As states slowly receive COVID-19 vaccines, there’s been much debate on how to best distribute them. While the federal government transports the vaccines to the states, it’s the state governments themselves that currently have the final say on which groups to prioritize. The CDC has issued vaccine allocation recommendations through the Advisory Committee on Immunization Practices (ACIP), suggesting that health care workers and long-term care residents be the first ones offered the vaccine, followed by persons over the age of 75 and non-health care frontline essential workers. Although non-binding, nearly every state has prioritized medical workers and residents, but beyond that, distributions differ. Most states have also adopted all or some of the other recommended groups in their first distribution phase. Meanwhile, other states have chosen to prioritize anyone over 65 over frontline workers in their initial round of vaccines. Furthermore, politicians not belonging to any noted high-risk or exposure group have also jumped the line and gotten their first dose.
Equality refers to the uniform distribution of a good or service to everyone. In other words, each person receives the same amount of whatever commodity is being distributed, regardless of their individual circumstances. Equity, on the other hand, refers to the fair distribution of goods and services based on individual need. Those who start with less are given more of the commodity, while those who have more receive less of it.
The US doesn’t have enough COVID-19 vaccines to go around, and with delayed federal allocations, that isn’t going to change any time soon. There’s no way to equally distribute the drug doses, so we’re forced to consider what’s the most equitable distribution. However, judging which group has the greatest need isn’t easy or clear-cut. The groups the CDC have singled out, however, are strong contenders, given what we currently know about COVID-19.
Frontline essential workers are included as a top priority because they’re extremely likely to come in contact with the coronavirus during their shifts. Furthermore, most of these workers are people of color, a group that's been disproportionately affected by COVID-19. Allowing them early access to the vaccine would help balance out healthcare inequalities, such as the fact that essential workers have a minimal number of sick days and are less likely to receive needed medical services.
Similarly, people over 75 need the vaccine because they’re an extremely vulnerable group. Roughly 80% of the total US covid deaths have been over 60 years old, with those 75 and older making up nearly 60% of US covid deaths on their own. If they catch it, they’re more likely to be hospitalized, have complications, and even die.
Therefore, these groups have been prioritized in recommendations because it’s the most equitable solution. Not all essential workers nor elderly persons are included, but rather the subset of both that have the greatest need. Eliminating either group from a state’s top priority list is short-sighted and unjust. An equitable distribution needs to take into account both who’s most at risk of dying and who’s most at risk of catching the coronavirus, and research has indicated these two groups qualify. Government officials and leaders were not specifically suggested because they can safely self-isolate and afford adequate, if not top-notch, medical services. Letting them jump the line is a flagrant abuse of power and creates an unfair allocation of such a scarce resource. It’s important that states follow equitable COVID-19 vaccine distributions. Doing so will lead to the most lives possible being saved. Learn about your state’s allocation plan and question whether it’s truly as equitable as it can be. What’s the most vulnerable, at risk groups in your state, and does the vaccine distribution protect them?