Imagine this: In order to see what gets the COVID vaccine, you open up an app on your phone and enter in all your medical problems. A doctor certifies the medical problems and a priority number is generated on the app. Periodic announcements are made by local health departments asking for people who have higher scores to come in for their vaccine.
Your app shows that you have a score of 92 and all those with a score between 90 and 95 are asked to show up for the vaccine. You show up at the vaccine site, open up the app, show your priority number and are given the vaccine. Your friend who has cancer and diabetes, had a much higher score and already got the vaccine much before you.
Currently, there is no plan to take into account medical problems when deciding who gets the vaccine first. This creates inequality as there are some people who are young but have more medical problems that puts them at risk for having a bad outcome with COVID. So, a young person with diabetes and obesity might be at a higher risk of having problems with COVID but under the current plan, will probably be the last to get the vaccine. This will cause unnecessary deaths amongst younger people who are vulnerable due to their medical conditions.
The proposed web-based system will ask people if they have diabetes, chronic kidney disease, COPD, Down’s syndrome, heart disease, obesity, pregnancy, sickle cell disease, diabetes or are a smoker. These are all medical problems that the CDC lists as causing an increased risk of severe illness with COVID. Additional points would be given for each of these medical conditions.
Age would also be given additional points and it is possible that some older people who have these medical problems would be very far ahead on the list. However, it would give some younger people who have many medical conditions a chance to get the vaccine first.
Ideally, this system should have been set up prior to the vaccine being available so we are behind in developing such a system. Speed is of the essence to prevent unnecessary deaths amongst vulnerable populations. The model can be a simpler one to start and as time goes on, can be made more complicated and can use newer data on risk factors to recalculate the score if need be.
Allocating scarce resources is common ethical problem and when we do it an organized logical fashion, it affirms our faith in humanity. The distribution of this vaccine worldwide is problem of gargantuan proportions and we need to design a better more equitable system that allow the vulnerable people a better chance of getting this life saving vaccine.