Equitable allocation of COVID-19 vaccines in the United States
Top Cited Papers
- 18 May 2021
- journal article
- research article
- Published by Springer Science and Business Media LLC in Nature Medicine
- Vol. 27 (7), 1298-1307
- https://doi.org/10.1038/s41591-021-01379-6
Abstract
Many vaccine rationing guidelines urge planners to recognize, and ideally reduce, inequities. In the United States, allocation frameworks are determined by each of the Centers for Disease Control and Prevention’s 64 jurisdictions (50 states, the District of Columbia, five cities and eight territories). In this study, we analyzed vaccine allocation plans published by 8 November 2020, tracking updates through to 30 March 2021. We evaluated whether jurisdictions adopted proposals to reduce inequity using disadvantage indices and related place-based measures. By 30 March 2021, 14 jurisdictions had prioritized specific zip codes in combination with metrics such as COVID-19 incidence, and 37 jurisdictions (including 34 states) had adopted disadvantage indices, compared to 19 jurisdictions in November 2020. Uptake of indices doubled from 7 to 14 among the jurisdictions with the largest shares of disadvantaged communities. Five applications were distinguished: (1) prioritizing disadvantaged groups through increased shares of vaccines or vaccination appointments; (2) defining priority groups or areas; (3) tailoring outreach and communication; (4) planning the location of dispensing sites; and (5) monitoring receipt. To ensure that equity features centrally in allocation plans, policymakers at the federal, state and local levels should universalize the uptake of disadvantage indices and related place-based measures.This publication has 29 references indexed in Scilit:
- Structural racism, economic opportunity and racial health disparities: Evidence from U.S. countiesSSM - Population Health, 2020
- Vaccine Rationing and the Urgency of Social Justice in the Covid‐19 ResponseHastings Center Report, 2020
- Law, structural racism, and the COVID-19 pandemicJournal of Law and the Biosciences, 2020
- Race and Economic Opportunity in the United States: an Intergenerational Perspective*The Quarterly Journal of Economics, 2019
- Vaccines don’t save lives. Vaccinations save livesHuman Vaccines & Immunotherapeutics, 2019
- Inequalities in Life Expectancy Among US Counties, 1980 to 2014JAMA Internal Medicine, 2017
- How Other Countries Use Deprivation Indices—And Why The United States Desperately Needs OneHealth Affairs, 2016
- Limited electricity access in health facilities of sub-Saharan Africa: a systematic review of data on electricity access, sources, and reliabilityGlobal Health: Science and Practice, 2013
- Defining equity in healthJournal of Epidemiology and Community Health, 2003
- Need: The idea won't do—But we still need itSocial Science & Medicine (1982), 1995