For weeks now, health and community leaders in Colorado have engaged in a sometimes tense debate over how best to allocate scarce supplies of the coronavirus vaccine in order to save the most lives.
One argument goes that the state should prioritize those most at risk of death – people who are older and people who have high-risk medical conditions. Another argues that the vaccine should be used to target outbreak-prone groups, like those living in prisons or college dorms, in order to reduce the spread of the virus and provide community-wide protection.
Both strategies can find support from previous, successful vaccination campaigns for other infectious diseases. What’s been missing from the debate has been research to help figure out the best strategy for the current pandemic.
“I don’t know that we have good insight that says this is how you control a pandemic caused by SARS-CoV-2 virus,” Dr. Eric France, the chief medical officer of the Colorado Department of Public Health and Environment, said, using the scientific name for the coronavirus that causes COVID-19.
But, it turns out, a possible answer has been sitting for months in a study published by University of Colorado Boulder researchers.
In September, CU professor Daniel Larremore, Ph.D. student Kate Bubar and five other researchers published a paper entitled, “Model-informed COVID-19 vaccine prioritization strategies by age and serostatus.” The paper was published on the website medRxiv, where scholars often post work before it has been peer-reviewed and accepted by a more traditional journal – a practice that has become common amid the express-lane speed of pandemic science.
Larremore is not a typical public health expert. He’s a professor of computer science, who also works with CU’s BioFrontiers Institute. He and his team created a computer model to estimate what impact different coronavirus vaccine allocation strategies would have on deaths.
And the conclusion?
“It’s clear that the recommendation should be that those most vulnerable people should get vaccinated first,” Larremore said.
“The traditional approaches”
This is exactly what the state now plans to do, though how Colorado ended up taking the approach that Larremore’s research says it should is somewhat fortuitous. Larremore said no one from CDPHE called to ask him about the study, and, when asked, France did not cite any particular studies that state health officials looked at when drafting the allocation plan.
Larremore’s research was used to help formulate guidance from the National Academies of Science, Engineering and Medicine, and that guidance informed Colorado’s planning. But, when Colorado released its initial allocation plan in October, it gave high priority to people living in outbreak-prone settings.
The state later – controversially – stripped those groups out of the plan. Gov. Jared Polis said the state, while also vaccinating health care workers and first responders, would focus on vaccinating those most at risk of death. France echoed that, saying Colorado decided “to take the traditional approaches.”
“Identify the populations that are most likely to die or have severe illness or be hospitalized and make sure they’re protected,” he said.
