulnerable, followed by the military and police.

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