Briggs: Indiana chose the simplest and best COVID-19 vaccine plan
The oldest people should be first in line for the vaccine. That's what's happening in Indiana.
One sign of good public policy is simplicity. By that measure, Indiana is taking the right approach to vaccine distribution.
The state last week adopted an age-based priority system for giving out shots of the COVID-19 vaccine. The older you are (or, more precisely, the older your age group is), the sooner you’ll get the vaccine.
State and city leaders spent hours explaining the new strategy last week, offering details on a lot of moving parts, but the main goal is so simple that it fits on a single sheet of paper. During Gov. Eric Holcomb’s press briefing Wednesday, the state shared a slide that showed Indiana residents aged 60 and older account for 22.5% of the state’s population; 64.1% of all COVID-19 hospitalizations; and 93.3% of deaths.
Those numbers make it extremely clear that if Indiana can give a vaccine shot to everyone 60 and older who is willing to receive it, then hospitalizations and deaths will plummet.
“By taking an age-focused approach, we can accomplish two tasks: protecting those at greatest risk for adverse consequences like death or hospitalization and then reaching older workers who are more likely to have (other health issues),” Dr. Kristina Box, the state health commissioner, said.
That doesn’t mean it’s going to be as easy in practice as it is on paper. Indiana on Friday took the first step in its age-based approach, opening up vaccinations to people 80 and older. Next, the process will open up for people 70-and-up and then 60-and-up. The timeline for all that is hazy.
Learn more:How to get a COVID-19 vaccine in Indiana
The demand on Friday morning quickly overwhelmed the capacities of the 211 phone number and website (ourshot.in.gov) where people tried to set up their appointments. This is likely a temporary problem, not uncommon during the early rollouts of massive new public programs (remember the Obamacare website?).
Indiana needed to make some changes. Indiana has lagged other states in using up its vaccine supply (the state had only used 31.4% of its vaccine doses as of Friday, according to Bloomberg) at an urgent time when people are getting infected and dying of COVID-19 by the thousands.
The benefits of Holcomb’s new plan seem self-evident, but it has not been universally adopted. New York, for instance, on Friday revealed it would mandate “social equity distribution” of vaccines through a convoluted program that factors in public housing, houses of worship and low-income census tracts.
New York, it should be noted, has gotten off to a faster start than Indiana in handing out vaccines, so we can’t dismiss its approach without seeing it play out. It will take weeks or months to determine which states are most efficient.
But, when you consider who’s most vulnerable to the worst health effects of COVID-19, there is no factor more important than age.
“We want to reach the people with the highest risk for hospitalization and the highest risk for deaths,” Dr. Virginia Caine, the Marion County public health director, said Thursday. “And we think that’s really important. But the most important point about that is we don’t want our hospital systems overwhelmed.”
Long term, Indiana needs to vaccinate 70% to 80% of its 6.7 million residents to put the pandemic in the rearview mirror. That’s going to take a long time. But the 60-and-older population is a 1.5 million-person slice.
State leaders were noncommittal on how long it might take to offer the vaccine to everyone in that large group, particularly since it's unclear when that level of inventory will be available.
“We don’t have that many doses or expect that many,” Box said, referring to the supply needed to vaccinate 1.5 million people who are 60 and older. “So we realistically are trying to just parse this out bit by bit and group by group to make sure that our most vulnerable population does get vaccinated first.”
As hard as it is to vaccinate that many people, though, it would be even harder if Indiana was trying to target teachers, grocery store employees or any number of other public-facing professions. Everyone generally agrees that it's best for health care workers to go first, but there are many competing views on which jobs and groups should go next (Indiana is granting priority to first responders).
There are ethical arguments for handling the vaccine in many different ways, but the age-based approach is the easiest solution to hastening the immunization speed, eliminating deaths and clearing out hospitals of COVID-19 patients. Even with the initial scheduling problems, there was reason for hope on Friday when more than 53,000 people ages 80 and older booked vaccine appointments.
If Indiana can execute its plan, then the state’s COVID-19 dashboard will start to look much better within the next several weeks.
Contact IndyStar metro columnist James Briggs at 317-444-6307. Follow him on Twitter: @JamesEBriggs.