How Alaska got vaccine prioritization right

It’s the question that will define at least the first half of 2021: Who gets the COVID-19 vaccine, and when do they get it? A host of competing priorities make it a thorny problem to solve. But Alaska’s vaccine allocation panel — a group of volunteers that didn’t exist before this pandemic — not only sorted it out, they did so in a way that other states would be well advised to emulate. And they did it by making some notable deviations from the order recommended by the federal group tasked with the same job.

Right now, across the nation, pretty much the same groups are getting vaccinated in every state: health care workers, nursing home residents and other frontline care providers, such as emergency medical technicians. But what happens after that initial stage — known as Phase 1a — is the subject of heated debate. In mid-December, the Advisory Committee on Immunization Practices (ACIP) recommended that Phase 1b be made up of adults over 75 and “essential workers” — first responders, education, food and agriculture, manufacturing, corrections workers, U.S. Postal Service workers, public transit workers, and grocery store workers — without regard to age.

Alaska’s vaccine panel made a different, better plan for Phase 1b: All Alaskans 65 and older. It’s a better idea than the federal recommendation, for several reasons:

1. It correctly emphasizes the value of Alaska’s elders. Especially in rural communities, elders of tremendous value to Alaska have been hit hard by COVID-19, and many have died. Ours is a sparsely populated state, and we lean heavily on our few elders for their wisdom, remembrance of our history and continuance of our culture. Losing even a few before their time has a major detrimental effect on us.

2. It will blunt the toll of COVID-19 dramatically. Hospitalizations and deaths from COVID-19 are overwhelmingly among those 65 or older; although that age group makes up only 16% of the U.S. population, they have suffered 80% of the deaths from the coronavirus pandemic. By vaccinating them first, Alaska should be able to avoid four-fifths of potential COVID-19 deaths, making the disease’s toll on Alaska far less severe.

3. It’s simple. Making age the first determinant before getting into more complicated determinations for who qualifies for the vaccine is easy to understand and administer — there are no loopholes or technicalities that could lead to fights about whether a person is eligible. And in this first broader phase, simplicity will be essential: The task is to get as many people as possible vaccinated as quickly as possible, for the maximum possible effect on mortality, hospitalizations and community spread.

Make no mistake, the scaling-up of vaccination efforts is essential to 2021 being a better year than 2020. As of Dec. 31, the state vaccination dashboard showed 13,772 Alaskans had received their first vaccine dose. It’s a good start — Alaska ranked No. 3 among states for per-capita vaccinations at the end of the year — but that’s an average of less than 1,000 vaccinations per day since the vaccine arrived in Alaska in mid-December. The state’s slow vaccination rate mirrors a national trend — across the U.S., an estimated 3-4 million vaccinations have been given so far, well short of the 20 million the federal government estimated it would be able to administer by year’s end.

Alaska has also administered less than one-fourth of the 61,900 doses of the vaccine the state has received so far, with more slated to show up within a week. If we can’t scale up our vaccinations to many times the current rate, administering shots will become a bottleneck, and thousands of doses will sit in deep-freeze while Alaskans get sick and die from infections that could have been forestalled. At 1,000 doses per day, it will take until the end of 2021 before the state approaches the 60% mark estimated to achieve herd immunity.

We can’t afford that. Alaska’s vaccine prioritization panel has been wise in its decision of who will get the vaccine first, and in what order. Now the state needs to flesh out its plan for distributing and administering that vaccine as quickly and efficiently as possible.