MELBOURNE – Now that COVID-19 vaccines are being rolled out, policymakers are wrestling with the question of how to distribute them quickly and equitably. There has been wide agreement that health workers should be vaccinated first, because they are needed to save the lives of those who are ill because of the virus. But deciding who should come next has spurred considerable debate.
One relevant fact is that people over 65 have a higher risk of dying from COVID-19 than younger people do, and those over 75 are at even higher risk.
Another relevant fact is that, in the United States and some other countries, members of disadvantaged racial and ethnic minorities have a lower-than-average life expectancy, and therefore are under-represented among those over 65. If we give priority to older people, the proportion who are members of those minorities will be lower than their proportion in the population as a whole. In light of the many disadvantages members of these minorities already experience, this seems unfair.
This sense of unfairness appears to motivate the suggestion by Kathleen Dooling, a public health official at the U.S. Centers for Disease Control and Prevention (CDC), that a different approach be taken. In a presentation to the CDC’s Advisory Committee on Immunization Practices, Dooling argued that “essential workers” — a group numbering approximately 87 million — should be vaccinated ahead of the 53 million Americans aged 65 and older, even though this would lead to between 0.5% and 6.5% more deaths.