Vaccine Prioritization — A relook

The ongoing COVID-19 pandemic is still raging like a wildfire, even after being amidst us, now, for more than a year now. Still awaiting any effective direct drug intervention, at present, the hopes of the masses are pinned on a range of vaccine candidates, which were developed, tried and approved in a record time in the history of vaccine development. Most of the countries have rolled out their adult vaccine program in a targeted fashion with medics and other frontline workers (definition varies according to jurisdiction) getting the primacy given the natural maximum risk faced by them and sheer societal dependence on them in the existent health crisis. The second priority group has been senior citizens (aged above 60 or 65, the lower range depending on the jurisdiction again), who being generally low in immunity, showed maximum vulnerability and death rate in the earlier phase of the COVID-19 pandemic, received all the attention. They shared their priority with those adults with comorbidities like chronic hypertension, rendering them more vulnerable to COVID-19. The third priority group happened to be those belonging to the age range of 45–59/64, or the mid-age population, the second most vulnerable group in terms of severity and mortality associated with COVID-19. Unfortunately, contrary to rationality and economic sense — the earning members, those supporting the rest of the population pyramid, in the age group of 18–44 received the least attention.

2. The analysis of current global age-wise mortality ratios clearly indicates that the age group of 18–44, left unattended and consequently unvaccinated, are at the receiving end of the vaccination priority regime. What’s now happening in various unfortunate families is that the earning members are becoming unsuspecting victims of the dreadful disease, as experts suggest, owing to two reasons: (i) venturing outdoors to make a living, and getting exposed to the deadly SARS-CoV-2 virus, and (ii) left at the mercy of imaginary immunity and vigour, while actually being completely vulnerable because of being unimmunized. Not surprisingly, the death toll in this maximum vulnerable group is surprisingly high, notwithstanding the perceived health vigour, in comparison to seniors or children. The economic cost of such loss of life is colossal, as the victims leave behind underage kids and/or old parents in lurch. With the earning members of family falling victims to the pandemic, who is going to support the fully vaccinated yet senile and dependent parents and the young children, each group having needs that finally fall on the shoulders of the earning adults.

3. I reckon that the root cause for this generational vaccine apartheid is that the so-called senior group, literally in control of all policy levers and initially appearing to be the most vulnerable designed the vaccination regime which benefitted them the most, being oblivious to the economic and emotional hazards involved.(A cursory look at the mean age of global world political leaders would convince you) Leaving behind the financially and emotionally dependent older and younger generations at the mercy of the cruel and unjust world, the earning and young group — 18–44 is dying off the world over. What should have been understood at the outset considering the primacy of working age groups in an economy, was to vaccinate and protect this group at priority. Had they being fully vaccinated, and given their general vigour and immunity, the earning group could have taken care of the children and parental generations. Now the worst case scenario may paint a harrowing scene of houseful of elders and underage children, with no earning members to take care of them financially or emotionally. The financial trauma and the emotional turmoil this situation entails are unimaginable.

4. Still, much is not lost, and the policy makers must prove the early economists correct and employ rationality and economy in their decisions and start allocating resources towards vaccinating the earning group members at top priority.

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Vybhav Dhar

Lifelong student of life, trained as biologist, working as a public policy practitioner