Who should get it first? Public preferences for distributing a COVID-19 vaccine

Luyten, Jeroen Tubeuf, Sandy [UCL] Kessels, Roselinde

Once a safe COVID-19 vaccine will become available, there will not be enough supply of it to vaccinate the entire population. Policy makers at national and international level are currently developing vaccine prioritization strategies. However, it is important that these strategies have sufficient levels of public support. We conducted a ranking exercise and a discrete choice experiment on a representative sample of 2,000 Belgians in order to elicit their preferences regarding how to distribute the COVID-19 vaccine across the population. We identified that three sub-groups had similarly high levels of support for access priority: the chronically ill, essential professions, and individuals likely to spread the virus the most. We identified two clusters of respondents. While both wanted to vaccinate essential professions, cluster one (N=1058) primarily wanted to target virus spreaders whereas cluster two (N=886) wanted to prioritize the chronically ill. Prioritizing those over 60 years of age was remarkably unpopular. Other strategies such as allocating the vaccine using a ‘lottery’, ‘first-come, first-served’ approach or willingness-to-pay received little support. Public opinion is a key variable for a successful engaged COVID-19 vaccination policy. A strategy simultaneously prioritizing medical risk groups, essential professions and spreaders seems to be most in line with societal preferences. When asked to choose, people agree to vaccinate essential professions but disagree whether to prioritise people with high-medical risk or virus spreaders.