Authors: Erin Stafford, Dobromir Dimitrov, Rachel Ceballos, Georgina Campelia, Laura Matrajt

Journal: medRxiv

Publication Year: May 11, 2023

Keywords: Covid-19, Vaccination/Immunization

Abstract:
NOTE: THIS MANUSCRIPT IS IN PRE-PRINT. IT HAS NOT BEEN SUBJECT TO PEER REVIEW.

One-Sentence Synopsis: In the situation where vaccines are in limited supply, there may an inverse relationship, a “trade-off”, between minimizing overall mortality risk and maximizing equity.

With the expiration of the emergency declaration for COVID-19, researchers, policy makers, and the public now have the opportunity to look back, learning and reflecting on the actions undertaken. While COVID-19 was unique that healthy equity was always a stated priority even from the beginning of the disease response and vaccine allocation.

This research uses simulation to explore hypothetical vaccine allocation plans in Oregon, trying to find a balance between overall disease burden and equity in a situation where COVID-19 vaccines are limited. First, they stipulate that there are only enough vaccines to cover 10% of the population of Oregon. Disease burden was measured with mortality and years of life lost (YLL). Inequity was measured using relative disparity in mortality, absolute disparity in mortality, index of mortality disparity, absolute disparity in YLL, and index of YLL disparity. The researchers used race as a primary proxy for multiple social determinants of health.

From their simulation, the researchers found that there was a trade-off between lowering overall disease burden and addressing equity. By minimizing disease burden, 100% of the restricted vaccine stock would be allocated to the most elderly, which in Oregon is primary White. However, based on Oregon data and their models, mortality rate for younger BIPOC Oregonians (0-19, 20-49, and 50-59) was higher than the mortality rate than younger White Oregonians. One of their suggested vaccine allocation plans would have been allocating 73% of available vaccines to older adults to reduce overall mortality and 27% of available vaccines to younger BIPOC populations to reduce inequities.

As a country, we have the ability now to look and evaluate how policy makers, the medical industry, and society responded to the pandemic. This is just a part of the conversation, offering a point of discussion when equity is a desired priority of policy and healthcare delivery, looking back, how can those strategies be improved.

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Source: Link to Original Article.

Type of Resource: Peer-reviewed scientific article