How to Ration Vaccines

Basing eligibility on age from now on is the scientific, and least political, method.

BWSJ editorial. Excerpt:

"Industry groups including hotels, airlines and ride-share companies are also lobbying states to have their workers vaccinated first. Gov. Andrew Cuomo this week announced that restaurant, taxi and ride-share drivers would be next in line for vaccines. But why restaurant workers before retail workers or 60-year-olds?

Workers who interact with the public face a higher risk of getting Covid than those who don’t. But households are bigger spreaders than workplaces, and age is the biggest risk factor. A 25-year-old Uber driver is less likely to get severely ill than the 50-something parents he lives with. There’s nothing “equitable,” to borrow a progressive buzz word, about prioritizing millennial workers over Baby Boomers.

Requiring “essential” workers to prove their eligibility also creates gratuitous bureaucratic headaches. Ditto for underlying conditions. Colorado has prioritized people with one or more “high-risk” medical conditions alongside those over 60, and Florida has done so for those “extremely vulnerable.” How are people supposed to prove their vulnerability?

Determining who is vulnerable or high-risk is as fraught as determining who is an essential worker. More than 40% of Americans meet the definition of obese (i.e., a body mass index over 30), but an Annals of Internal Medicine study found that the morbidly obese—those with BMIs over 40—are most at risk.

Studies have found that age accounts for most risk attributed to medical conditions—that is, older people are more likely to have hypertension and diabetes. A 40-year-old with hypertension is at modestly higher risk than someone of the same age who doesn’t have a chronic condition, but he is still far less likely to get severely sick than an average 60-year-old.

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Basing eligibility in stages from oldest to youngest from now on is simple, scientific and fair. As supply increases, this will be the fastest way to inoculate the most people, reduce demands on the health-care system, and allow more businesses to reopen. Interest groups will complain, but the public will understand and politicians won’t take the inevitable grief for favoritism."