Vaccination plan should prioritize workers, not just older people: SFU researchers

Infection models by SFU analysts show COVID-19 can be better managed by targeting younger, at-risk people, thus benefiting seniors by reducing community transmission

Caroline Colijn of Simon Fraser University studies COVID-19 infection models. Given the limited vaccine rollout, she suggests vaccinating higher-risk young working people as opposed to seniors who are better able to avoid community interactions. SFU photo.

Essential workers should share top priority with B.C.’s oldest residents under the province’s COVID-19 vaccination plan, according to pandemic analysts from Simon Fraser University.

“Our simulations strongly suggest that it is better for everyone if we vaccinate essential workers once those who are 80 and older are vaccinated,” stated SFU mathematicians Paul Tupper and Caroline Colijn and health economist Chris McCabe from Alberta’s Institute of Health Economics.

Their research challenges the province’s existing vaccination plan, which is based largely on age, after front-line healthcare workers, Indigenous people and seniors over age 80 are vaccinated.

The logic is that by vaccinating more at-risk people, overall community transmission will be lowered.

The study takes issue with the plan that would, for example, vaccinate a healthy, retired couple in their late sixties, who can more easily avoid the virus during the course of their day, but have a 25-year-old food production worker, police officer, social worker or teacher exposed through the summer.

“You might think that the best thing to do is vaccinate people in descending order of age, in order to minimize the harm. This works if everyone is equally likely to be exposed to the virus – but they aren’t,” the report states.

The academic trio admits the proposal may seem counterintuitive. But they say their models show much less transmission of the virus by targeting essential workers.

Also at the root of their assumptions is that B.C.’s supply of vaccines is presently limited – at least through the summer – and new, more infectious variants of the virus may spread quickly.

And, granted the vaccine is ineffective for 5% to 10% of people and some seniors cannot get the vaccine, or may decline to get it, there could be as many as one in four seniors unprotected under the existing plan.

“So even if we devoted all our vaccine resources to the elderly they will not be completely protected. We will need to use other measures to prevent many hospitalizations and deaths. 

“On the other hand, by vaccinating younger people with many contacts we can greatly reduce the amount of virus in the population. This will mean that very few elderly people are ever exposed to the virus. Fewer exposures means many fewer infections among the elderly, whether they have been vaccinated or not,” stated the report.

Another stated reason to do this is to reduce the possible incidences of long-term side-effects of COVID-19, or “long COVID.”

The BC Teachers Federation has already voiced its opposition to the age-based vaccination plan.

“B.C. teachers, like many others, will be disappointed to see there is no prioritization for the frontline workers who have kept our schools, public services, and economy open,” BCTF President Teri Mooring said January 22. “There had been hope in prior announcements that such prioritization would be possible.”

A consortium of food industry groups informed Premier John Horgan of similar concerns in December.

“It’s been challenging for food companies to maintain consistent production and prioritizing production workers would be immensely beneficial to the food industry,” said James Donaldson, CEO of BC Food and Beverage, told Glacier Media.

In B.C. there have been numerous outbreaks at both fruit and meat processing plants, as well as on farms and in other production facilities.

We recognize that COVID-19 vaccines will roll out over time and encourage you to develop prioritization criteria for food processing workers based on considerations such as plant population density, whether a plant is located in a high-COVID-19 zone, and any potential animal welfare issues if a plant were to close,” stated Donaldson’s group to Horgan.

The SFU group is effectively recommending changes to what’s been deemed Phase 3 and Phase 4 vaccine rollouts. Phase 3 states people age 60-79 will get the vaccine between April and June (with exceptions for “clinically extremely vulnerable” people). Phase 4 states people age 18-59 will get the vaccine.

The government has added online one caveat: “Once additional vaccines are approved and become available, people between the ages of 18 and 64 who are front-line essential workers or work in specific workplaces or industries may be included in the later part of Phase 3.”

Colijn stressed the issue may become more severe if variants spread.

“The punch line is that failure to prevent or contain this now spells disaster in March,” she wrote.

“We should take steps to prevent introductions of new variants into Canada: tighten rules on travel, define essential travel and stop non-essential travel. We should step up quarantine and isolation of travellers. We should improve detection, using tests that can detect B.1.1.7.”