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

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Science Advances

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COVID-19 mortality increases markedly with age and is also substantially higher among Black, Indigenous, and People of Color (BIPOC) populations in the United States. These two facts can have conflicting implications because BIPOC populations are younger than white populations. In analyses of California and Minnesota—demographically divergent states—we show that COVID vaccination schedules based solely on age benefit the older white populations at the expense of younger BIPOC populations with higher risk of death from COVID-19. We find that strategies that prioritize high-risk geographic areas for vaccination at all ages better target mortality risk than age-based strategies alone, although they do not always perform as well as direct prioritization of high-risk racial/ethnic groups. Vaccination schemas directly implicate equitability of access, both domestically and globally.

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This work is supported in part by the National Institutes of Health. E.W.-F., A.R.R., M.B., and D.V.R. are supported in part by the National Institute on Aging (E.W.-F. and D.V.R.: P30AG066613; A.R.R.: T32AG049663; M.B.: P30AG012839 and R03G058110). E.W.-F., D.V.R., and J.P.L. are supported in part by the Eunice Kennedy Shriver National Institute of Child Health and Human Development (P2CHD041023). M.V.K. is supported in part by the National Institute on Drug Abuse (K99DA051534). In addition, E.W.-F. is supported by a Sustainable Development Goals Rapid Response Grant, a College of Liberal Arts Seed Grant, and, during initial data processing stages, was supported by the Fesler-Lampert Chair of Aging Studies at the University of Minnesota. This research also relied on data and research support from the NHGIS, which is supported by the National Institutes of Health (R01HD057929) and National Science Foundation (1825768). Last, we thank the Berkeley Workshop in Formal Demography [supported by the National Institutes of Health (R25HD083136, P30AG012839, and P2CHD073964)], which facilitated the initial connection between the California-based and Minnesota based research teams. The funders of the study had no role in study design, data collection, data analysis, data interpretation, or writing of the report. The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH or NSF.

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10.1126/sciadv.abj2099

Previously Published Citation

E. Wrigley-Field, M. V. Kiang, A. R. Riley, M. Barbieri, Y.-H. Chen, K. A. Duchowny, E. C. Matthay, D. Van Riper, K. Jegathesan, K. Bibbins-Domingo, J. P. Leider, Geographically targeted COVID 19 vaccination is more equitable and averts more deaths than age-based thresholds alone. Sci. Adv. 7, eabj2099 (2021).

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Wrigley-Field, Elizabeth; Kiang, Mathew V.; Riley, Alicia R.; Barbieri, Magali; Chen, Yea-Hung; Duchowny, Kate A.; Matthay, Ellicott C.; Van Riper, David; Jegathesan, Kirrthana; Bibbins-Domingo, Kirsten; Leider, Jonathon P.. (2021). Geographically targeted COVID-19 vaccination is more equitable and averts more deaths than age-based thresholds alone. Retrieved from the University Digital Conservancy, 10.1126/sciadv.abj2099.

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