Can vaccination roll-out be more equitable if population risk is taken into account?

<h4>Background</h4> COVID-19 vaccination in many countries, including England, has been prioritised primarily by age. However, people of the same age can have very different health statuses. Frailty is a commonly used metric of health and has been found to be more strongly associated wit...

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Autores principales:	David R. Sinclair, Asri Maharani, Daniel Stow, Claire E. Welsh, Fiona E. Matthews
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/4626976b8d3f4eafa80d41a675e54d21
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spelling	oai:doaj.org-article:4626976b8d3f4eafa80d41a675e54d212021-11-25T05:54:23ZCan vaccination roll-out be more equitable if population risk is taken into account?1932-6203https://doaj.org/article/4626976b8d3f4eafa80d41a675e54d212021-01-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC8592495/?tool=EBIhttps://doaj.org/toc/1932-6203<h4>Background</h4> COVID-19 vaccination in many countries, including England, has been prioritised primarily by age. However, people of the same age can have very different health statuses. Frailty is a commonly used metric of health and has been found to be more strongly associated with mortality than age among COVID-19 inpatients. <h4>Methods</h4> We compared the number of first vaccine doses administered across the 135 NHS Clinical Commissioning Groups (CCGs) of England to both the over 50 population and the estimated frail population in each area. Area-based frailty estimates were generated using the English Longitudinal Survey of Ageing (ELSA), a national survey of older people. We also compared the number of doses to the number of people with other risk factors associated with COVID-19: atrial fibrillation, chronic kidney disease, diabetes, learning disabilities, obesity and smoking status. <h4>Results</h4> We estimate that after 79 days of the vaccine program, across all Clinical Commissioning Group areas, the number of people who received a first vaccine per frail person ranged from 4.4 (95% CI 4.0-4.8) and 20.1 (95% CI 18.3-21.9). The prevalences of other risk factors were also poorly associated with the prevalence of vaccination across England. <h4>Conclusions</h4> Vaccination with age-based priority created area-based inequities in the number of doses administered relative to the number of people who are frail or have other risk factors associated with COVID-19. As frailty has previously been found to be more strongly associated with mortality than age for COVID-19 inpatients, an age-based priority system may increase the risk of mortality in some areas during the vaccine roll-out period. Authorities planning COVID-19 vaccination programmes should consider the disadvantages of an age-based priority system.David R. SinclairAsri MaharaniDaniel StowClaire E. WelshFiona E. MatthewsPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 16, Iss 11 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q David R. Sinclair Asri Maharani Daniel Stow Claire E. Welsh Fiona E. Matthews Can vaccination roll-out be more equitable if population risk is taken into account?
description	<h4>Background</h4> COVID-19 vaccination in many countries, including England, has been prioritised primarily by age. However, people of the same age can have very different health statuses. Frailty is a commonly used metric of health and has been found to be more strongly associated with mortality than age among COVID-19 inpatients. <h4>Methods</h4> We compared the number of first vaccine doses administered across the 135 NHS Clinical Commissioning Groups (CCGs) of England to both the over 50 population and the estimated frail population in each area. Area-based frailty estimates were generated using the English Longitudinal Survey of Ageing (ELSA), a national survey of older people. We also compared the number of doses to the number of people with other risk factors associated with COVID-19: atrial fibrillation, chronic kidney disease, diabetes, learning disabilities, obesity and smoking status. <h4>Results</h4> We estimate that after 79 days of the vaccine program, across all Clinical Commissioning Group areas, the number of people who received a first vaccine per frail person ranged from 4.4 (95% CI 4.0-4.8) and 20.1 (95% CI 18.3-21.9). The prevalences of other risk factors were also poorly associated with the prevalence of vaccination across England. <h4>Conclusions</h4> Vaccination with age-based priority created area-based inequities in the number of doses administered relative to the number of people who are frail or have other risk factors associated with COVID-19. As frailty has previously been found to be more strongly associated with mortality than age for COVID-19 inpatients, an age-based priority system may increase the risk of mortality in some areas during the vaccine roll-out period. Authorities planning COVID-19 vaccination programmes should consider the disadvantages of an age-based priority system.
format	article
author	David R. Sinclair Asri Maharani Daniel Stow Claire E. Welsh Fiona E. Matthews
author_facet	David R. Sinclair Asri Maharani Daniel Stow Claire E. Welsh Fiona E. Matthews
author_sort	David R. Sinclair
title	Can vaccination roll-out be more equitable if population risk is taken into account?
title_short	Can vaccination roll-out be more equitable if population risk is taken into account?
title_full	Can vaccination roll-out be more equitable if population risk is taken into account?
title_fullStr	Can vaccination roll-out be more equitable if population risk is taken into account?
title_full_unstemmed	Can vaccination roll-out be more equitable if population risk is taken into account?
title_sort	can vaccination roll-out be more equitable if population risk is taken into account?
publisher	Public Library of Science (PLoS)
publishDate	2021
url	https://doaj.org/article/4626976b8d3f4eafa80d41a675e54d21
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Can vaccination roll-out be more equitable if population risk is taken into account?

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