EQUITY A MUST
There is sound logic in Connecticut’s new age-based COVID-19 vaccine rollout plan, but Gov. Lamont cannot lose sight of those getting left out
Gov. Ned Lamont upended Connecticut’s COVID-19 vaccine rollout plan Monday, tossing aside CDC guidance and shifting to a far simpler plan that will prioritize vaccine eligibility based on one criterion: age.
The change promises to get more vaccine into more people’s arms faster but has sparked serious concerns on two fronts.
First, in setting aside priority for most frontline essential workers, which includes grocery store employees among others, the new plan sidelined a group with a relatively high representation of Black workers. That is a serious issue in a state that has significantly lagged when it comes to equitable distribution of the lifesaving COVID-19 vaccine.
It also moved down the priority list people under the age of 55 with comorbidities known to worsen the effects of the coronavirus. Cancer, diabetes, severe obesity and other medical conditions have been established by the CDC as aggravating factors for those infected with COVID-19. A federal disabilities lawsuit was filed Wednesday.
But the plan also recognizes a simple reality we have painfully witnessed as we’ve lost grandparents, parents, aunts and uncles over this last year: Age is the single largest risk factor. The older you are, the more likely you will die from COVID-19. As of Feb. 24, those 50 and older accounted for 98 percent of all COVID-19-related deaths in
Connecticut, according to state data. Of the 7,595 COVID-19-associated deaths in Connecticut, 163 were people under the age of 50. Prioritizing by age makes a lot of sense.
The new system also acknowledges the limitations of state government and the likelihood of bureaucratic tangles. Was the grocery store worker category going to include retail workers in big-box stores that also sell food? Who would verify that someone signing up for the vaccine actually works in, say, manufacturing — a profession that includes many independent contractors? Would a doctor’s note or prescription need to be reviewed before someone with a preexisting condition was eligible for a shot?
In a state that has trouble making something as simple as renewing a driver’s license easy, this system had the potential to both significantly slow the process of vaccine distribution and open the door to fraud and abuse.
Finally, the plan — in focusing on speed and simplicity — recognizes that the faster more people are inoculated, the more benefits there may be for everyone in Connecticut. There is increasing evidence that both the Pfizer and Moderna vaccines don’t just prevent serious illness, they slow the rate of transmission. If that proves true — and there are numerous studies underway to test that theory — the impact of moving more quickly will benefit
The Lamont administration, however, is still explaining how this policy was crafted, as it circumvented the process set up to make recommendations on a vaccine rollout strategy. While a Lamont spokesman said several members of the state’s advisory group on vaccine distribution were consulted, along with other experts, the issue did not get a full airing before the committee. A dramatic departure from the committee’s recommendations, which followed CDC guidance, should have been up for public discussion and review.
The administration also has yet to provide detail on the critical question of how, under this new model, the state will address the issue of equity. While Connecticut has been a national leader in vaccine distribution, that distinction has not benefited all equally. Among those 75 and older, about 31 percent of white residents had received the vaccine compared with only 19 percent of Black residents as of early February. That gap aggravates an already grim reality — death and serious illness have disproportionately hit the Black community.
In announcing the rollout, Gov. Lamont committed to putting additional focus on community outreach to help tackle this problem and issuing numerical goals to ensure accountability. That promise needs to move quickly from concept to action, with transparency into both process and outcomes. The state resources that might have been tied up in confirming eligibility under the original plan should now be deployed to improving access and bolstering community outreach — both key factors in the effort to achieve greater equity in vaccine distribution.
The shift in vaccine priorities made the eligibility pool less diverse. That is a problem, a reality that demands the rollout be far more equitable than it has been to date. Even with the new eligibility guidelines, there is plenty of room — and need — for dramatic improvement. Among those who will be eligible to be vaccinated starting March 1 — including teachers and residents 55 and older — the state must move aggressively to ensure the gaps we have already seen in the older groups are reversed. That means getting the vaccine into more neighborhoods and working with community organizations on logistics like registration and transportation. The state must be as committed to equitable distribution as it is to maintaining its national status as a leader in overall distribution.
After a year of fear, death and loss, there are promising signs on the horizon. The vaccines are working. Coronavirus infection rates in Connecticut are dropping. Deaths are slowing. Simplifying the eligibility process and prioritizing older residents have the potential to accelerate that process and get more people back to some semblance of how life looked before coronavirus upended our lives.
In moving faster, Gov. Lamont must ensure communities of color are not left behind. The coronavirus pandemic has aggravated racial inequities in education, health care and employment. In the effort to ensure the COVID-19 vaccine is distributed equitably, we don’t simply have an opportunity. We have a duty.