Fairness and efficiency considerations in COVID-19 vaccine allocation strategies: A case study comparing front-line workers and 65-74 year olds in the United States.
Fairness and efficiency considerations in COVID-19 vaccine allocation strategies: A case study comparing front-line workers and 65-74 year olds in the United States.
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DOI：
10.1371/journal.pgph.0001378
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发表时间：
2023
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美国新冠肺炎疫情的特点是两个明显的差异。新冠肺炎的负担在种族和民族之间分配不均，与此同时，老年群体的死亡率大幅上升。这些差异导致一些人提出，可以通过先为一线工作人员接种疫苗再为老年人接种疫苗来减少不平等，因为在美国，老年人中非西班牙裔白人的比例不成比例。我们比较了两种分配政策的表现，一种是向一线工作人员分配疫苗，另一种是向65-74岁的老年人分配疫苗。我们估计，在美国和每个州，根据每项政策，在总体上和在每个种族/族裔群体中，挽救的生命数量和挽救的生命年数。我们表明，与在每个种族/民族、整个美国和几乎每个州分配疫苗相比，优先为65-74岁的老年人接种新冠肺炎疫苗可以挽救更多的生命和更多的生命年数。在评估疫苗分配政策的公平性时，应考虑每个人口亚组对影响的总体益处，而不仅仅是分配给每个亚组的疫苗的比例。进一步的工作可以确定在多个股权指标上表现更好的优先顺序方案。
The COVID-19 epidemic in the United States has been characterized by two stark disparities. COVID-19 burden has been unequally distributed among racial and ethnic groups and at the same time the mortality rates have been sharply higher among older age groups. These disparities have led some to suggest that inequalities could be reduced by vaccinating front-line workers before vaccinating older individuals, as older individuals in the US are disproportionately Non-Hispanic White. We compare the performance of two distribution policies, one allocating vaccines to front-line workers and another to older individuals aged 65-74-year-old. We estimate both the number of lives saved and the number of years of life saved under each of the policies, overall and in every race/ethnicity groups, in the United States and every state. We show that prioritizing COVID-19 vaccines for 65-74-year-olds saves both more lives and more years of life than allocating vaccines front-line workers in each racial/ethnic group, in the United States as a whole and in nearly every state. When evaluating fairness of vaccine allocation policies, the overall benefit to impact of each population subgroup should be considered, not only the proportion of doses that is distributed to each subgroup. Further work can identify prioritization schemes that perform better on multiple equity metrics.