Public opinion in vaccine allocation priority: who comes first?

Objective: We investigated people's preferences in COVID-19 vaccine allocation priority, comparing different social categories based on age and occupation. Vaccine allocation preferences were related to perceived health vulnerability and economic backlash (economic negative consequences) endured by the different social groups during the pandemic. In-group favoritism in vaccine allocation preferences was analyzed.

Design: Data were collected through an online survey in Italy ( = 506) before the start of the vaccination campaign.

Main Outcome Measures: Vaccine allocation preferences, health vulnerability, and economic backlash due to COVID-19, measured through ranking tasks.

Results: The healthcare workers category was placed at the top of the ranking in vaccine allocation priority by 65% of the respondents. Vaccine allocation priority was related to perceived health vulnerability and not economic difficulties. Limited self-preference effects emerged. People who did not consider healthcare workers a priority (1/5 of the sample) had a lower education level, were more worried about COVID-19 infection risk, and did not trust vaccines.

Conclusions: A consensus emerged on who should be vaccinated first. Governments and policymakers should be aware of these preferences when designing and communicating vaccine allocation plans to predict and foster the public's acceptance of the COVID-19 vaccination programs created by experts.