Vaccination Priority – Who Gets the Vaccine First?


The rollout of the Covid vaccines has failed to live up to expectations for a number of reasons. Disputes between state and federal officials, varying opinions on priorities, and insufficient supplies of vaccines are just a few of the excuses we’ve heard.

Politics, unfortunately, has only added to the confusion and the difficulties of getting vaccines in the arms of vulnerable Americans. Federalism gives states the freedom to make their own decisions about distribution of the vaccines and some states have clearly done a better job than others.

I am blessed to live in the state of Florida. We have a governor, Ron DeSantis, who has done a wonderful job of keeping our people safe while reopening our economy with safety guidelines. This has kept our virus infection numbers reasonable while maintaining our economy and our schools. He has also shown good judgment in the distribution of the vaccines.

The CDC recommended “Phase A” provide vaccine to healthcare workers and nursing home residents as the top priority. There was not much disagreement on this initial prioritization. Certainly, you should be sure your healthcare workers get vaccinated first, since they not only are at high risk but must provide the treatment others will need. Nursing homes have been the sites of over 40% of all Covid deaths, so they also must be a high priority.

The real trouble comes after that. Many states want to place “essential workers” ahead of the elderly who are not living in nursing homes and others who are at high risk. Teachers unions want teachers to get higher priority, restaurant associations want restaurant workers to get higher priority, police associations want police to get higher priority, and on and on. A system of simplification is needed, based on risk.

There is no question that risk is associated with age for this virus, all other factors considered. The older you are, the greater your risk. Paul E. Peterson, writing in The Wall Street Journal, says age must be the determining factor in prioritizing vaccinations.

Florida Governor DeSantis says more than 80% of Covid deaths in Florida are in persons over age 65. In Massachusetts the average age of death from the virus during roughly the first two weeks of December was 80. Over that short period, 420 octogenarians and older in the state died – a death rate of 143 per 100,000. The death rate for those between 70 and 80 was 33 per 100,000. For those between 60 and 70, the rate was less than 10 per 100,000. Rates for those in their prime working years – 30 to 50 – are only about 1 in 100,000.

Therefore, it is clear that age should be the number one determinant of vaccine eligibility. Not only does this prioritize by risk, but it also simplifies the eligibility documentation. By simply producing a driver’s license, people can be certified for vaccination. This is working well in Florida and should be adopted in all states.

This is not to suggest that others are not vulnerable. Many younger Americans are still at high risk due to immunocompromised conditions including cancer, obesity, diabetes, and chronic lung and heart conditions. They should also receive the vaccine as soon as possible.

Peterson says, “The need for simplicity and speed is similarly important. Shortening the pandemic by one month would save thousands of lives. This isn’t the right moment for deliberate selection among multiple claimants for protection. Keep it simple. Tempus fugit: Vaccinate the population before autumn leaves begin to fall.”


  1. An excellent blog. Easy to understand.

    Comment by Allen Higginbotham on January 21, 2021 at 9:07 am

  2. Thanks for your encouraging comments.

    Comment by Robert Roberts on January 22, 2021 at 9:50 am