Lisätty 21.01.2021.

Vaccination order and at-risk groups for COVID-19

Source: Finnish institute for health and welfare: Vaccination order and at-risk groups for COVID-19

COVID-19 vaccination is offered to all persons aged 16 or older who are willing to take the vaccine. 

Because the number of available vaccines is limited in the beginning, they are first offered to people with a higher risk of severe COVID-19 disease or being exposed to the virus at work, for example.

What were the grounds for deciding the vaccination order?

The objectives of Finland’s COVID-19 vaccination strategy are:

  • to lower the disease burden of COVID-19, i.e. severe cases, premature deaths and years of potential life lost; and
  • to maintain the functioning of the health care system.  

The selected vaccination order supports these objectives, and it is based on medical risk assessment. The risk assessment was conducted by the National Advisory Committee on Vaccines (KRAR) appointed by the Finnish Institute for Health and Welfare (THL).

In order to help its member states create a national strategy for COVID-19 vaccination, the WHO has published a values framework and a roadmap for prioritizing. Although health matters are covered by national decision-making, the European Commission has also called on its member states to consider certain target groups among the first to be vaccinated.

What high-risk groups is the coronavirus vaccine recommended for?

Age is the most important risk factor for serious coronavirus disease. For that reason, the vaccine is recommended for the elderly.

Highly predisposing conditions for severe COVID-19 disease include, for example, severe chronic kidney disease, severe immunosuppressive condition (organ transplant, acute cancer treatment) and severe chronic pulmonary disease.

Predisposing conditions for severe COVID-19 disease include, for example, coronary artery disease and cirrhosis of the liver.

The schedule for offering the vaccination to various groups depends on the availability of the vaccines, the clinical efficacy and safety of the vaccine to various target groups and the conditions of the marketing authorisation determining, for example, the age group that can be vaccinated. 

In what order is COVID-19 vaccination offered to various groups? 

The Ministry of Social Affairs and Health has stated that Finland will procure coronavirus vaccines for its entire population. Initially, only a limited number of vaccines are available in Finland, which is why the vaccines are offered only to certain target groups first.

The Government decided on Finland’s vaccination order by adopting a Decree on 22 December 2020. Based on this Decree, vaccinations will be offered to various population groups in the following order:

  1. Social and health care personnel who examine or directly treat and care for patients with confirmed or suspected COVID-19 disease or who provide other kinds of urgent care, and workers and residents in residential services and nursing homes for the elderly; 
  2. Those aged 70 years or older; 
  3. Persons at high risk for severe COVID-19 disease due to underlying health conditions; and
  4. Other persons than those in priority groups 1–3.  

THL is responsible for specifying the vaccination order based on, for example, age, risk factors and susceptibility to severe disease. That is why THL has provided a more detailed recommendation on the vaccination order, based on the statements and the medical risk assessment of the National Advisory Committee on Vaccines (KRAR). 

The recommendation will be specified further when more information emerges on the availability of the various COVID-19 vaccines and their suitability for different target groups.

To ensure flexible and rapid vaccinations, it is possible to vaccinate consecutive groups at the same time. Vaccinations can be offered to the next group when the majority of the previous group have been vaccinated. This helps to avoid delays in vaccinations and prevent vaccine waste. 

The Finnish Institute for Health and Welfare recommends that COVID-19 vaccinations are offered to different groups in the following order:

1.  Health care personnel caring for coronavirus patients as well as personnel and residents in round-the-clock care facilities

  1. Personnel in intensive care units
  2. Personnel in inpatient wards and emergency wards treating diagnosed or suspected COVID-19 patients and emergency care personnel
  3. Personnel at infectious diseases clinics treating diagnosed or suspected COVID-19 patients, COVID-19 testing personnel, and laboratory personnel involved in COVID-19 diagnostics
  4. Personnel and residents in social services for residential care and enhanced institutional, round-the-clock care units (groups 3 and 4 may be vaccinated simultaneously)
  5. A limited number of critical personnel in social welfare and health care, for example, personnel in organ transplant units

The total number of people in these groups exceeds 150,000, if only care services for the elderly are included.

2. The elderly, and persons with underlying conditions that predispose to severe COVID-19

  1. 80-year-olds and older, including carers living in the same household                                     
  2. 75–79-year-olds, including carers living in the same household
  3. 70–74-year-olds, including carers living in the same household
  4. Those under the age of 70 with a highly predisposing condition for severe COVID-19. Highly predisposing conditions for severe COVID-19 disease include, for example, severe chronic kidney disease, severe immunosuppressive condition (organ transplant, acute cancer treatment) and severe chronic pulmonary disease.
  5. Those under the age of 70 with a predisposing condition for severe COVID-19. Predisposing conditions for severe COVID-19 include, for example, coronary artery disease and cirrhosis of the liver.

The order in which those suffering from underlying diseases are vaccinated is affected by how effective the vaccine is in these groups. There are approximately 800,000 people over the age of 70 in Finland.

When more information becomes available about the new COVID-19 vaccines, their marketing authorisations and their supply to Finland, the assessment of medical risk groups will be continued.  At the same time, the list can be specified to divide people with underlying conditions to several groups based on the magnitude of the risk. 

In addition, the priority listing for social welfare and health care professionals and the rest of the population can be clarified.

3. Others 

COVID-19 vaccinations will be offered to the entire population when a sufficient number of vaccines becomes available. Vaccination of children is not relevant until paediatric vaccine and effectiveness studies have been completed.

Updated: 13 Jan 2021