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A major focus of debate about rationing guidelines for COVID-19 vaccines iswhether and how to prioritize access for minority populations that have beenparticularly affected by the pandemic, and been the subject of historical andstructural disadvantage, particularly Black and Indigenous individuals. Wesimulate the 2018 CDC Vaccine Allocation guidelines using data from theAmerican Community Survey under different assumptions on total vaccine supply.Black and Indigenous individuals combined receive a higher share of vaccinescompared to their population share for all assumptions on total vaccine supply.However, their vaccine share under the 2018 CDC guidelines is considerablylower than their share of COVID-19 deaths and age-adjusted deaths. We thensimulate one method to incorporate disadvantage in vaccine allocation via areserve system. In a reserve system, units are placed into categories and unitsreserved for a category give preferential treatment to individuals from thatcategory. Using the Area Deprivation Index (ADI) as a proxy for disadvantage,we show that a 40% high-ADI reserve increases the number of vaccines allocatedto Black or Indigenous individuals, with a share that approaches their COVID-19death share when there are about 75 million units. Our findings illustrate thatwhether an allocation is equitable depends crucially on the benchmark andhighlight the importance of considering the expected distribution of outcomesfrom implementing vaccine allocation guidelines.

Do Black and Indigenous Communities Receive their Fair Share of Vaccines Under the 2018 CDC Guidelines