Prioritising people of colour for the covid-19 vaccines when they were in short supply would have prevented more deaths than rolling out the vaccine purely by age groups, a US modelling study suggests.
When the coronavirus vaccines were in limited supply earlier this year, US authorities, along with most high-income countries, advised offering them first to healthcare workers, care home residents and then to people in age order. Age is one of the biggest determinants of risk from covid-19, but US and UK studies show that people of colour are also at higher risk 鈥� perhaps because they are more likely to live in crowded housing, have worse healthcare access and work in jobs with more .
at the University of Minnesota and her team investigated if a roll-out taking account of people鈥檚 race as well as their age would have avoided more deaths. They looked at two states, California and Minnesota, and modelled scenarios such as what would have happened if the vaccine had been offered to Black, Indigenous and people of colour (BIPOC) groups aged 50 to 64 when it was available more broadly for anyone aged 65 to 69.
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They found that offering vaccines to groups of people defined by race and age bands, rather than just by age, would have avoided more risk of death. They didn鈥檛 calculate the number of deaths that might have been avoided by this strategy because the covid-19 death rate has varied throughout the pandemic.
As targeting people by their race could have been discriminatory, health services should have organised vaccine distribution by combining age bands with where people live, to target neighbourhoods with high numbers of BIPOC people, says Wrigley-Field.
The researchers found that, in California, targeting the vaccine by combining age bands with lower-income geographical neighbourhoods would have been effective at reaching BIPOC groups, but that this strategy would have worked less well in Minnesota.
They also discovered that, in some circumstances, it could be helpful to introduce pop-up clinics offering vaccines to all adults within small, very high-risk neighbourhoods if uptake among older people is low there. 鈥淵ou can鈥檛 look at determinants of risk one at a time,鈥� says Wrigley-Field.
She says that future booster jabs designed for any newer, dangerous coronavirus variants should be targeted by combining age bands with geographic neighbourhoods. 鈥淲e are thinking ahead to boosters that may have a roll-out where there鈥檚 not enough for everybody.鈥�
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