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Evaluation of Health Equity in COVID-19 Vaccine Distribution Plans in the United States

Educational Objective
To identify the key insights or developments described in this article
1 Credit CME

SARS-CoV-2 and the resulting COVID-19 pandemic has affected more than 106 million people worldwide with more than 2.31 million deaths as of February 2021.1 Upon the emergency use authorization for a COVID-19 vaccine by the US Food and Drug Administration, the National Academies of Sciences, Engineering, and Medicine developed an overarching framework to assist US policy makers in planning for equitable allocation of COVID-19 vaccines.2 Minority populations have approximately 5 times greater risk of adverse COVID-19 consequences related to social determinants of health that may exacerbate patient comorbidities.4,6 Equitable distribution would eliminate vaccination disparities while mitigating the disproportionate effect of the COVID-19 pandemic in underserved populations, which are disadvantaged because of limited access to health care, low socioeconomic status, or race. This study aims to determine how every state planned to ensure equitable vaccine distribution.

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CME Disclosure Statement: Unless noted, all individuals in control of content reported no relevant financial relationships. If applicable, all relevant financial relationships have been mitigated.

Article Information

Accepted for Publication: May 1, 2021.

Published: July 2, 2021. doi:10.1001/jamanetworkopen.2021.15653

Open Access: This is an open access article distributed under the terms of the CC-BY License. © 2021 Hardeman A et al. JAMA Network Open.

Corresponding Author: Juan C. Rojas, MD, Department of Medicine, University of Chicago, 5841 S Maryland Ave, MC 6076, Chicago, IL 60637 (jrojas1@medicine.bsd.uchicago.edu).

Author Contributions: Drs Rojas and Wong had full access to all of the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis. Dr Hardeman and Ms Wong are co-first authors and contributed equally to this work.

Concept and design: All authors.

Acquisition, analysis, or interpretation of data: Hardeman, Wong, Denson, Postelnicu.

Drafting of the manuscript: All authors.

Critical revision of the manuscript for important intellectual content: Hardeman, Wong, Denson, Postelnicu.

Statistical analysis: Postelnicu.

Administrative, technical, or material support: Denson, Postelnicu.

Supervision: Denson, Postelnicu, Rojas.

Conflict of Interest Disclosures: Dr Denson reported receiving grants from the Society of Critical Care Medicine and the Betty Moore Foundation outside of the submitted work. No other disclosures were reported.

Funding/Support: Dr Denson was supported by grant 7-20-COVID-053 from the American Diabetes Association, grant U54 GM104940 from the National Institutes of Health, and grant 75D301-20-R-67897 from the US Centers for Disease Control and Prevention.

Role of the Funder/Sponsor: The funders had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.

References
1.
McClung  N , Chamberland  M , Kinlaw  K ,  et al.  The Advisory Committee on Immunization Practices’ ethical principles for allocating initial supplies of COVID-19 vaccine—United States, 2020.   MMWR Morb Mortal Wkly Rep. 2020;69(47):1782-1786. doi:10.15585/mmwr.mm6947e3PubMedGoogle ScholarCrossref
2.
US Food and Drug Administration. FDA takes key action in fight against COVID-19 by issuing emergency use authorization for first COVID-19 Vaccine. U.S. Food and Drug Administration. December 11, 2020. Accessed April 19, 2021. https://www.fda.gov/news-events/press-announcements/fda-takes-key-action-fight-against-covid-19-issuing-emergency-use-authorization-first-covid-19
3.
US. COVID-19 vaccination program interim playbook for jurisdiction operations. October 29, 2020. Accessed January 31, 2021. https://www.cdc.gov/vaccines/imz-managers/downloads/COVID-19-Vaccination-Program-Interim_Playbook.pdf
4.
Webb Hooper  M , Nápoles  AM , Pérez-Stable  EJ .  COVID-19 and racial/ethnic disparities.   JAMA. 2020;323(24):2466-2467. doi:10.1001/jama.2020.8598PubMedGoogle ScholarCrossref
5.
Farroni  JS , Tumilty  E , Mukherjee  D , McCammon  S , Chooljian  DM , Eves  MM .  Emerging roles of clinical ethicists.   J Clin Ethics. 2019;30(3):262-269.PubMedGoogle Scholar
6.
Marshall  WF . Coronavirus infection by race: what's behind the health disparities? Mayo Clinic. August 13, 2020. Accessed April 19, 2021. https://www.mayoclinic.org/diseases-conditions/coronavirus/expert-answers/coronavirus-infection-by-race/faq-20488802
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