COVID-19 in Iceland: Randomise Vaccination to Achieve Herd Immunity Sooner

When Icelandic authorities finishing vaccination of priority groups, the general public will not be offered the jab by descending age groups, but will instead be randomly selected. Iceland’s Chief Epidemiologist confirmed this to mbl.is today. A recently published study from deCODE genetics found that this strategy would achieve herd immunity to COVID-19 sooner than vaccinating the population from oldest to youngest.

So far 29.89% of Iceland’s population have received one or both shots of COVID-19 vaccine. While vaccination efforts got off to a slow start on December 29, they have accelerated in pace with vaccine rollout. Icelandic authorities have stated they are on target to reach their goal of vaccinating 75% of the population (with at least one dose) by the end of July.

Priority Group Seven Out of Ten Now Being Vaccinated

In Iceland, COVID-19 vaccines have been administered according to priority groups defined by the Chief Epidemiologist. The first groups were front line healthcare workers and nursing home residents, followed by the oldest demographics. Currently, inoculations are being offered to the seventh priority group: individuals of all ages with chronic illnesses. The remaining three groups are school and welfare service staff; individuals vulnerable due to social or economic factors (such as homelessness); and the general population. These groups will not be invited to inoculation in descending age groups, but randomly.

“It will be somewhat random in relation to age,” Chief Epidemiologist Þórólfur Guðnason stated. “It will also be like that when for example teachers and people in social services are called in; it won’t be divided by age groups, it won’t go down from the oldest demographic, rather it will be somewhat random. We will try to hit two birds with one stone, that is to say to reach prioritised individuals and at the same time work toward herd immunity as well as possible.”

Herd Immunity Reached Sooner By Vaccinating Young People First

A study conducted by deCODE and presented to Icelandic authorities on April 29 concluded that herd immunity would be reached fastest in Iceland if the age groups who have yet to receive vaccination would be invited from youngest to oldest, in the opposite order from what Iceland, and most other countries, have been doing.

Katrín Jakobsdóttir COVID-19 mask
deCODE genetics. Prime Minister Katrín Jakobsdóttir and other government ministers at the presentation of a deCODE study on vaccination against COVID-19, April 29, 2021.

Vaccinating younger people would limit the spread of the SARS-CoV-2 virus more than vaccinating older groups. “In order to limit the epidemic to 100 people (assuming strict gathering regulations remained in place) we would have to vaccinate 75% of adults,” stated Páll Melsted, one of the scientists behind the study. “But if we start by vaccinating teenagers then we get to that point after vaccinating 55%. If we are going to get to that point sooner, we should start with those who are younger. We also achieve a similar goal if we do it completely randomly. Well, maybe it would be better politically to vaccinate both downwards and randomly, but I don’t intent to promote that.”

DeCODE CEO Kári Stefánsson warned against lifting restrictions quickly before herd immunity was achieved. “I think we should stick to the restrictions and be more Catholic than the Pope for a few more weeks and then we’ll come out of this well,” he stated.

Chief Epidemiologist Turns Down Priority Vaccination Spot

Chief Epidemiologist Þórólfur Guðnason

Iceland’s Chief Epidemiologist Þórólfur Guðnason turned down his first invitation to receive a COVID-19 vaccine as a healthcare professional and will wait until he is invited based on his age group. “I’m not working with patients, so I’ll wait,” Þórólfur told Vísir reporters. Þórólfur has encouraged other licenced healthcare professionals in his situation to do the same.

Icelandic health authorities began vaccinating against COVID-19 on December 29, 2020, according to defined priority groups. The first to get vaccinated were nursing home residents and frontline healthcare workers. Now vaccination has been offered to the fifth priority group: healthcare professionals working outside of healthcare institutions. The Chief Epidemiologist was offered vaccination on that basis.

Þórólfur turned down the offer as he is not working directly with patients and has encouraged others in his position to do the same and wait until they are offered the jab based on their age group. It will likely be a short wait for Þórólfur: vaccination of locals born in 1951 began this week, and the Chief Epidemiologist was born in 1953.

Everyone on Permit Register Received Invitation

While frontline healthcare workers have already been offered vaccination in Iceland, now the jab is being offered to priority group number five, defined as “other healthcare staff that have direct contact with patients and require COVID-19 vaccination according to further definitions by the Chief Epidemiologist.” The group includes 33 diverse healthcare professions ranging from nurses and midwives to optometrists, dentists, and speech pathologists.

Read More: What’s the status of COVID-19 vaccination in Iceland?

There are around 20,000 locals with valid licences in one of these professions, and it was not possible for authorities to contact everyone on the permit register to confirm they are currently working in a clinical setting. Therefore, all those with valid licences received an invitation to get vaccinated, but the Chief Epidemiologist’s Office sent out a notice urging those who are working in other jobs to turn down the invitation.

Chronically Ill and Under 70 Next in Line

The next priority groups are those with chronic illnesses under 70 years of age. Some individuals from these groups will be vaccinated this week.  So far 28,056 people have been fully vaccinated in Iceland, or 7.6% of the population. Authorities have stated they are on track to vaccinate 280,000 people (75% of the population) by mid-July.