Min Joo Choi1, Won Suk Choi2, Hye Seong3, Jun Yong Choi4, Jong Hyun Kim5, Yae Jean Kim6, Eun Young Cho7, Dong Hyun Kim8, Hyesook Park9, Heeyoung Lee10, Nam Joong Kim11, Joon Young Song3, Hee Jin Cheong3, Sang Il Kim12, Kyong Ran Peck13. 1. Department of Internal Medicine, International St. Mary's Hospital, Catholic Kwandong University College of Medicine, Incheon, Korea. 2. Department of Internal Medicine, Korea University Ansan Hospital, Korea University College of Medicine, Seoul, Korea. 3. Department of Internal Medicine, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea. 4. Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea. 5. Department of Pediatrics, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Suwon, Korea. 6. Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. 7. Department of Pediatrics, Chungnam National University Hospital, Chungnam National University, Daejeon, Korea. 8. Department of Social and Preventive Medicine, Hallym University College of Medicine, Chuncheon, Korea. 9. Department of Preventive Medicine, Graduate Program in System Health Science and Engineering, Ewha Womans University College of Medicine, Seoul, Korea. 10. Center for Preventive Medicine and Public Health, Seoul National University Bundang Hospital, Seongnam, Korea. 11. Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea. 12. Department of Internal Medicine, Seoul St. Mary's Hospital, The Catholic University College of Medicine, Seoul, Korea. 13. Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. krpeck@skku.edu.
Abstract
BACKGROUND: This study presents a framework for determining the allocation and distribution of the limited amount of vaccines against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). METHODS: After analyzing the pandemic strategies of the major organizations and countries and with a literature review conducted by a core panel, a modified Delphi survey was administered to 13 experts in the fields of vaccination, infectious disease, and public health in the Republic of Korea. The following topics were discussed: 1) identifying the objectives of the vaccination strategy, 2) identifying allocation criteria, and 3) establishing a step-by-step vaccination framework and prioritization strategy based on the allocation criteria. Two rounds of surveys were conducted for each topic, with a structured questionnaire provided via e-mail in the first round. After analyzing the responses, a meeting with the experts was held to obtain consensus on how to prioritize the population groups. RESULTS: The first objective of the vaccination strategy was maintenance of the integrity of the healthcare system and critical infrastructure, followed by reduction of morbidity and mortality and reduction of community transmission. In the initial phase, older adult residents in care homes, high-risk health and social care workers, and personal support workers who work in direct contact with coronavirus disease 2019 (COVID-19) patients would be prioritized. Expansion of vaccine supply would allow immunization of older adults not included in phase 1, followed by healthcare workers not previously included and individuals with comorbidities. Further widespread vaccine supply would ensure availability to the extended adult age groups (50-64 years old), critical workers outside the health sector, residents who cannot socially distance, and, eventually, the remaining populations. CONCLUSION: This survey provides the much needed insight into the decision-making process for vaccine allocation at the national level. However, flexibility in adapting to strategies will be essential, as new information is constantly emerging.
BACKGROUND: This study presents a framework for determining the allocation and distribution of the limited amount of vaccines against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). METHODS: After analyzing the pandemic strategies of the major organizations and countries and with a literature review conducted by a core panel, a modified Delphi survey was administered to 13 experts in the fields of vaccination, infectious disease, and public health in the Republic of Korea. The following topics were discussed: 1) identifying the objectives of the vaccination strategy, 2) identifying allocation criteria, and 3) establishing a step-by-step vaccination framework and prioritization strategy based on the allocation criteria. Two rounds of surveys were conducted for each topic, with a structured questionnaire provided via e-mail in the first round. After analyzing the responses, a meeting with the experts was held to obtain consensus on how to prioritize the population groups. RESULTS: The first objective of the vaccination strategy was maintenance of the integrity of the healthcare system and critical infrastructure, followed by reduction of morbidity and mortality and reduction of community transmission. In the initial phase, older adult residents in care homes, high-risk health and social care workers, and personal support workers who work in direct contact with coronavirus disease 2019 (COVID-19) patients would be prioritized. Expansion of vaccine supply would allow immunization of older adults not included in phase 1, followed by healthcare workers not previously included and individuals with comorbidities. Further widespread vaccine supply would ensure availability to the extended adult age groups (50-64 years old), critical workers outside the health sector, residents who cannot socially distance, and, eventually, the remaining populations. CONCLUSION: This survey provides the much needed insight into the decision-making process for vaccine allocation at the national level. However, flexibility in adapting to strategies will be essential, as new information is constantly emerging.
Authors: Seonju Yi; Jong Mu Kim; Young June Choe; Sujin Hong; Siwon Choi; Seong Bae Ahn; Miya Kim; Young-Joon Park Journal: J Korean Med Sci Date: 2022-01-03 Impact factor: 2.153