Coronavirus vaccination: Recommendation to prioritise vaccine groups based on infection situation
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Based on the current infection situation, the elderly in nursing homes and residential care homes, as well as people at increased risk should be given priority for the coronavirus vaccine. However, the situation may change, and the Norwegian Institute of Public Health recommends that prioritisation is assessed on an ongoing basis.
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Today, the Norwegian Institute of Public Health (NIPH) submitted its recommendations to the Government, who will make the final decisions on which groups will be prioritised when vaccines are available.
Recommend two main groups
Based on the current infection situation, the Norwegian Institute of Public Health (NIPH) recommends that the following groups should be prioritised for the coronavirus vaccine:
- the elderly over the age of 65 years and people aged 18–64 with certain underlying diseases and conditions
- healthcare personnel
Current knowledge shows that the elderly over the age of 65 years have a particularly high risk of severe disease course and death, as well as adults under the age of 65 with certain underlying diseases and conditions. Residents in care homes and nursing homes appear to be particularly vulnerable.
"If we have to begin vaccination with a limited number of vaccine doses, we may need a narrower prioritisation within the two recommended main groups," says Geir Bukholm, Director of Infection Prevention and Control at NIPH.
Possible prioritisation of people at risk
At each vaccination site and in each municipality, there may be a need for a more detailed order of priority among of people at risk. In that case, NIPH suggests this order that is based on the known risk of having a serious disease course:
- The eldest, down to 65 years.
- People under the age of 65 with one or more specified diseases / conditions. It may also be relevant to divide this group into two: 50–65 years first, and then 18- 50 years.
"A more detailed order of priority must be made if this need arises and when the vaccine's properties are known, explains Bukholm.
"It may also be appropriate to prioritise a larger part of the population when we know more about the vaccines that are approved, and we see how the pandemic develops."
Bukholm emphasises that the NIPH's recommendation will be re-evaluated when more detailed information about each vaccine becomes available.
"The order of priority can also change depending on how much transmission there is in society, the strain on the healthcare system and which vaccines we get access to, but we must also consider how each vaccine works in different age groups and risk groups,"says Bukholm who stresses that these recommendations are preliminary.
Healthcare professionals are an important group who may also be exposed to infection. As long as the infection situation is under control, the Norwegian Institute of Public Health considers it most important to prevent transmission for those who may need medical attention, thereby protecting the health service and those who work there.
With more widespread transmission, it becomes more important to protect healthcare personnel directly. It may be necessary to give higher priority to certain groups of healthcare personnel, even in the case of less widespread transmission.
Around 1.3 million in risk group
According to the recommendations, it is estimated that more than 40,000 people live in nursing homes in Norway, and that there are approximately 1.3 million in the risk group, who are either over 65 years of age or who have one or more of the specified underlying diseases / conditions. It is uncertain how many vaccine doses Norway will receive in the first months of 2021.
It may be appropriate to prioritise by geography if there are different disease burdens in different regions and Norway receive a few doses at a time, but the NIPH recommends postponing this decision until nearer the time of approval for the various vaccines. Then more will be known about the different vaccines and how the different vaccines are best used in the current infection situation.
An external ethics group has been an important contributor to the assessments behind the recommendations.