Background: The timely implementation of the vaccination campaign and sharp rules for vaccine administration can make a difference. The paper investigates the impact of alternative policies based on scientific vaccination priorities inspired by the extended statistics on Covid-19 fatalities.
Methods: In the case of Covid-19 vaccination, a principal role is played by promptly adopting a reverse-order of age approach (to target first the elderly) coupled to covering the high priority categories but postponing the low priority ones. We implemented an in silico vaccination simulator capable of comparing what happened in reality with what might have happened if alternative vaccination policies had been adopted. The immunization profile and the death distribution curve allowed measuring the distance between reality and alternative policies and finally quantifying the expected number of saved lives.
Results: The alternative approach to vaccination was applied to Italy and Lombardy that host 60 and 10 million residents respectively. In about 100 days of vaccination based on (a) a reverse-order of age policy (from 90+ to 80-89 to 70-79 year-olds, etc.), (b) vaccination of priority categories, (c) postponement of non-priority categories and reallocation of such doses to (a) and (b), the saved lives would have been 3969 in Italy (of which 799 in Lombardy). In the same period, Italy suffered 30,911 fatalities (of which 5,613 in Lombardy). Of those fatalities, about 12.8% in Italy and 14.2% in Lombardy might have been avoided if a different approach to vaccination had been applied. Even better results would have been achieved if the elderly vaccination had been anticipated a few days (which started only 53 days after the very beginning of the Italian vaccination campaign) or if the vaccination engine had performed better in terms of daily administered doses while respecting the available delivered doses.
Conclusions: A different approach to the vaccination politics based on sharp and straight policies based on scientific quantitative data of Covid-19 mortality as a function of age and comorbidities would have accomplished a better quantitative effect on extinguishing the pandemic and containing the fatalities toll.