After spending weeks publicly complaining that the federal government was not providing them with a sufficient number of COVID-19 vaccine doses, states have only been able to administer a small fraction of the vaccines they have received. Even allowing for some lag in reporting and lost time over the holiday season, the United States is likely to fall far short of its goal of vaccinating 20 million people in December. Failure to pick up the pace in the new year will needlessly cost lives and extend the pandemic.
There are arguably many culprits for the slow rollout of the vaccine, but one discouraging sign is the extent to which many states have ignored science and common sense and put together complicated distribution plans that not only bog down the process, but will likely result in more deaths.
It makes sense to vaccinate front-line medical workers first. We know where to find them, they are putting themselves in harm’s way to treat others, and if we keep them healthy, it will help to maximize our medical capacity during the winter surge. It also makes sense to vaccinate those in nursing homes, which have been places of extensive spread and a disheartening amount of death.
After that, the most straight-forward way to approach vaccination is to do older people first.
If we were vaccinating about 1 million people a day (which would be consistent with the roughly 30 million per month projection by the administration), the U.S. would be able to administer the first doses to everybody 85 and over within one week. That group, despite being around 2% of the population, accounts for nearly a third of U.S. COVID-19 deaths.
Going further, the age 65-and-over population is about 54 million people (or about one-sixth of the population), yet has accounted for about 80% of U.S. deaths. With a proper administration plan, this group could theoretically be vaccinated by the end of February.
There is no better “bang for the buck” in terms of lives saved than vaccinating older people as soon as possible. Doing so offers the quickest way out of this pandemic.
And yet, states are complicating matters due to a variety of reasons that have nothing to do with lives saved, such as equity (because older Americans are disproportionately white) and allegedly for economic reasons.
New York, for instance, doesn’t start vaccinating seniors until phase three of its current distribution plan — putting them behind not only medical workers but also other workers deemed “essential.” As it currently stands, New York’s plan could see teenage grocery store employees vaccinated before 90-year-olds. But before those essential workers can get vaccinated, Gov. Andrew Cuomo announced that drug addicts in rehab facilities have to go first.
Putting essential workers before seniors would not only save far fewer lives but will prove much more complicated. Emphasizing essential workers requires getting into debates over what professions qualify as “essential.” It is also much harder to track down individuals in a variety of professions than it is to administer shots to the over-65 population, who are easy to find because they are enrolled in Social Security and/or Medicare.
In terms of the economic impact, it’s worth flashing back to March, at the beginning of the pandemic. Back then, we were told that the extraordinary measures being taken to shut down social and economic activity were being done to protect older people and prevent the collapse of hospital systems. Once the over 65 population and front-line medical workers are protected by a vaccine with 95% efficacy, COVID-19 becomes much more akin to the flu or other illnesses that don’t trigger massive, population-wide mitigation strategies.
Put another way, it is much safer to open up a nation in which the over-65 population is protected than it is to open one in which the government is tracking down grocery store cashiers while leaving tens and millions of elderly still vulnerable.
This isn’t a time to overthink things with complicated distribution algorithms. States need to concentrate on distributing the vaccine as quickly as possible with the interest of maximizing the number of lives saved. Just start vaccinating older people.
