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'It's Complicated' Is Not Good Enough: Why Connecticut May Be Missing The Mark On Vaccine Equity

Madeline Fall, 25, of Vernon, receives the first dose of the Pfizer vaccine from at Connecticut’s largest drive-through vaccination clinic. “I’m the first one in my family to get this so I kind of feel like a guinea pig," said Fall, a health care worker.
Cloe Poisson

Connecticut has bucked national trends -- and CDC guidance -- by prioritizing COVID-19 vaccination on a strictly age-based system. Gov. Ned Lamont and his top public health officials have argued this simpler approach is more efficient and equitable -- and now they’ve reinforced that approach by moving up to April 1 the date when everyone over 16 can sign up for a shot. 

But Dr. Saad Omer, the director of the Yale Institute for Global Health, says by leaving out younger, high-risk individuals, Connecticut’s vaccine strategy has already missed the mark.

In arguing for a largely age-based approach, the Lamont administration pointed to the fact that 96% of COVID-related deaths in Connecticut were residents over the age of 55. And Omer said it did make sense to prioritize by age for the first stages of the general public vaccine rollout. 

“I think there was a lot of value on focusing on age in very early stages, and even going down to, say, 55 or above, because we know the risk of death is really, really high as your age progresses,” he said. 

But as Connecticut opens eligibility to younger and younger age ranges, Omer believes some will inevitably be left behind in the rush. 

“I think missing and not prioritizing people with comorbidities had implications,” he said.

Omer was part of a group of public health experts commissioned by the federal government to develop an initial framework for vaccine distribution. 

Speaking on Connecticut Public Radio’s Where We Live, he said Connecticut had the opportunity to start identifying high-risk individuals early on, because it was clear since the summer of 2020 -- when national guidance was first beginning to be developed -- that high-risk individuals with health conditions would be high priorities for vaccines. 

“What were we doing in terms of preparing throughout the fall to identify people with comorbidities?” Omer asked.

The Lamont administration has argued that determining which health conditions would or wouldn’t be eligible to be prioritized would be too complicated, and that could lead to equity concerns if wealthier residents could get doctor’s notes more easily than low-income communities. 

But Omer says “it’s complicated” is not a good enough reason to leave high-risk young people off the priority list, especially those with multiple comorbidities. 

“That’s what happens when you learn about the vaccine system on the job, not necessarily familiarizing senior members of your administration with the vaccine system,” said Omer. “It doesn’t compute well for our state to say that it was just too hard, and using, unfortunately, equity as the reason why we couldn’t identify or prioritize people.”

And he pointed out, it’s not as if the strategy is working on addressing the equity question. Connecticut has continued to see stark disparities in vaccination rates between white residents and residents of color. 

“So it’s not that we’re doing really well in terms of equity in our state and this is an approach that’s working,” said Omer. 

As of March 22, state Department of Public Health officials report that white residents are more than twice as likely than Black and Hispanic residents to be fully vaccinated against COVID-19, though officials caution that because they do not know the race of about 14% of those fully vaccinated, “coverage of these groups is likely underestimated and should be interpreted with caution.” 

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