✔ Vaccination Priority Criteria 

• Frontline workers and essential service workers (health care workers, law enforcement officials, emergency response workers, armed forces and guard)

• High exposure risk (bus, port and airport etc)

• Persons who live in group residence (residents and staff in residential facilities, correction facilities

• Senior citizens and high-risk groups with chronic diseases 

But, Cambodia, China, India, Laos, Pakistan, Sri Lanka, & Vietnam no senior citizens in Phase 1 group.

• Some countries prioritize people likely to travel outside the country (diplomats and their families, study abroads, athletes, etc) - Brunei, China, Taiwan, Thailand, & Vietnam

• Bangladesh & the Philippines includes migrant workers in Phase 1 group

• Indonesia has regional priority (e.g. Java, Bali)

✔ Key Issues

1. Vaccine Shortage 

 1) Sufficiency

• Central question: have countries procured enough vaccines to meet the aim of achieving herd immunity?

• The Philippines, Indonesia, Thailand, Pakistan: face worries about shortage

• Nepal: indefinitely halted its immunization program

• India has blocked all major exports of AstraZeneca vaccine, delay delivery to COVAX: reaction to US exports ban to prioritize Pfizer

 2) Pace of Rollout

• Vaccine rollout is slower than expected amid high levels of vaccine hesitancy

• Governments are more concerned with the successful implementation of the vaccination strategy and vaccine acceptance than just shortage

 3) Vaccine Acceptance

• Shortages have influenced public acceptance of vaccines, and how governments purchase or accept donations

• The Philippines: healthcare workers pressured into accepting Sinovac despite concerns of effectiveness, safety

• Nepal: government is reluctant to accept vaccines from China for fear of increasing vaccine hesitancy

3. Inequality 

1) Private Sector Purchases

• To address concerns of shortages, reopening the economy and the pace of vaccination, some governments have allowed controlled private sector import and sale of vaccines

• Increased concerns about the inequality in distribution, vaccine rollout and worsening of vaccine shortages

• Indonesia: “Vaksinasi Mandiri”

• Pakistan: price cap on imports

2) Private Sector Distribution

• Private sector has been included in the rollout to increase the pace, scope and reach of the vaccination

• Used to overcome logistical challenges

• India: private hospitals allowed to vaccinate from Phase 2

• Indonesia: Grab is coordinating with the government to expedite rollout

4. Logistical Challenges 

1) Distributional challenges have been about accessibility, physically and digitally

• Reaching rural regions: Pakistan, Nepal, Indonesia, Cambodia

• Vaccinating refugee, migrant and vulnerable populations: Bangladesh, Pakistan, India

• Shortage of medical equipment: Japan (low dead space syringes)

• Digital Illiteracy: India, Malaysia, Bangladesh

2) Despite concerns of inter-regional and intra-regional inequality, countries appear willing to cooperate with each other at least for economic reasons

• Singapore is vaccinating Malaysian cargo workers who regularly visit Singapore

• Cambodia, Laos and Vietnam have agreed to vaccinate nationals of each other’s countries who reside in their country

✔Passport to back to normality? 

1) Insufficient scientific evidence

• How much protection vaccines offer against transmission?

• How effective against variants?

• The duration of immunity through vaccination (vaccine-based immunity vs infection-based immunity)

2) Disparity in distribution

• “perfectly coordinated global vaccination can end the pandemic” - local landscape of immunity

• No vaccine for children

3) “Vaccine passport is inevitable”

• To protect vulnerable population: Nursing home patients, cancer patients, newborns, etc 

4) Change Human Behavior

• Very hard to keep vaccinated people reverting to pre-pandemic behavior

• Some US states already lifting social distancing bans, even though a sizeable population remains unprotected.

• Non-pharmaceutical interventions are still crucial

5) Challenges to government

• Prioritizing who gets the vaccine first

• Ensuring equitable access to vaccination

• Reassuring the vaccine-sceptical