The UK’s Joint Committee on Vaccination and Immunisation (JCVI) created a series of priority groups for Phase 1 of the Coronavirus vaccination program. The Isle of Man Government is partly following it, and some people in our community are already discussing who should be prioritised in phase 2 – that is, after the vulnerable people are vaccinated.

Looking at the underlying science published by the JCVI reveals that once we have vaccinated the vulnerable people1 the order of remaining vaccinations doesn’t matter much. Those high-risk groups “represent around 99% of preventable mortality from COVID-19.”2.

Adam Finn, a professof of paediatrics and member of the JCVI, put it very starkly when he told the Guardian:

“We worked out that if you give 20 people in a care home a dose of vaccine, you’ll save a life,” he said. “If you give 160 people in their 80s a dose of vaccine, you’ll save a life. But once you get down to people in their 60s, you’re up to more than 1,000. If you go down to teachers or policemen, you’re approaching one in 50,000.”

Older age groups in UK ‘will die’ if Covid vaccine priority goes to younger key workers

Thus, to apply the same mathematics, there are a little under 10,000 people in IOM working in professional, educational, medical & scientific services3. That includes teachers, but also scientists, medics, and many, many, many, MANY, more professional workers (such as, I think, lawyers and so on).

If we vaccinated EVERY SINGLE one of those roughly 10,000 people working in professional, educational, medical and scientific services on the Isle of Man, we would expect to save around 0.2 lives directly4. Saving 0.2 lives is a comparison against vaccinating no one – obviously, we will save some lives from vaccinating other people in our community, so the net benefit of vaccinating any particular occupational group first is likely to be incredibly small or undetectable.

Once we vaccinate all the vulnerables, it seems that there’s currently no strong scientific reason to worry too much about who goes next: The maths tells us that it just doesn’t matter that much to saving lives. Future developments might well change, but as of today, it doesn’t matter much.

In favour of occupational priorities

The best reason in favour of vaccinating various occupations in phase 2 of the vaccination program is that it might be a nice thing to make those people feel good. I’m fine with that, and like that rationale: that’s a much stronger reason than organised lobby groups stretching credibility to claim that there’s a strong scientific basis.

Mind you, if we are going to vaccinate people on the basis of what feels good, I think those people who kept working out in the community during the lockdowns would have the strongest argument to go first: the bus drivers, the police, the supermarket staff, the people in the power station, etc. These people can’t work from home. These people endured a higher risk of the disease during the times of greatest uncertainty, and such a recognition would be a nice way to thank them for their services.

People who have secure jobs, and can work from home, have a much weaker argument in favour of getting vaccinated than those people who do not have such secure employment protections5.

Against occupational priorities

The best reason against setting priorities for vaccinating certain is that it risks delaying the roll-out. If we accept that there’s currently no meaningful difference to saving lives, then spending resources to identify and prioritise various occupational groups is not a good way to spend taxpayer-funded resources.

Indeed, in discussing the phase one vaccination priority groups, the JCVI made this very point:

Age-based programmes are usually easier to implement and therefore achieve higher vaccine uptake. An age-based programme is also likely to increase uptake in those with clinical risk factors as the prevalence of these increases with age.

Joint Committee on Vaccination and Immunisation: advice on priority groups for COVID-19 vaccination, 30 December 2020

  1. (people aged over 50, plus clinically extremely vulnerable, and people with underlying health conditions which put them at higher risk of serious disease and mortality)
  2. Joint Committee on Vaccination and Immunisation: advice on priority groups for COVID-19 vaccination, 30 December 2020
  3. Isle of Man in Numbers 2020, page 12
  4. There may be secondary benefits from herd immunity consequences, and some of those 10,000 people will be aged over 50, and thus, already vaccinated, so this estimate is only roughly indicative.
  5. Indeed, this is another reason that we should upgrade sick pay protections on the Isle of Man to be at least equal to those in the United Kingdom!