Prioritising the vulnerable in COVID-19 vaccination for 18-plus group is essential
When supply is finite, it is a no-brainer that a burgeoning demand will not be met. Tailoring supply for optimal effect would then be the prudent way ahead, a strategy that the Centre would do well to employ in its COVID-19 vaccination programme. Though the ideal, distant at this stage, is to achieve vaccination of the entire population or enough to create herd immunity, supply considerations will necessarily mean prioritisation of groups for vaccination. While the vaccines have been shown to be effective in preventing death or severe disease by and large, the vaccine’s effect on interrupting or reducing transmission is also an important consideration in deployment. Studies have shown an inverse correlation between vaccinations and infections; a study in Tamil Nadu showed that the percentage of people over 60 years infected in the second wave had come down by 7%, even as the numbers in other age groups rose. This age segment was among the early priority groups for vaccination. With the government opening up vaccinations for all adults, it is imperative that some line list of priority be readied, on the basis of vulnerability and societal role.
Primary among them are people in the services sector — those whose jobs mandate interactions with multiple people. This would include those in banks, delivery agents, transportation staff, store workers, vendors, lawyers and journalists. As States begin free vaccinations for the 18-plus age group, it will be prudent to draw up a priority list even in the 18-44 age category, as Kerala, Karnataka and Tamil Nadu have done, for instance. While Kerala seeks to prioritise those with co-morbidities, disabilities and 43 categories of field staff of various departments, Karnataka has included 18 categories of people in its priority list for the 18-plus age group — including bank workers, forest department staff and construction workers. Tamil Nadu has determined a broad list of categories including the disabled, vendors, e-commerce staff, pharmacy and grocery store staff, those in the transportation sector, and school and college teachers, besides mediapersons. The Centre, which has assumed a sutradhar’s role in this entire pandemic, must draw up a list of priority categories that each State can then adapt to its local requirements. While lockdowns, in force in most States, will slow down the pace of transmission and give health-care resources a much-needed break, the way ahead is certainly vaccination — and prioritised vaccination. Once vaccine supply picks up, a more expansive first-come, first-served basis, as in the private sector now, can be adopted. Until then, it is the government’s bounden duty to ensure an equitable coverage among vulnerable groups of people who are most at risk, and carry a higher risk of transmission, because of the sheer number of people they interact with daily.