Strategic COVID-19 vaccine distribution can simultaneously elevate social utility and equity

Chen, Lin; Xu, Fengli; Han, Zhenyu; Tang, Kun; Hui, Pan; Evans, James A.; Li, Yong

doi:10.1038/s41562-022-01429-0

Cited by 21 publications

(17 citation statements)

References 59 publications

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“…Most of these studies evaluate vaccination success as the reduction of the overall disease burden (mortality, hospitalizations, or infections) without accounting for projected equity gaps. A few studies include inequity outcomes, mostly focusing on the geographic distribution of vaccines among countries, states, or affected regions ( 46 , 47 ), and only a handful discuss reducing inequities in access or disparities in outcomes between racial groups ( 48–50 ).…”

Section: Introductionmentioning

confidence: 99%

Retrospective analysis of equity-based optimization for COVID-19 vaccine allocation

Stafford,

Dimitrov,

Ceballos

et al. 2023

PNAS Nexus

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Marginalized racial and ethnic groups in the United States were disproportionally affected by the COVID-19 pandemic. To study these disparities, we construct an age-and-race-stratified mathematical model of SARS-CoV-2 transmission fitted to age-and-race-stratified data from 2020 in Oregon and analyze counterfactual vaccination strategies in early 2021. We consider two racial groups: non-Hispanic White persons and persons belonging to BIPOC groups (including non-Hispanic Black persons, non-Hispanic Asian persons, non-Hispanic American-Indian or Alaska-Native persons, and Hispanic or Latino persons). We allocate a limited amount of vaccine to minimize overall disease burden (deaths or years of life lost), inequity in disease outcomes between racial groups (measured with five different metrics), or both. We find that, when allocating small amounts of vaccine (10% coverage), there is a trade-off between minimizing disease burden and minimizing inequity. Older age groups, who are at a greater risk of severe disease and death, are prioritized when minimizing measures of disease burden, and younger BIPOC groups, who face the most inequities, are prioritized when minimizing measures of inequity. The allocation strategies that minimize combinations of measures can produce middle-ground solutions that similarly improve both disease burden and inequity, but the trade-off can only be mitigated by increasing the vaccine supply. With enough resources to vaccinate 20% of the population the trade-off lessens, and with 30% coverage, we can optimize both equity and mortality. Our goal is to provide a race-conscious framework to quantify and minimize inequity that can be used for future pandemics and other public health interventions.

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Section: Introductionmentioning

confidence: 99%

Retrospective analysis of equity-based optimization for COVID-19 vaccine allocation

Stafford,

Dimitrov,

Ceballos

et al. 2023

PNAS Nexus

View full text Add to dashboard Cite

show abstract

“…Still, we propose that the matrix of forces we identified, along with the network approaches we demonstrated, can be used to describe and analyze triage in settings beyond the case of housing vouchers. In the U.S. context, our approach is transferable to a variety of high-stakes settings in which policies create hierarchies to allocate scarce resources, such as childcare subsidies (Bouek 2020), tutoring (Coffin and Rubin 2022), home- or community-based long-term care financed by Medicaid (Musumeci, Chidambaram, and Watts 2019), and vaccines (Chen et al 2022). Beyond the United States, other liberal welfare states and universalist welfare states implementing austerity measures (Scruggs 2008) further add to the range of settings where local resource allocation dilemmas emerge.…”

Section: Discussionmentioning

confidence: 99%

Hierarchies in the Decentralized Welfare State: Prioritization in the Housing Choice Voucher Program

Zhang

Johnson

2023

Am Sociol Rev

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Social provision in the United States is highly decentralized. Significant federal and state funding flows to local organizational actors, who are granted discretion over how to allocate resources to people in need. In welfare states where many programs are underfunded and decoupled from local need, how does decentralization shape who gets what? This article identifies forces that shape how local actors classify help-seekers when they ration scarce resources, focusing on the case of prioritization in the Housing Choice Voucher Program. We use network methods to represent and analyze 1,398 local prioritization policies. Our results reveal two patterns that challenge expectations from past literature. First, we observe classificatory restraint, or many organizations choosing not to draw fine distinctions between applicants to prioritize. Second, when organizations do institute priority categories, policies often advantage applicants who are formally institutionally connected to the local community. Interviews with officials, in turn, reveal how prioritization schemes reflect housing agencies’ position within a matrix of intra-organizational, inter-organizational, and vertical forces that structure the meaning and cost of classifying help-seekers. These findings illustrate how local organizations’ use of classification to solve on-the-ground organizational problems and manage scarce resources can generate additional forms of exclusion.

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“…The rapid development and emergency authorization of vaccines, despite unknown long-term side effects, have fueled hesitation, especially toward mRNA vaccines, among the global community. Concerns, largely unfounded, have been raised regarding the safety of COVID-19 vaccines, particularly in relation to platelet function, 62 cardiovascular complications, 63 and the potential for increased risk of DNA damage, chronic autoinflammation, autoimmunity, and cancer. 64 On 5 May 2023, the WHO declared that the COVID-19 pandemic no longer constituted a global health emergency.…”

Section: Past Lessons and Future Direction In Covid-19 Vaccine Pricingmentioning

confidence: 99%

Cost-based COVID-19 vaccination and willingness to pay: A post-pandemic review

Wong,

Lee,

Alias

et al. 2024

Human Vaccines & Immunotherapeutics

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The primary objective of this paper is to serve as a valuable resource for policymakers who are confronted with the evolving landscape of the coronavirus disease 2019 (COVID-19), considering both free and cost-based vaccination approaches. The potential consequences of shifting from free to cost-based vaccination are explored, encompassing its impact on global vaccine equity and prioritization, economic well-being, healthcare systems and delivery, public health policies, and vaccine distribution strategies. Examining past studies on willingness to pay for the initial COVID-19 vaccine dose and booster shots provides insights into how individuals value COVID-19 vaccinations and underscores the significance of addressing issues related to affordability. If COVID-19 vaccinations incur expenses, using effective communication strategies that emphasize the importance of vaccination and personal health benefits can increase willingness to pay. Making COVID-19 vaccines accessible through public health programs or health insurance can help alleviate financial barriers and increase vaccination rates.

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Strategic COVID-19 vaccine distribution can simultaneously elevate social utility and equity

Cited by 21 publications

References 59 publications

Retrospective analysis of equity-based optimization for COVID-19 vaccine allocation

Retrospective analysis of equity-based optimization for COVID-19 vaccine allocation

Hierarchies in the Decentralized Welfare State: Prioritization in the Housing Choice Voucher Program

Cost-based COVID-19 vaccination and willingness to pay: A post-pandemic review

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