While the Federal Government is committed to聽executing聽a , the distribution聽of聽vaccines falls individually on state and local government support. In our聽blog series on the vaccine rollout, 有料盒子APP鈥檚 Chief Medical Officer Kevin Vigilante and our health聽experts examine best practices and lessons learned from across the health landscape, including聽potential聽strategies听补苍诲 approaches聽that could help聽state and local governments improve vaccination rollouts.
Streamline distribution with age-based priority, lottery
To protect the most exposed workers and most at-risk populations (e.g., those with preexisting conditions), an elegantly phased COVID-19 vaccination rollout was created. But many state and local health departments are finding that vaccine distribution plans are missing their mark. Well-intended criteria are hard to define, difficult to document, and are slowing down the process. How do you prove you have diabetes to a volunteer vaccinator? Anyone with a computer and a printer can produce a doctor鈥檚 note鈥攐r sell them. This has led to conflict, line jumping, and gaming the system鈥攁n environment in which influence and privilege usually prevail.聽
Prioritize by Age, Then Use a Lottery
In a recent have proposed a simpler approach in which age is the primary criterion for vaccination. They suggest starting with those 75 and over and working down to those 55 and over鈥攁pproximately 100 million people. This 55 and up age cohort accounts for 92% of all COVID deaths. And unlike the long list of occupations and conditions (which vary by severity) in the current plan, age is easily defined and documented with licenses and birth certificates. Once we have vaccinated all those 55 and above, they advocate that the rest be determined by lottery.聽Instead of pitting Uber driver against bus driver, a vaccine lottery would determine who goes next.
鈥淚nstead of pitting Uber driver against bus driver, a vaccine lottery would determine who goes next.鈥�
Prioritize Health Equity in Vaccine Distribution
But as ,听even with a lottery, more still needs to be done to equalize vaccination opportunities for economically disadvantaged populations. Building trust through culturally sensitive communications is the first step. Locating vaccination sites near socially vulnerable zip codes and near mass transit access points is essential. Simplified registration procedures and centralized statewide scheduling systems that don鈥檛 require citizens to explore dozens of websites would also help; as would in-person and phone access for scheduling.聽
The Bottom Line
An age and lottery-based prioritization approach may not be perfect. But, with a thoughtful implementation that takes health equity into account, it could be a quicker and fairer path to herd immunity. And that would benefit everyone.
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