The vaccine rollout was meant to prioritize vulnerable communities, but four months of data shows healthier — and often wealthier — counties have been faster to vaccinate.
As the U.S. rushes to vaccinate its population against the coronavirus, most counties with the sickest residents are lagging behind and making only incremental progress reaching their most vulnerable populations.
A ProPublica analysis of county data maintained by the U.S. Centers for Disease Control and Prevention shows that early attempts to prioritize people with chronic illnesses like heart disease, diabetes and obesity have faltered. At the same time, healthier — and often wealthier — counties moved faster in vaccinating residents, especially those 65 and older. (Seniors are a more reliable measure of vaccination progress than younger adults, who are less likely to have been eligible long enough to receive their second shots.) Counties with high levels of chronic illnesses or “comorbidities” had, on average, immunized 57% of their seniors by April 25, compared to 65% of seniors in counties with the lowest comorbidity risk.
A similar gap has also opened for all other adults. The one-third of counties with the highest chronic illness risk have on average finished shots for 15% of their 64-and-under residents, four percentage points below the average for the healthiest one-third of counties.
In counties with high rates of chronic disease, residents are more likely to die prematurely from heart or pulmonary diseases, diabetes or illnesses related to smoking or obesity. Those conditions also increase a person’s risk of developing severe COVID-19.
People with chronic illnesses are especially important to vaccinate because their coronavirus infections are more likely to end in hospitalization and death, said Janet Baseman, an epidemiology professor at the University of Washington. If counties with high comorbidities remain behind, she said, “then we are not accomplishing our objective, as communities or as a nation, of saving lives.”
In the four months since public vaccinations began, clear disparities have emerged in how quickly the richest and poorest counties have delivered shots to their residents. Multiple health experts and officials say the numbers underscore a key strategic misstep under the Trump administration, which asked state and local governments to prioritize people with illnesses that would increase their chances of hospitalization or death, but provided no additional funding to support the efforts.
Many states chose a simpler approach, opening vaccine appointments to everyone 65 and older with minimal on-the-ground outreach to people with chronic illnesses. “It made some states go a little bit faster,” said Dr. Grace Lee, a member of the CDC’s Advisory Committee on Immunization Practices and an infectious diseases physician at Stanford Children’s Health. “But I think it really increased the inequities early on.” Continue Reading