Right now, it looks like we won’t be getting the vaccines we need to inoculate even 10 percent of our population or 10 million this year. We have to rationally determine, and decide very soon, how to allocate the vaccines that will be available.

The biggest chunk of vaccines will come from China, with which we have a firm order of 25 million, with 1 million given as donation to the Armed Forces of the Philippines. The US and the West have hoarded as much of the vaccines as they can and will decide only later if they would be kind enough to allow poorer nations to get these life-saving dosages.

According to Secretary Carlito Galvez Jr., chief implementer of the National Task Force Against Covid-19, other vaccines to be delivered by June are 2 million doses of the Russian Sputnik V, 1.3 million of AstraZeneca (from the Covax Alliance) and 194,000 of Moderna. Rollout of Sputnik and Moderna will not be as fast as Sinovac as they require special below-zero degrees storage, which is not easy to install or may even be available.

We have to face the harsh reality of deciding how best to allocate the vaccines that would be available. At present, the vaccination priority are frontline health workers (A1), senior citizens (A2), persons with co-morbidities (A3), frontline personnel in essential sectors including uniformed personnel (A4) and “indigent” population (A4), which, however, is vaguely defined.

Priority B are teachers and social workers, “other government” workers, “other essential workers,” those with a “significantly higher risk other than senior citizens and poor population, overseas Filipino workers, and finally “other remaining workforce.”

The not-easily-noticed basis for this prioritization is: those most vulnerable will have priority in vaccination. That certainly seems compassionate and even logical.

Deadliness
But Covid-19’s deadliness to humanity isn’t just because it kills. It is highly contagious, spread even by those who aren’t sick with it (“asymptomatic”) and because of its low fatality rate, spreads nearly exponentially.

That is, even if it kills only 1.7 percent of 1 million infected, or 17,031 (as is the figure for the Philippines), that same fatality rate of 1.7 percent means 588,337 people killed, if those who got sick of it total 33 million (as in the US).

There are factors beyond the arithmetic that would make things worse: as the number of those infected overwhelm a country’s hospital facilities, more and more are killed because they are not given adequate treatment.

We cannot escape the implications of Covid-19’s nature: the most important thing to do is to slow down and stop its spread. While this might seem to be commonsensical, the rationale for quarantines, lockdowns and mandatory mask-wearing, it raises the more difficult question when it involves vaccine prioritization:

Should vaccination priority be to save the lives of those vulnerable, the elderly and those with co-morbidities? Or should the goal be to prevent its spread, which means priority for vaccination be given to the more likely spreaders of the virus, that is, workers not just in service industries (who interact with so many customers each day) but workers in general who congregate in the riskiest places, which are enclosed spaces such as factories, offices and even in the public vehicles they use to commute.

Media
Include there media, even columnists, as journalism here has gone to the dogs, with more and more journalists relying on online information rather than human sources. This illustrates the point here: no matter how much we hate media men, let’s vaccinate them as they go around so much, they could be superspreaders.

Seniors, on the other hand, are more likely to spend most of their time at home since they are mostly retired and are themselves averse to using public transportation and even malling so that they are less exposed than young workers to Covid-19.

We got our model for prioritizing seniors from the US, where a lot of the elderly died from Covid-19 because many were in nursing homes, where one infected person easily contaminated so many others in that confined space. Here, most of the elderly live in their homes or those of their children — who refuse to let them go out of the house.

This question has not been given much attention of course because of the domination of our mindsets by the media of the US and Europe, which have no problems with vaccine supply as they have hoarded those produced on their soils.

Immunologists, however, have confronted the question, with a cruel answer. “The consensus among most modelers is that if the main goal is to slash mortality rates, officials must prioritize vaccinating those who are older, and if they want to slow transmission, they must target younger adults,” concluded a Scientific American article entitled “Doing the touchy math on who should get a Covid vaccine.”

This was echoed by a New York Times article: “Ultimately, the choice comes down to whether preventing death or curbing the spread of the virus and returning to some semblance of normalcy is the highest priority.”

Normalcy
The term “normalcy” underestimates the desired state of things. “Normalcy” would mean that an economy’s engines would be up and running, which would enable workers to get the income, the nutrition that they and their family need to prevent diseases that could kill them. There has also been an increase in deaths from other diseases as those afflicted have avoided doctors’ clinics in hospitals.

Not given much attention — perhaps as the Chinese themselves wouldn’t want to — is that China, with a 1.4 billion population, has had to confront the question of prioritizing vaccination. Instead of the elderly, the Chinese prioritized working people, as they are mobile and therefore would have been Covid-19’s spreaders. Did it work?

The data would speak for themselves: for the biggest country in the world, with a population four times that of the US, Covid-19 cases in China total 90,000 compared to the 33 million in the US.

Indonesia appears to be following the Chinese model, under which working age adults will be vaccinated after frontline health workers and public servants. The British wire services Reuters reported: “Professor Dale Fisher from the Yong Loo Lin School of Medicine at the National University of Singapore explained: ‘Younger working adults are generally more active, more social and travel more so this strategy should decrease community transmission faster than vaccinating older individuals.’”

Prioritization
The Inter-Agency Task Force for the Management of Emerging Infectious Diseases (IATF-EID) in charge of government’s response to the pandemic, must examine rationally, and not emotionally, our vaccine prioritization policy.

Private companies — since their businesses would collapse if Covid-19 spreads in their workplaces — should be allowed to buy vaccines on their own, and even given government support to do so, to get their employees as well as their families, vaccinated urgently.

San Miguel Corp. and the Lucio Tan Group of Companies, among others, have such programs in the pipeline already. Retail companies such as the fast-food and supermarket companies and the country’s biggest conglomerates must be required to get their employees vaccinated and given a deadline for such.

It would be easy, I would think, for the Federation of Filipino Chinese Chambers of Commerce and Industry Inc. or huge Filipino companies in mainland China such as the Oishi Group to purchase Chinese vaccines on their own.

I would suggest that rather than allocating the available vaccines to seniors all over the country, which total 4.5 million, the more rational policy is to vaccinate all workers in the National Capital Region bubble (which includes adjacent provinces) as well as residents in slum areas and other densely populated urban areas. After all, the NCR Plus accounts for more than 60 percent of Covid-19 cases, at the same time that it produces 36 percent of our GDP.

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