Back in early January, Prime Minister Boris Johnson predicted that “with a fair wind in our sails”, the UK would be able to offer a first COVID-19 vaccine dose to its first four priority groups by mid-February.
The winds have evidently been good. All frontline health workers, care home staff and residents, extremely clinically vulnerable people and over-70s – some 15 million people – were offered a first dose before the middle of the month arrived. The question is what happens next.
The UK government’s remaining priority groups cover everyone aged 50-70 and all other clinically vulnerable people. However, the government has shown that it’s willing to be somewhat flexible with prioritisation, having this week added 1.7 million people to the clinically vulnerable list. Half of those added have yet to receive a first dose, so have been moved up the queue.
The motivation behind this was a new model that calculates who is most vulnerable to COVID-19 using factors that weren’t considered before, such as weight, socioeconomic deprivation and ethnicity. As Vageesh Jain and Paula Lorgelly from UCL argue, this sort of approach makes sense, but could be extended even further.
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Given the risk of death from COVID-19 is low for under-65s, the case can be made for allowing others to filter into the vaccine queue. Good candidates could be younger people who are key workers – such as teachers or transport staff – or people in places where protection is limited, such as homeless shelters or prisons. Other countries are already prioritising these groups.
But assuming the vaccine priority list isn’t altered significantly further, the UK government is aiming to have offered a first dose to all over-50s by the beginning of May. On the current pace of rollout, this target would be hit a month earlier, but the supply of doses from manufacturers may slow down in the coming weeks.
In other parts of the world, vaccine rollout is moving very slowly. Lower-income countries are less likely to have access to vaccine doses, as rich countries have bought up initial supplies. But poorer countries are also stymied by not being able to make their own, as Ronald Labonté, an expert in health equity from the University of Ottawa, explains in the latest Conversation Weekly podcast.
For the past few months, a group of countries have been pushing for intellectual property rules around COVID-19 vaccines to be temporarily relaxed, arguing this would help expand supply and push down costs. But a small group of other countries – many of them home to the companies that hold the patents for vaccines that have been authorised – are trying to block it. The issue is likely to be discussed at the World Trade Organisation’s General Council in early March.
In the meantime, the World Health Organisation (WHO) has called for world leaders to increase contributions to Covax, its worldwide vaccine-sharing initiative. The WHO has even said that countries should try to share doses with Covax while rolling out their own national campaigns.
The WHO has also called on all countries to begin rolling out COVID-19 vaccines in the first 100 days of 2021, and for healthcare workers in lower and middle-income countries to be protected first. For many countries, though, being able to do this will rely on Covax meeting demand.
Take Ghana, for example. It hasn’t been able to cut direct deals with vaccine manufacturers for doses, so will instead rely initially on Covax and the African Vaccine Acquisition Task Team for supplies, explains Nana Kofi Quakyi, a research fellow at New York University. Whether Ghana will be included in the task team’s first wave of deliveries remains to be seen, and while it is due to receive doses from Covax, Ghana isn’t due to get them until late March – not long before the 100 days are up.
While the will to start rolling vaccines out is strong in Ghana, this isn’t the case elsewhere. Madagascar and Tanzania have declared that they have no desire or plans to vaccinate their populations. Ahmed Kalebi, a lecturer in pathology at the University of Nairobi, explains why this is so risky.