Media release

From: AAAS

COVID-19 vaccination plans that target people of all ages in high-risk U.S. geographic areas may be more equitable and could prevent more deaths than vaccination plans based on age-related risk alone, according to a new modeling study.

This study analyzed how hypothetical vaccination plans could affect COVID-19 mortality and equity in California and Minnesota, 2 demographically divergent states. The analysis suggests that states should target all adults in highly specific geographic areas using tactics that would reach more vulnerable people, as well as more older residents, specifically. The findings, which may be applied to global vaccination strategies, indicate that a vaccination plan that accounts for risk based on geographic location would have a low direct opportunity cost, since it would require allocating only a small number of additional vaccines to high-risk geographies.

While U.S. guidelines for vaccine rollout issued by the CDC were consistent with evidence that COVID-19 mortality risk increases with age, the guidelines did not account for evidence that risk of exposure to SARS-CoV-2 is much higher for Black, Indigenous, and People of Color.

Elizabeth Wrigley-Field and colleagues first evaluated the effects of prioritizing vaccine rollout based on age alone in California and Minnesota using observed COVID-19 mortality data for 2020. They found that, while vaccinating all people age 75 and older would have prevented nearly two-thirds of white deaths in each state, this strategy alone would have prevented far fewer Black, Latino, and Asian and Asian-American deaths in both states.

Next, the researchers explored the effects of alternative vaccination strategies. They found that prioritizing vaccination for more vulnerable racial groups within each age bracket would better target high-risk individuals than age-based vaccination alone, but noted that there would be legal, political, and practical barriers to prioritizing based on race. Alternatively, further analyses suggested prioritizing vaccination based on geography, a potentially less controversial strategy, would improve equity and avert more deaths than prioritizing age alone.