Geographically-targeted COVID-19 vaccination is more equitable than age-based thresholds alone

Area of Science:

• Epidemiology
• Public Health Policy
• Health Equity

Background:

• COVID-19 mortality disproportionately affects older adults and racial/ethnic minority groups in the U.S.
• Demographic differences, such as younger populations in minority groups, create complex trade-offs in age-based health interventions.
• Existing disparities necessitate careful consideration of vaccination strategies to ensure equitable outcomes.

Approach:

• Analyzed COVID-19 vaccination strategies in California and Minnesota, states with divergent demographics.
• Compared the effectiveness of age-based prioritization versus strategies prioritizing high-risk geographic areas or racial/ethnic groups.
• Evaluated how different prioritization methods impact mortality risk across diverse populations.

Key Points:

• Solely age-based COVID-19 vaccination schedules disproportionately benefit older white populations.
• Younger Black, Indigenous, and People of Color (BIPOC) populations face higher COVID-19 mortality risk, which is not adequately addressed by age-only strategies.
• Prioritizing vaccination in high-risk geographic areas demonstrates improved targeting of mortality risk compared to age-based strategies alone.

Conclusions:

• COVID-19 vaccination strategies must account for both age and race/ethnicity to address mortality disparities effectively.
• Geographic prioritization can mitigate some inequities but may not be as effective as direct prioritization of high-risk racial/ethnic groups.
• Equitable public health policy requires nuanced approaches that move beyond single-factor prioritization to address complex health risks.