Without prioritizing urban areas with high infection pressure

The government will not prioritize densely populated areas with a lot of infection when the vaccine arrives.

The recommendations of the National Institute of Public Health (NIPH) for the vaccination strategy for Norway state that the elderly and risk groups should have priority in a vaccination program.

But the professional body also argues that authorities should be able to set priorities based on geographic conditions. The background is that the spread of the infection has been greater in the larger cities, both in Norway and in other countries.

When Health Minister Bent Høie (H) presented the government’s vaccination plans on Friday, it was stated that no municipality will be given priority when shipping the coronary vaccine.

He surprised the leader of the Oslo city council, Raymond Johansen (A).

– After reading the recommendations of the National Institute of Public Health, I thought that vaccinating in densely populated areas with high infection pressure would be a priority. However, it is important that vaccination is not politicized. Here we must trust that the national health authorities set the correct priorities and that the vaccination is set in a way that kills the coronavirus as quickly as possible, the city council leader tells Aftenposten.

– The infection in Oslo and Bergen is not in the priority level

The Minister of Health justifies why they have chosen to ignore the geographic prioritization of 2.5 million doses of vaccines expected in Norway during the New Year.

– We follow FHI’s advice that to the extent that higher areas should be prioritized for vaccination, it is linked to a very serious infection situation and I perceive that the ethics commission has the same conclusion, Høie responds.

– Does that mean you don’t think the infection situation in Oslo and Bergen is so serious now?

– It is not at the level that should serve as a basis for a possible other vaccine distribution, responds the Minister of Health.

– The health service must be threatened

Høie points out that the distribution of the vaccine may change if infection increases dramatically in densely populated areas. But then, first and foremost, vaccinating health personnel in an area with high infection pressure will be considered.

– It is related to the fact that one is in a situation that indicates that the capacity of the health service is threatened. So, probably in the first place, it is not a general vaccination, but rather that priority would be given to health personnel in that area, says Høie.

– What is the reason for choosing not to vaccinate densely populated and highly infected areas, such as Stovner, Alna and Bjerke in Oslo?

– Because we still do not know if this vaccine protects against infections and future infections. What we know first of all is that, first and foremost, they protect against serious disease. So it’s natural to prioritize those who are in the risk group for serious illness, responds Bent Høie.

As the situation is now, the vaccine is distributed evenly to municipalities, depending on the population, explains the director of infection control, Geir Bukholm, at FHI.

– The reason is that we have a vaccine that primarily has an individual effect. If we are going to prioritize this differently, we must have a situation where we have a risk of geographic collapse, first and foremost the health service, but also other social functions, says Bukholm.

NIPH: – There must be big differences in infection.

In its recommendations, FHI opens to prioritize vaccination in areas that have large virus outbreaks, the so-called reactive vaccination.

However, the recommendation lists several factors that should be considered when considering prioritization based on geographic differences in infection:

• There must be sufficiently clear differences in infection.
• Vaccines must have properties that make them suitable
• What is the pattern of travel in and between the affected regions?
• How is such geographic differentiation perceived?
• Logistically it is more demanding.

If authorities do not choose to prioritize densely populated areas, an arsenal of emergency vaccines must be built so they can be used reactively in the event of major outbreaks in areas with low vaccine coverage, according to the NIPH.