Fig. 1

Demography, distribution of health care workers, SARS-CoV-2 cases, and deaths across Madagascar. A The ranking for vaccine distribution based on the population size and number of healthcare workers per region. B Using the population size and number of healthcare workers, each of the 22 regions was prioritized with regions with a large population size and high number of healthcare workers ordered first (yellow) and those with the smallest population size and number of healthcare workers ranked last (purple). The size of the point corresponds to the proportion of people over 60 years old. C In contrast, the rankings for regions based on D the number of confirmed SARS-CoV-2 cases (March 20, 2020 – July 30, 2021) based on the number of reported cases and confirmed COVID-19 deaths. Regions would receive doses first if they had the largest reported outbreaks (yellow) and last (purple) if they had few reported cases and deaths. The size of points indicates the number of healthcare workers per capita