Vaccination appears to be the only sustainable long-term solution to controlling Covid-19, so it is pleasing to see that the UK has made excellent progress to-date in rolling out large numbers of vaccinations. Nevertheless, it is interesting to consider what lessons we can take from other countries to ensure a successful vaccination programme.
Firstly, the approach to prioritisation has differed from country to country. The UK vaccine roll out prioritises according to clinical need, starting with care home residents and people older than 80, then those considered vulnerable, including patients with cancer, and those with weakened immune systems. There are other systems available and in use, however. In the US, healthcare workers, emergency responders and the vulnerable will be given priority. An approach using the Centre for Disease Control’s Social Vulnerability Index has been proposed, which identifies factors such as poverty, lack of access to transport, or crowded living environments that are linked to poor health outcomes. In Japan, a country with a third of its population over 65, has elected to employ a coupon scheme to ensure suitable prioritisation. In India the approach focuses on the vaccination of front-line health workers, police personnel and sanitation workers. And Australia has included people working in supply and distribution services and certain ethnic profiles in its prioritisation, offering Aboriginal people as one of the groups to be initially vaccinated. The UK’s prioritisation system currently only clarifies order of priority up to age 55 and over, or for people over 16 with conditions that put them at high risk. Once these groups are vaccinated, the UK will have to reprioritise vaccination for younger age groups and people without high-risk underlying conditions. We should do so informed by data from the various approaches taken in other countries in order to maximise the benefits of vaccination at pace.
There are also opportunities to learn from other countries who are managing vaccination rapidly. As at Jan 30th 2021, the UK had vaccinated 11.25 per 100 people, which placed it fourth-highest in a global country ranking of doses per population (The Economist). Israel, however, has vaccinated over four times as fast as the UK. Although Israel’s population is much smaller than the UK’s, it is also taking different approaches that contribute to rapid vaccination:
An efficient registration system for the public has enabled Israel to create ‘pop-ups’ to vaccinate in the community, and to mobilise more volunteers.
Well-established data infrastructure has also ensured Israel’s health system can update patient records quickly after vaccination.
At the end of every day, leftover vaccines from those that did not attend their appointments are announced as available to the public. While it does mean that some of the younger population are being vaccinated, it also ensures efficiency.
Israel’s health services are providing vaccinations 24/7. Their ability to do this has again been bolstered by strong data management and the ability to redeploy capacity to meet demand through a digitised, localised system. As at 13th Jan 2020, the UK government announced that 24/7 vaccination would be trialled in some areas by the end of January, but concerns have been raised about pressures on staff and the accessibility of 24/7 clinics for older people.
The above is just a snapshot of one country’s differing approach, intended to highlight that we can continue to accelerate our vaccination journey by listening and learning from the different approaches across the world. While each approach may be different and influenced by the context in which the country operates, key decisions taken across areas such as data management, resourcing and the role of the community offer solutions in uncharted territory.