Arguably one of the reasons for the rapid vaccine rollout in Israel is that it has devised very simple vaccination priority criteria that simultaneously target individuals at highest risk of death, at highest risk of hospitalization, and those in most frequent contact with cases. Rosen et al. report that Israel defined four broad vaccination groups for its rollout: those age 60 and over; those with certain pre-existing conditions; nursing home residents; and front-line health workers. This simple but far-reaching strategy contrasts with the approaches of some European countries.
One of the most notable rollout strategy differences is that some European countries have first focused their attention on frontline health workers and/or care home residents before the general population above a pre-defined age, in line with WHO guidance developed for a context with limited vaccine supply . This approach recognizes not only that these groups are at a high risk of exposure to Covid-19, but also that in an overstretched health workforce every professional is needed, especially in ICUs.
For example, in Slovakia health workers, medical students, social service home staff, armed forces and some infrastructure workers are being offered the vaccine in the first round, while patients over age 65 and the chronically ill are not eligible until the second round. Spain is also prioritizing residents and workers in assisted-living nursing homes, as well as care centres for highly-disabled people in addition to front line healthcare and social care workers. Only after vaccination of these groups is completed, other health and social care workers and non-institutionalised highly dependent people will be offered the vaccine.
In Latvia health workers treating COVID-19 patients and professionals working in Emergency Medical Services (EMS) are in the top priority group. Lithuania also prioritizes those who work directly with Covid-19 patients. The Dutch Health Council originally recommended a strategy comparable to the Israeli rollout. However, following lobbying efforts from the hospital sector, which used the delayed roll out and the prospect of a third wave to its political advantage, this was changed to first prioritize hospital and nursing home personnel over other groups, including older people and those with pre-existing conditions. Therefore, one key difference that we note is that in contrast to Israel, some European countries have not decided to prioritize people for vaccination based on age.