A University of Pennsylvania expert in health policy says older people should not necessarily be on a priority list for COVID-19 vaccinations because they tend to be white.
And making them a lower priority will “level the playing field a bit.”
The expert, Harald Schmidt was quoted in a New York Times article titled “Who should get the coronavirus vaccine first?”
“Older populations are whiter,” he said. “Society is structured in a way that enables them to live longer. Instead of giving additional health benefits to those who already had more of them, we can start to level the playing field a bit.”
His argued it was reasonable to put “essential workers” ahead of older populations, at least partly because they are disproportionately minorities.
The Centers for Disease Control, he said, should integrate the agency’s “social vulnerability index” to determine the order in which people get vaccinated.
The “index” considers 15 components of the Census, such as crowded housing, lack of vehicle access and poverty.
The Times report was published Dec. 5, before the FDA authorized distribution of COVID-19 vaccines.
“Should the country’s immunization program focus in the early months on the elderly and people with serious medical conditions, who are dying of the virus at the highest rates, or on essential workers, an expansive category encompassing Americans who have borne the greatest risk of infection?” it asks.
It explained that under existing CDC plans, health care workers and residents of long-term-care facilities likely would be put at the top of the list.
But it then debates who goes next.
“Ultimately, the choice comes down to whether preventing death or curbing the spread of the virus and returning to some semblance of normalcy is the highest priority.”
Dr. Scott Gottlieb, a former commissioner for the Food and Drug Administration said: “If your goal is to maximize the preservation of human life, then you would bias the vaccine toward older Americans. If your goal is to reduce the rate of infection, then you would prioritize essential workers. So it depends what impact you’re trying to achieve.”
Dr. Peter Szilagyi of the University of California Los Angeles said, “To me the issue of ethics is very significant, very important for this country, and clearly favors the essential worker group because of the high proportion of minority, low-income and low-education workers among essential workers.”
The World Health Organization, the National Academies of Sciences, Engineering, and Medicine and others have said reducing deaths by protecting the elderly is their priority.
And CDC Director Dr. Robert Redfield has expressed hope to “prioritize the elderly.”
Ultimately, the states will determine who gets vaccinated first.
The Times report said Marc Lipsitch, an infectious-disease epidemiologist at Harvard’s T.H. Chan School of Public Health, argued that teachers should not be regarded as essential workers if the objective is to reduce health inequities.
“Teachers have middle-class salaries, are very often white, and they have college degrees,” Lipsitch said. “Of course they should be treated better, but they are not among the most mistreated of workers.”
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