"Who among us will get the first shot?"
With the continuing spike of Covid 19 cases across the globe especially in the US and the European Union, the announcement that at least three COVID-19 vaccine manufacturers, Pfizer, Moderna and Astra-Zeneca, are well on the way to roll out their respective products at the earliest by next month has prompted a battle-of-sorts among countries and even the private sector for the acquisition of millions of vials of this prized product.
We have joined the fray after President Duterte authorized the release of at least P20 billion to secure our own share of the initial production run. So, even as the US and other developed nations have apparently reserved and, in the case of the US and Great Britain, actually funded a good part of the research and trials of the manufacturers, we have reason to believe that we will not be left behind. That said, the foremost question now in the minds of our people is: Who will get vaccinated first?
But this should not even be asked. We already have some kind of metric which has gained public acceptance since the start of the pandemic, namely: a) care of the vulnerable and b) need to ensure essential services.
In the first case, we should start with those remaining in isolation centers and those living in and/or those uprooted by the series of disasters which devastated the country over the past four weeks and, definitely, with those aged from 5-15 and those from 59-up.
In the second case, we are talking about health care workers and other front liners (police, security forces, firemen, etc), basic production workers (agriculture and manufacturing), utility workers (power, water, telecoms, transport) and, of course, key government officials and other key public/private sector employees like banks.
There should be no question that these groups and related subsets of the priority sectors should be first in our list for vaccination. Once these segments and sectors have been attended to, then we can proceed with vaccinating on a per-area basis using an updated protocol of our earlier successfully implemented vaccination programs such as those for polio, smallpox and the like. We can start in the metro or mega areas like Mega Manila, Metro Cebu and Metro Davao, and then the rest of the vulnerable such as informal settlers, indigenous peoples. and on and on and on, down to the last barangay as our funds and vaccines would permit.
Should there be need for additional metrics to assist a wary and weary public as well as those assigned to administer this critical mass vaccination program, we are giving space to an abridged version of the paper of Jill Neimark, a writer based in Atlanta, Georgia, whose work has been featured in Discover, Scientific American, Science, Nautilus, Aeon, NPR, Quartz, Psychology Today, and the New York Times, entitled “Who Should Get A Covid 19 Vaccine First” featured in the MIT Technical Review which partakes of various models on the most effective and efficient way of rolling out the vaccine.
“Age indirectly influences transmission patterns. In 2009, Yale epidemiologists Alison Galvani and Jan Medlock published a mathematical model in Science, showing that targeting flu vaccines to children and young adults (in addition to the elderly) could have slashed swine flu infections from 59 million to 44 million; and for seasonal influenza, 83 million infections could plunge to 44 million. Children, it turns out, drive a disproportionate amount of flu transmission, and protecting them protects society at large.
“The study, and others like it, inspired a change in CDC policy to prioritize vaccinating children. “It was a revolution in how we think about vaccines,” says Larremore. Vaccination models now routinely consider the power of indirect protection of the most vulnerable by vaccinating those most responsible for spread.
“Age also intersects, in complex ways, with social connectivity in different regions. For instance, African-American and Latino communities in the United States have been disproportionately hit by covid-19, in part because of the prevalence of multiple generations living together: Older individuals are much more exposed to the young adults who might be the likeliest carriers of infection.
“Modeling connectivity requires drawing grids that represent how we live and move among each other. In 2008, a landmark paper built a grid that epidemiologists everywhere still use today. It stratified people into groups based on age, from birth to 70 years old and up. In the study, more than 7,000 individuals kept a diary of their contacts—nearly 98,000 of them—over the course of one day. Contacts were sorted by place (home, school, work, leisure) and by nature (physical or nonphysical, brief or longer lasting). The model found that 5- to 19-year-olds tend to experience the highest incidence of infection when a new pathogen begins to spread in a completely susceptible population, possibly because of their more frequent and physical contact with others. It also showed how profoundly a society’s grids of connection influence transmission.
“The model was expanded globally in 2017, with contact rates for 152 countries. ‘It’s what we all use,’ says Matrajt, “because it’s the best thing we have to identify how people contact each other.” She incorporated the contact grid into her model.
“For example, ‘if kids are really the hubs around which society is built,’ Larremore says, ‘so that if you vaccinate the kids, you fragment that transmission network, then that’s going to give us a totally different way of rolling out this vaccine.’”
To be continued