Union health secretary Rajesh Bhushan caused some stir recently. When asked whether the Narendra Modi government should open vaccination to all, he replied: “The aim is not to administer the vaccine to those who want it, but to those who need it.” The statement was controversial because many believe that prioritising the elderly will slow vaccination rollout, and speedy vaccination is critical to stopping Covid. But we think the health secretary may have the better of this argument — at least based on recent data and epidemiological models.

There is little debate that vaccines are the best hope India has in its fight against the coronavirus pandemic. India is in the middle of a second wave of infections. However, obstacles to manufacturing and distribution have slowed the country’s vaccination campaign. We cannot vaccinate everyone before they get Covid. So some rationing will occur regardless. If the elderly are vaccinated first, then the young may be vaccinated too late. If access is opened to all, then some of the elderly will not get it.

To make the best of a bad situation, we can all agree that the government should choose the policy that most benefits India as a whole. It should prioritise those who benefit the most or offer the most benefit to others from vaccination. The challenge is to figure out what that policy is.

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