Journal article
Equitable allocation of COVID-19 vaccines in the United States
Nature medicine, Vol.27(7), pp.1298-1307
07/2021
DOI: 10.1038/s41591-021-01379-6
PMID: 34007071
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.
An analysis of COVID-19 vaccine allocation frameworks in the United States across 64 Centers for Disease Control and Prevention jurisdictions reveals that, as of 31 March 2021, 37 jurisdictions had adopted disadvantage indices to reduce health disparities. The analysis also highlights the importance of vaccine prioritization based on health and place.
Details
- Title: Subtitle
- Equitable allocation of COVID-19 vaccines in the United States
- Creators
- Harald Schmidt - University of PennsylvaniaRebecca Weintraub - Brigham and Women's HospitalMichelle A. Williams - Harvard UniversityKate Miller - Brigham and Women's HospitalAlison Buttenheim - University of PennsylvaniaEmily Sadecki - University of PennsylvaniaHelen Wu - University of PennsylvaniaAditi Doiphode - University of PennsylvaniaNeha Nagpal - University of PennsylvaniaLawrence O. Gostin - Georgetown UniversityAngela A. Shen - Children's Hospital of Philadelphia
- Resource Type
- Journal article
- Publication Details
- Nature medicine, Vol.27(7), pp.1298-1307
- DOI
- 10.1038/s41591-021-01379-6
- PMID
- 34007071
- NLM abbreviation
- Nat Med
- ISSN
- 1078-8956
- eISSN
- 1546-170X
- Publisher
- Nature Publishing Group US
- Number of pages
- 10
- Language
- English
- Date published
- 07/2021
- Academic Unit
- Family and Community Medicine
- Record Identifier
- 9984961046802771
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