This commentary is by Liz Winterbauer, a consulting epidemiologist and health services researcher. She also teaches at UVM and St. Michael’s College in Vermont.
From the beginning of the pandemic, Vermont has had a thoughtful, data-driven approach with the goal of minimizing direct harm from Covid-19. The state has kept hospitalizations and deaths low and its early choice to distribute vaccines by descending age groups has saved lives. As of March 25, vaccination is available to those most at risk of dying from Covid-19 (94% of deaths occurred in persons age 60+).
On the other hand, more Vermonters are being infected by Covid-19 today than at almost any time during the pandemic, and neighboring states are experiencing disturbing increases in cases. We need to again listen to our data and refocus vaccine prioritization to those most likely to become infected and/or transmit Covid-19.
As of Monday March 29, all Vermonters age 50-59 may sign up for the vaccine. Yet, the rate of Covid-19 cases in those aged 50-59 is lower than every age group between 10 and 49 years. Younger Vermonters are fueling the pandemic, with more cases in 20-29-year-olds than any other group. Cases also vary by race and ethnicity, with Blacks and Asians infected at two to three times higher rates than whites, and Hispanic Vermonters infected more often than non-Hispanic ones.
Instead of continuing the age-banding approach, I suggest reserving enough vaccine doses to immediately:
- Vaccinate on-campus students and staff at every college and university in the state.
- Vaccinate all inmates.
- Vaccinate frontline workers at grocery stores, restaurants, and other businesses that have stayed open and have frequent, regular interactions with people outside of their homes.
- Prioritize communities disproportionately impacted by Covid-19.
Because there are only minor differences in the risk of harm for Vermonters between ages 16 and 49, we should open up vaccination to everyone else once we’ve provided targeted vaccinations to those at most risk of infection.
I am 44 years old, and eager to feel the increased normality getting vaccinated might bring. But my spouse and I work from home, and our children attend virtual learning programs. We are not contributing substantially to transmission, and feel deeply for others whose lives and livelihoods are threatened every day they remain unvaccinated.
I also recognize that my family is more at risk in the long run if we don’t reexamine our vaccine priorities. I still expect to be fully vaccinated by Gov. Scott’s July 4 target, even if we change our strategy as I’ve recommended.
A reasonable seeming objection to changing course is that we’re less than a month away from allowing everyone to schedule their vaccination. But a lot can happen in a month of this pandemic:
- College students may need to transition to remote learning and increased restrictions for the rest of their spring semester.
- Frontline workers could become infected and struggle with debilitating long-haul symptoms.
- Medical providers will need to care for even more patients with Covid-19 symptoms over the next months or years.
- Children, who may need to wait until 2022 before receiving a safety-tested vaccine, will have to wait longer to see their friends safely because of the high amount of Covid-19 in their community.
If we don’t make a serious effort to greatly reduce transmission, this pandemic will not end. The more people we allow to become infected, the more mutated Covid-19 strains will emerge. Unfortunately, some variants are proving more transmissible, more deadly, or sometimes both. Our children may be more susceptible to these variants. Most worrying of all, each day with widespread transmission increases the chance Covid-19 adapts to evade our current vaccines.
The virus is evolving. So must our strategy.
