When is vaccine prioritization worth optimizing?

Optimizing vaccine prioritization is often treated as the default policy response when vaccine supply is limited.

Yet optimized prioritization carries administrative, ethical and communication costs, motivating an upstream question: whether differences among vaccine allocations can alter epidemic outcomes enough to make optimization epidemiologically necessary.

We show that optimization is not always worth pursuing: in some regimes, vaccination markedly reduces epidemic burden, but many feasible allocation rules perform almost equally well, making the necessity of optimization low.

We quantify this necessity as the range of epidemic outcomes generated by different allocations under fixed supply and show that it is governed by competition between vaccinating high-contact groups to slow transmission and vaccinating groups that benefit most directly: necessity is low when these protection routes are balanced and high when one dominates.

Increasing transmission intensity changes this balance and drives a transition in the optimal allocation from transmission-focused prioritization toward direct protection.

Different prevention objectives exhibit distinct transition thresholds, creating regimes in which optimizing one objective substantially compromises another, thereby revealing when the choice of prevention target matters most.

This framework reframes vaccine prioritization as a prior decision problem, identifying when optimization is warranted, when simpler rules suffice, and when prevention goals conflict.