Working Paper: NBER ID: w27817
Authors: Parag A. Pathak; Harald Schmidt; Adam Solomon; Edwin Song; Tayfun Sönmez; M. Utku Ünver
Abstract: A major focus of debate about rationing guidelines for COVID-19 vaccines is whether and how to prioritize access for minority populations that have been particularly affected by the pandemic, and been the subject of historical and structural disadvantage, particularly Black and Indigenous individuals. We simulate the 2018 CDC Vaccine Allocation guidelines using data from the American Community Survey under different assumptions on total vaccine supply. Black and Indigenous individuals combined receive a higher share of vaccines compared to their population share for all assumptions on total vaccine supply. However, their vaccine share under the 2018 CDC guidelines is considerably lower than their share of COVID-19 deaths and age-adjusted deaths. We then simulate one method to incorporate disadvantage in vaccine allocation via a reserve system. In a reserve system, units are placed into categories and units reserved for a category give preferential treatment to individuals from that category. Using the Area Deprivation Index (ADI) as a proxy for disadvantage, we show that a 40% high-ADI reserve increases the number of vaccines allocated to Black or Indigenous individuals, with a share that approaches their COVID-19 death share when there are about 75 million units. Our findings illustrate that whether an allocation is equitable depends crucially on the benchmark and highlight the importance of considering the expected distribution of outcomes from implementing vaccine allocation guidelines.
Keywords: COVID-19; Vaccine Allocation; Equity; Minority Populations; Area Deprivation Index
JEL Codes: D47; I14; I28
Edges that are evidenced by causal inference methods are in orange, and the rest are in light blue.
| Cause | Effect |
|---|---|
| ADI reserve (Y20) | Vaccine allocation to disadvantaged groups (I14) |
| Vaccine allocation to Black and Indigenous individuals (J15) | Share of vaccines received compared to population share (Y10) |
| Reserve system based on ADI (F33) | Vaccine allocation to Black and Indigenous individuals (J15) |
| Vaccine allocation under 2018 CDC guidelines (I18) | Share of vaccines received by Black and Indigenous populations (J15) |