Florida’s Vaccine Strategy Adds to Some Health Inequities: CDC Advisor
Several more places are now open for some Floridians to get a COVID-19 vaccine shot. Publix, Winn-Dixie, and Harveys grocery stores now dole out doses. Other pharmacies are now dispersing shots, even as the number of people getting vaccinations over the past seven days dropped compared to last week.
New federally-run COVID-19 vaccine locations will open next week in Miami, Jacksonville, Orlando, and Tampa. They will help in adding to the more than 1.5 million seniors in the state who have already received both doses. As more Floridians receive their shots, a new analysis of state vaccine plans found Florida is the only state that has not telegraphed who will be next in line for a vaccine.
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Dr. Jason Goldman is an American College of Physicians liaison to the CDC advisory committee on immunization practices. He joined host Tom Hudson on the Florida Roundup to discuss vaccine eligibility.
Here’s an excerpt of the conversation:
HUDSON: Tell us the scientific recommendation for who should be next in line to receive COVID-19 vaccinations?
GOLDMAN: The guidelines have never really changed. The initial phase was based on ethical considerations, fairness, justice to make sure that those most at need, not just at risk for getting the disease and dying from it, but those that are most at risk for transmitting, balance with those who are essential to the functions of society as well as making sure that we had equity and eliminated health care disparities.
So those guidelines really haven't changed with health care workers, those over 75, and those in long-term care facilities. And then when we went to 1B, it was those over 75, as well as those who were on the front line and essential workers. It was never meant to be an age-based approach because an age-based approach, in and of itself, doesn't solve the ethics and the fairness, especially when you consider that minorities and people of color, many of them may not reach age 65 because of the health care disparities. Yet they're on the front lines, and we've seen a disproportionate number of them fall prey to this illness. So, an age-based approach is not really where it was intended to go. We really needed to give the vaccine to those most at risk of getting the disease who could not protect themselves through other means.
Florida did not follow those recommendations, which came out in early December and then were amended to some degree in mid-December. You spoke about these recommendations being grounded in fairness, justice, and equity. Because Florida has really followed an age-based eligibility, although it does have health care workers, long-term care residents, and those with certain underlying medical conditions that present more vulnerability to COVID-19, should the virus present in those patients. With the Florida strategy being really focused on age-based 65 plus, is that unfair, unjust, and inequitable?
In some ways, yes, it is because what it is not doing is giving it to those who may be most at risk for getting the disease. Certainly, we know that the elderly population is more at risk for dying, but they may be able to protect themselves through other means as opposed to someone who's on the front lines and cannot get to protect themselves through other means. Someone who has to go to work, has to be in the public, has to be exposed to people, may need the vaccine more than someone who can isolate and quarantine.
Has Florida's age-based strategy added to health inequities?
In some ways, it has. As I said, you know, many people in minorities and people of color won't get to age 65. You know, we've found through the American College of Physicians studies that one of the biggest determinants of life expectancy was your zip code. So we know that if you were not living in the right zip code, you may not live as long. So we really need to target those who are most at risk for getting the disease as well as balanced and necessary functions of society.
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