ECRI Statement on Equitable Distribution of COVID-19 Vaccine

The National Academies of Science, Engineering and Medicine (NASEM) just released a draft framework on equitable allocation of COVID-19 vaccine. The NASEM has published this publicly for review and comments.

The study was requested by the CDC and NIH with the expectation that such a framework would inform the decisions by health authorities, including the Advisory Committee on Immunization Practices (ACIP), as they create and implement national and/or local guidelines for SARS-CoV-2 vaccine allocation.

It is ECRI’s objective observation that it is important to first be certain that the appropriate rigor went into the development and testing of each vaccine. Rushing the process to mass distribute a vaccine, even in the most well thought out way, means nothing if the vaccine is not effective. At the same time, vaccine distribution resulting from such a rapid development cycle is likely to lead to a rapid relaxation of social distancing, which would lead to an increase in exposure risks. The FDA has set a threshold of 50% efficacy.  Groups who receive the vaccine believing they are effectively protected, and are not, will be at increased risk of infection. It is also important for leaders to understand a vaccination is not a replacement for adequate PPE. This is a yes, and conversation. Also, there needs to be a recognition that some of the vaccines may need a booster, so it would be important to anticipate this, as well as the risks to the population if boostering does not occur and many are now not protected as above.

With regards to the equitable allocation of the vaccine, it is encouraging to note that equity is a crosscutting consideration in that, in each phase of distribution, is expected to be prioritized by the geographic areas identified as socially vulnerable by the CDC on the basis of several factors or themes such as socioeconomic status, household composition, race/ethnicity/language and Housing and transportation. The Social Vulnerability Index (SVI), which has been used to estimate the amount of supplies needed in the event of an emergency, will be used to determine the vaccine allocation pattern as well.