Vaccinating to End the Pandemic — How Strategic Vaccination Works and Why You Might Not Get the Vaccine Straight Away (Or Might!)
In the best piece of news all year, we now have two vaccines that appear to be safe and effective for COVID-19.
It’s the light at the end of the tunnel (and several more vaccines are a bit behind them). Which means it’s time to understand one basic fact:
You might not be able to get vaccinated straight away.
And whether you can get the vaccine early is going to depend on factors that strongly include…your job.
What is Strategic Vaccination?
Strategic vaccination, also called targeted immunization, is the policy of using a limited number of vaccine doses to control an outbreak quickly.
Essentially, it means vaccinating the right people at the right time to get the numbers down as quickly as possible.
Why do we Need Strategic Vaccination?
So, why do we need to do this? It boils down to simple logistics.
It’s going to take time to ramp up manufacturing capacity, especially as both of the vaccines that will be reviewed soon require an initial series of two shots.
If we wait until we can vaccinate everyone, then we’re going to living like this until at least late spring, early summer of next year. At least.
I’m assuming none of us want to be under even partial lockdowns for that long.
And that means strategic vaccination.
So, What’s the Plan?
The way strategic vaccination works is that people are prioritized for vaccination based off of how likely that person is to catch COVID-19.
Strategic vaccination is not vaccinating people more likely to die if they catch it first. That’s the instinctive way we want to go, but it’s not actually the best thing to do. Before you accuse me of throwing grandma under the bus to save the economy, remember this basic fact: High risk and immune-compromised people are less likely to be able to be vaccinated and less likely to have the vaccine work. We protect them better by reducing spread.
Instead, a good strategic vaccination plan targets people based off of spread risk and societal factors.
This means that you do start with the obvious: Healthcare workers go first. This includes first responders and it includes the staff in long-term care homes. Hospital workers and first responders go first, dentists and eye doctors and others who primarily handle more routine stuff second.
Vaccinating healthcare workers reduces the burden on the healthcare system by protecting it from worker loss and downtime. This then starts to reduce deaths, both from the virus and from incidental factors such as people putting off cancer screening or vaccinations. If your doctor is vaccinated, you can be more comfortable about going in to get stuff done.
Then, after that, it moves not to high risk people, but to essential workers. Starting with essential retail workers, public transportation workers and teachers.
By vaccinating all the grocery store workers, you reduce transmission in grocery stores.
Then you move on to less essential functions in society that nonetheless can’t be done without human contact. This means non-essential retail, personal care, etc.
IF this is done right, yes, this means your hair stylist will get the vaccine before you do.
The other group of people who get vaccine priority are those living in what we call “congregational settings.” Congregational settings are where people are living in close quarters, eating communally, etc. They include prisons, ships, college dorms, homeless shelters, etc. Outbreaks in these places are really common.
The point of the exercise is to set up “firewalls” that slow community spread, by vaccinating the people most “responsible” for that spread.
This lets us all start to slowly return to normal even while we wait for our own dose of the vaccine.
I wanted to explain this because I know some people will react to the concept with “What about me?” By every possible plan I’m going to be close to the bottom of the list.
And I’m fine with that.