The disparate impact of age-based COVID-19 vaccine prioritization by race/ethnicity in Denver, Colorado

• Published in: Health Policy OPEN Vol. 3; p. 100074
• Main Authors: Aiona, Kaylynn, Bacon, Emily, Podewils, Laura J., Haas, Michelle K.
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier B.V 01.12.2022; The Authors. Published by Elsevier B.V; Elsevier
• Subjects: COVID-19; Health Equity; Immunization; Race/ethnicity; COVID-19; Immunization; Health Equity; Race/ethnicity
• ISSN: 2590-2296; 2590-2296
• DOI: 10.1016/j.hpopen.2022.100074

•Rates of COVID-19 hospitalization and death are higher among communities of color.•Differences in COVID-19 outcomes by race/ethnicity are greater at younger age groups.•Fewer percentages of Black and Latino COVID-19 outcomes met vaccine prioritization criteria.•Age-based vaccine prioritization policy systematically advantaged White residents in Denver. COVID-19 vaccines are an effective tool in preventing severe disease. Most states used an age-based prioritization for vaccine rollout. We examined the impact of a primarily age-based prioritization policy on reductions of severe disease in different racial and ethnic groups. We calculated age-specific rates of COVID-19 hospitalization and death by race/ethnicity in Denver, Colorado. To assess potentially averted hospitalizations and deaths by race/ethnicity, we then applied the first three phases of Colorado’s primarily age-based vaccine rollout criteria to historical 2020 COVID-19 hospitalizations and deaths in Denver, Colorado. In the first 3 phases, 40% (1403/3473) of hospitalizations and 83% (503/604) of deaths occurred among those meeting age and long-term care facility criteria and could have been averted. Impacts varied by race/ethnicity with only 28% (440/1587) of hospitalizations and 74% (131/178) of deaths averted among Hispanic or Latino residents, compared to 57% (619/1094) of hospitalizations and 92% (252/274) of deaths among non-Hispanic White residents. We demonstrate using local data and policy that early age-based prioritization decisions disproportionately promoted reductions in severe disease among non-Hispanic White residents irrespective of COVID-19 risk in Denver, Colorado. These findings suggest that more equitable future vaccine prioritization policies, which lead with a goal of reducing health disparities through prioritizing susceptibility to adverse health outcomes rather than overall population-based cutoffs, are necessary. Our results have implications for future vaccination rollouts in limited vaccine resource conditions.