Most health authorities have made a tradeoff regarding vaccination strategy. There is an argument to be made that it would be better to vaccinate the groups that would spread the virus most in their day-to-day activities, such that herd immunity (for the groups that actually spread the disease, making it available to everyone) is achieved faster.
But my impression is this decision has been too hard to defend, since it would necessarily mean more deaths in risk groups while the vaccination campaign is ongoing. And the difference in time to herd immunity is relatively small if vaccine access is good, only a quarter or two.
> But my impression is this decision has been too hard to defend, since it would necessarily mean more deaths in risk groups while the vaccination campaign is ongoing.
You may be right about their motivation, but it does not follow that it would necessarily increase deaths in high-risk groups. To become infected you must first be both susceptible and exposed.
I think there was a clear argument for reserving vaccine doses for high-risk groups when those populations were totally naive to the virus. At this point, though, the marginal returns on the population susceptible-exposed product (i.e. infections) are so low, focusing on targeting the most likely community spreaders--regardless of age or individual risk profile--might have an even greater impact on mortality in high-risk groups.
Vaccinating yourself lowers your susceptibility to infection. Vaccinating others lowers your probability of exposure to the virus. It's not super clear exactly where the best trade-off lies, but I think at this point we need to focus on reducing incidence in the entire community.
Vaccination does not 100% guarantee you will not get sick, it almost 100% guarantees you will not have a severe case. Studies also suggest that it does not completely prevent spread and if you catch virus while vaccinated you can still pass it to other people including risk groups, therefore main focus is on preventing deaths and logical way to do that is to vaccinate the risk groups first.
But my impression is this decision has been too hard to defend, since it would necessarily mean more deaths in risk groups while the vaccination campaign is ongoing. And the difference in time to herd immunity is relatively small if vaccine access is good, only a quarter or two.