# Geographically targeted COVID-19 vaccination is more equitable and averts more deaths than age-based thresholds alone
###### tags: `articles`

[TOC]

- [Online Avalible](https://www.science.org/doi/10.1126/sciadv.abj2099)
- [Supplementary Materials](https://www.science.org/doi/10.1126/sciadv.abj2099)
- proiritize vaccations depending on
- [mortality](14)
- [risk of transmission](15,16)
- [age](17,18)
- [comorbidities, occupations](14,16,19-21)
## Introduction
- Vaccine prioritization based solely on age may have exacerbated racial/ethnic inequities because BIPOC populations are younger, more likely to be infected at younger ages, and at higher risk of dying from COVID-19 at all ages.
- Prioritizations that consider other dimensions of risk alongside age may more effectively target those at greatest risk of COVID-19 death while reducing racial and ethnic inequities.
- Geographic targeting may be more practical.
- Compare strategies based on age, race and ethnicity, and alternative measures of geographic risk.

## Results
- Age-based prioritization alone results in substantial racial and ethnic disparities in averted deaths
- Geographic prioritization based on area-level deprivation improves equity and averts more deaths
- Universal adult vaccination in the highest-mortality neighborhoods can improve equity and avert more deaths
- Directly identify Census tracts with historically higher COVID-19 mortality.
- Prioritizing high-mortality tracts would also markedly increase vaccine access for BIPOC communities.
- Universally lowering the age of eligibility averts fewer deaths and is less equitable than selectively lowering eligibility age

## MATERIALS AND METHODS
- Mortality data: deaths occurring in 2020
- Geographic disadvantage: ADI and metropolitan status

### Mortality data
- California
- 24880
- Minnesota
- 2584

### Geographic disadvantage
- ADI
- metropolitan status
- Census tracts
- California
- 8057
- Minnesota
- 1338

### Statistical analysis

$$
M_{i,a}=\frac{D_{i,a}}{N_{i,a}}\cdot w_{i,a}\cdot 100,000
$$

where
- $i$ is the geographic group
- $a$ is the age grooup
- $D_{i,a}$ is a count of COVID-19 deaths
- $N_{i,a}$ is a count of population
- $w_{i,a}$ is a weight for different senarios
- $1$ as default