Recovery, Renewal, Resilience

Vaccines must be a global public good, which contribute to the equitable protection and promotion of human well-being among all people. At national level, a clear aim for vaccine programmes is essential, e.g. reduce immediate risk to life, in order to inform the identification of priority groups. As sufficient vaccine supply for whole populations will not be immediately available, WHO have provided a Prioritization Roadmap and a Values Framework, to assist with the prioritization of target groups. The WHO guidelines and framework advise to:

• Identify groups that will achieve the vaccine programme aim where there is an immediate risk to life, e.g. Stage 1 Priority Group - Care home residents, staff and volunteers working in care homes; Stage 2 Priority - Frontline health workers and those of 80 years of age and over. Priority groups should be listed and detailed to cover the whole population that is to be vaccinated
• Clearly define groups within priority phases, e.g. workers who are at very high risk of becoming infected and transmitting COVID-19 because they work in, for example, frontline health care, COVID-19 treatment centres, COVID-19 testing laboratories, or have direct contact with COVID-19 infected patients
• Avoid classifying groups as 'essential workers' as a qualifier
• Make priority groups explicit, straightforward, concise and publicly available
• Assess the prioritisation of those who are in high population density settings, e.g. refugees/detention camps, prisons; or who are not recorded in existing systems, e.g. un-registered persons
• Recognise vaccination as a global issue to begin conversations that identify how we will achieve the aim of reducing immediate risk to life globally, through international collaboration

During COVID-19 decision makers have grappled with containing outbreaks and how to reopen or reclose business and services based on infection numbers and other measures. Research in Canada has shown that accounting for geography, epidemiology, and travel patterns, localized county approaches to lockdown result in fewer days of service and business closure, and impacts fewer people compared to entire province closures. The research suggests, when implementing a local lockdown, to consider:

• The trigger conditions that require a local lockdown to be enforced and ensure they are agreed with central government but can be enacted upon by local government
• Coordinating with neighbouring counties or metropolitan areas, including the criteria for when and how local lockdowns should be implemented and when a neighbouring region should also lockdown
• Gathering local lockdown lessons that can provide useful insights into compliance of measures, and implementing learning to help avoid ineffective strategies
• Decentralizing control over when a local lockdown should be enforced to ensure local decision makers can enact closures promptly