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More States Adopting Age-Based COVID-19 Vaccine Strategy After Connecticut Shift

  • Several states begin adopting age-based COVID-19 vaccine distribution strategies after Connecticut switches to this model in late February
  • Most states make exceptions for people with serious health issues, with Maine as the only other state using age as the sole factor for determining eligibility
  • Some hope for vaccine availability to soon eliminate eligibility factors, with President Joe Biden directing that states be able to offer vaccines to all adults by May 1

Summary by Dirk Langeveld

Several states have adopted an age-based COVID-19 vaccine distribution strategy, following Connecticut’s lead after the state deviated from federal guidance on Feb. 22. However, most states that have made this change are continuing to make exceptions for people with serious health issues.

Five states have made the vaccine eligible to people ages 50 or 55 and up. On Tuesday, Alaska became the first state to open eligibility to anyone ages 16 and up who lives or works in the state. The Food and Drug Administration has authorized use of the Pfizer vaccine for anyone ages 16 and up, while the Moderna and Johnson & Johnson vaccines are available for ages 18 and up.

While the Centers for Disease Control has issued guidance on issuing the vaccines, individual states decide how they who will receive priority. This has led to a patchwork of rules, though states have generally offered vaccines to older residents first. Most states have also expanded eligibility to include certain workers who are considered to be at greater risk of exposure, with more than half allowing grocery workers to receive a vaccine.

States have also given strong consideration to underlying health issues, though the differing rules mean that a condition that qualifies an individual for a dose in one state won’t do so in another. Still, many states are allowing individuals with qualifying health issues to receive a vaccine even as they move to age-based distribution. In Vermont, vaccines are available to people ages 55 and older with high-risk health conditions and will shortly be available to all adults with serious underlying health conditions.

Connecticut was originally set to open COVID-19 vaccine eligibility to frontline essential workers and people with pre-existing health conditions that put them at greater risk of developing a severe illness. Governor Ned Lamont said the change to an age-based system continues to give priority to older residents who are more likely to be at higher risk while also sidestepping complications in determining if someone is eligible based on their profession or health.

Eligibility in Connecticut is currently open to residents ages 55 and older, and will expand to ages 45 and older on March 22, ages 35 and older on April 12, and all adults ages 16 and up on May 3. The state also allow an exception for preK-12 staff and faculty as well as child care providers, and is setting up specialized vaccination clinics for these recipients.

As of the latest data released on Thursday, Connecticut had fully vaccinated 445,231 residents. These included 54 percent of all residents over the age of 55 and 29 percent of those over the age of 16.

Maine is the only other state where COVID-19 vaccine eligibility is determined solely by age, as residents ages 60 and older may receive a vaccine. Similar to Connecticut, Maine officials decided on Feb. 26 that an age-based distribution would allow it to distribute vaccines more efficiently while also reaching more at-risk older populations. CDC data indicates that people in the 50-64 age group are nine times more likely to die of COVID-19 than people in their 30s.

Critics of this approach say it makes it more difficult to get vaccines to people with serious health conditions as well as racial and ethnic communities that have been disproportionately affected by COVID-19. A recent Washington Post editorial by a trio of law and health policy professors argues that age-based distribution has its own shortcomings, such as preventing co-workers or household members from going to get a vaccine together, and that vaccines would be better targeted at workers in areas of high transmission to help curb the spread of the virus.

Proponents of age-based distribution say it will help speed up the vaccine rollout while also minimizing the risk that people will fraudulently claim to have a serious medical condition in order to receive a vaccine. There are also hopes that the vaccine supply will increase enough in the coming weeks to simply make enough doses available to anyone who wants one. In a primetime address on Thursday, President Joe Biden directed states to make vaccines available to all adults by May 1.

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