The University of Wisconsin Health and the UW Health Innovation Program created a tool that prioritizes those who need the COVID-19 vaccine so they receive it first.
Medical Director of Clinical Analytics and Reporting at UW Health Dr. Grace Flood developed the tool to ensure the highest exposure medical professionals working for UW Health could receive the COVID-19 vaccine first.
Flood said the tool encompasses a range of data to conclude who is in most need of the vaccine. The data used is the employee’s risk of mortality, age and the Social Vulnerability Index.
The Social Vulnerability Index is a measurement created by the Centers for Disease Control and incorporates factors like socioeconomic status, household composition, minority status or housing type and transportation.
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“We put [the tool] out there and on HIPxChange for others to use if they wish to do so,” Flood said.
The tool is currently only being used to determine the vaccine prioritization in the UW Health system, but can be used anywhere.
With a limited stock of vaccines available, Flood created something to ensure UW Health’s employees could be best protected.
“I’m glad we took equity into account when doing the vaccine rollout,” Flood said.
The tool was developed to equitably prioritize the vaccine distribution in the most objective manner possible.
Retired professor of public health and previous Medical Director of the City of Milwaukee Dr. Geoffrey Swain explains why health equity is important during an outbreak.
“People of color, particularly in this country, are more at risk for adverse outcomes,” Swain said. “There’s no evidence that shows that people of color are biologically more likely to be infected by COVID-19.”
Despite not being more biologically at risk, there are a disproportionate amount of people of color infected with COVID-19.
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The CDC lists American Indian or Alaska Native and Non-Hispanic persons as making up 1.8 times as many cases as white persons. They also list Black persons as making up 1.4 times and Hispanic or Latino persons as making up 1.7 times as many cases as white persons.
“In our country people of color, in general, are lower in socio-economic status,” Swain said. “That means they are more likely to have jobs that are considered to be essential and can’t be done remotely and that involves interaction with the public. This makes them not biologically more at risk of exposure to COVID, but physically at greater risk, they’re less likely to be able to work from home.”
People of color are also more likely to die from complications with the illness.
The CDC lists the ratio of deaths as larger than the disproportionate number of cases, with people of color making up 1.1 to 2.8 times as many deaths as white people.
“People of color are more likely to have other underlying conditions, like diabetes or asthma and even obesity,” Swain said. “They are much more likely to experience day-to-day discrimination racism and chronic stress of living in poverty and in under-resourced neighborhoods.”
Underlying conditions and general health are not the only reasons for the higher rate of death.
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Factors of social and economic circumstances put them more at risk, specifically in regards to the healthcare system, Swain explained.
“[People of color] are working in jobs, on average, which are less likely to provide them paid sick leave, so they have much less easy of a time to be able to stay home when they’re sick,” Swain said. “They’re also much less likely to have a job that provides them with adequate health insurance.”
Swain explained the combination of factors is responsible for the disproportionate infection and CDC death statistics.
According to Swain, paid sick leave is necessary to combat the pressures people feel to go to work, even when sick. Swain said changes in a living wage and housing security would be the biggest chronic stress reducer.
“One reason is that there is some hesitancy among people of color to trust the vaccine because people of color have learned through history that they have not always gotten the kind of quality medical care that white people have gotten and sometimes even they’ve been taken advantage of in ways that remain very painful to remember and really are not helpful in encouraging trust in our system,” Swain said.
Swain said the tool is a good step in the right direction to amend health inequities.
The tool is just a start though, Swain explained, saying more change is needed on a long-term scale in order to truly have equity in our society.
“If we don’t care adequately for all of us, then we are all at risk,” Swain said. “And the pandemic makes that crystal clear in a way that I think we haven’t seen before.”