States are already facing substantial lobbying over which professions should be deemed frontline. They’re poised to initiate another wave of injustices and are guaranteed to generate the same kinds of discord that turned face masks into symbols of partisanship. The takeaway is that attempts to prioritize groups by granular categories aren’t just impractical. If vaccinating a few thousand health care workers is this complicated, one can only imagine the chaos in store as we try to vaccinate a few hundred million Americans. The test is whether the system is easy to implement, transparent, broadly acceptable, generally equitable and resistant to abuse.Īlready in the past two weeks, vaccine distribution in several top health systems - which enjoy world-class computer systems and have robust human resources departments that can track their employees - have devolved into line-jumping, cheating and noisy protests over who goes first.
VACCINE ROLLOUT TIMELINE DRIVER
But the crucial test of the next few months will not be whether we have devised an allocation system that accurately parses whether a 27-year-old Latino bus driver should go before or after a 52-year-old white store manager with diabetes. The current plans to vaccinate essential workers and people with medical conditions early have obvious merit. But, as Winston Churchill might have said, it’s the worst system except for all the others. Lotteries are hardly a perfect way to distribute vaccines. Then, to determine the order for the remaining 150 million or so American adults, use a lottery. Then we should vaccinate all people over 55, from oldest to youngest, a group of approximately 97 million that accounts for the vast majority of Covid-19 deaths. By the end of January, we should be done vaccinating health care workers and long-term-care residents. We suggest a more straightforward approach. This would only sow distrust in the broader public. There are plans that try to take into account the disproportionate toll of Covid-19 on people of color, the inability of certain workers to avoid exposure, and the higher risk of illness and death in the elderly and in individuals with underlying health conditions.īut in their well-meaning effort to achieve equity and fairness, these plans threaten to become excessively complex - and thus ripe for manipulation by the privileged, including myriad interest groups that are vying for a place at the front of the line. However, with a limited supply, a halting rollout and the threat of an even more contagious version of the virus now in the mix, the debate over who goes first has become increasingly contentious. The miraculous development of two Covid-19 vaccines offers us a real chance to end the pandemic in 2021.
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