As health care workers and nursing home residents await the first scarce syringes of COVID-19 vaccine, few realize that when they will get a dose depends a lot on what state they live in.
Though they’re first in line for the vaccine, some people in those groups may end up getting vaccinated after people in other states who are deemed lower priority.
The vaccine is allocated according to the number of adults in each state, which doesn’t correlate to the number of high-risk people there. As long as supplies are limited, some states won’t get doses proportionate to their needs.
In those places, medical workers and residents of long-term care facilities will be exposed to the coronavirus for weeks or months longer. They’ll be more vulnerable to sickness and death.
Nevada is one of the winners. According to a USA TODAY analysis of data from Surgo Ventures and Ariadne Labs, the state has relatively few residents in the highest priority group. Based on the federal formula, it will be able to vaccinate all front-line health workers and nursing home residents once the federal government distributes 13.6 million doses nationwide.
Massachusetts, which has a lot of medical workers, won’t hit that threshold until 25.5 million doses have been distributed across the country – potentially weeks into the new year. By the time Massachusetts vaccinates the last person in its highest priority group, Nevada could have moved on to lower priority groups such as elderly people, teachers and grocery workers.
Washington, D.C., fares worst in the country. It won’t be able to vaccinate all its health care workers until 27.3 million doses have been distributed nationwide.
Mayor Muriel Bowser sent a letter this month to Operation Warp Speed leaders complaining about the “one-size-fits-all formula.” The distribution plan, she wrote, “will leave the district unable to provide vaccinations to the vast majority of our healthcare workers.”
Health and Human Services Secretary Alex Azar touted the per-person formula as fair. “We wanted to keep this simple,” he said.
Some immunization experts agree with that rationale. Others contend the point of prioritizing doses is to protect the most vulnerable, and a rationing system based on population doesn’t do that.
“Easiest may not be ethically best, most defensible or best for public health,” said Jeffrey Kahn, director of the Johns Hopkins Berman Institute of Bioethics. “You want something that’s lifesaving to go where it’s most needed, not just evenly spread across the country.”

hmmm ok