Health officials are wrestling with who should be first to receive a COVID-19 vaccine. Is it time to redefine what’s fair?
An influential report proposes first dibs for emergency responders but also, for the first time in history, recommends that priority be given to people with social vulnerabilities. Photograph by Stephen Ferry, Redux
Sarah Elizabeth Richards
Whenever a new vaccine gets approved, health officials have to tackle the difficult question of who should be first in line to receive it. Typically health-care workers are first, and in previous outbreaks, such as the H1N1 swine flu in 2009, people whose health was most vulnerable got priority, too.
With the widely anticipated COVID-19 vaccine, there’s a new factor being considered: fairness.
On October 2, the National Academy of Medicine revealed its recommendations for COVID-19 vaccine distribution in an influential 237-page framework commissioned by the National Institutes of Health and the U.S. Centers for Disease Control and Prevention.
The report proposes distributing a vaccine in four phases as it becomes available. The first recipients are obvious picks: health-care workers, emergency responders, people with underlying conditions, and older adults living in group settings. This mirrors similar recommendations by the World Health Organization, and it is a foundational principle for the COVAX collaboration, a global effort to improve poorer countries’ access to a vaccine, which 171 nations have pledged to join. (The U.S. is not one of them, and a small group of scientists question the wisdom of putting some health-care workers at the top.)
But for the first time in history, the report also recommends that priority be given to people who score high on the CDC’s Social Vulnerability Index, which identifies factors such as poverty, lack of access to transportation, or crowded housing that are linked to poor health outcomes. The committee of virologists, epidemiologists, economists, and other health researchers who wrote the report said the goal is to rectify the pandemic’s disproportionate burden on minorities and poor people and “work toward a new commitment to promoting health equity.”
The disparities are stark: Compared with white people, African Americans, Hispanics, and Native Americans are nearly three times more likely to contract the coronavirus. Blacks are twice as likely to die. Read more >>