Our previous thought piece delved into the question of how many doses of Covid-19 vaccines are needed to protect front-line health workers and people at higher risk of severe or critical Covid-19 disease. We knew at that point we were leaving out all other essential workers and received several queries on what that number could be.
It’s an essential question but has not been easy to answer. It helps that there seems to be general consistency between countries and international organizations on the types of jobs that are considered to be essential during a pandemic. But there is limited data on how many people actually work in each job category.
The Netherlands has detailed, publicly available data on their essential workers (1). In total, they have counted 3.5 million essential, or key, workers. The majority are in health and welfare (1.3 million). The education sector (pedagogical occupations) includes 460,000 key workers, amounting to 14% of the total. The job categories include:
In reviewing the job categories, the subgroup with the most consistent definition between countries is primary school teachers. Global, regional and national data on primary school teachers is available from the World Bank (2). In the Netherlands 4.5% of their essential workers are primary school teachers. We have used the 4.5% proportion from the Netherlands to develop a proxy to extrapolate a rough estimate of what a global key/essential workforce could look like.
From the global data there is a primary education teacher workforce of 29 million (out of 84 million teachers across education levels globally) (3).When applying a factor of ~22 (100%/4.5%), it gives an approximate global essential workers workforce of 650 million, including the estimate of 52 million health workers previously calculated. The proportion of essential workers corresponds to ~9% of the total global population.
This global calculation assumes that the proportion of primary education teachers to other essential workers is the same in all countries as in the Netherlands. We are aware that this will not be the case; however, it allows us to develop a rough proxy to get a first view of the scale of this potential target group. We looked for a means of cross validating the result of 9% of the global population being essential workers based on the above methodology and found data on essential workers in two other countries - the United Kingdom (4) and the U.S. (5), which shows the proportion of essential workers as 16%, and 17%, respectfully. If we used these proportions instead, the global essential workers population could potentially be more than 1 billion people rather than the estimation of 650 million.
Using the methodology that is based on the number of primary school teachers, the largest proportion of essential workers are in Norway and Netherlands, where 21% of the population is part of the essential workers segment, and the smallest proportion is in CAR, Moldova and UAE at 4%.
The largest proportion per region is in North America with 11% of the population being part of the essential workforce and the smallest regional proportion is in Africa with 8%.
Adding all essential workers to the number of people who should be prioritized to receive Covid-19 vaccine, brings the total to 2.252 billion. This includes 727 million people over the age of 65 and 880 million people under the age of 65 with hypertension – the proxy we used for a Covid-19 complicating co-morbidity factor. The 52 million essential health workers are also included and were not double counted. However, there is some double-counting of people with hypertension who are under the age of 65 and are also an essential worker. The regional groupings of the 2.252 billion people are as follows.
Presuming a two-dose vaccine course with high coverage and some wastage, the total number of doses needed is just under 5 billion. This is for people for whom society has a duty to care (essential workers) and for those at higher risk of severe or critical Covid-19 disease.