New York (Sept. 3, 2020)—In oral and written testimony delivered today to the National Academies of Science, Engineering, and Medicine (NASEM), the American Geriatrics Society (AGS) stressed the importance of prioritizing health professionals and older adults in the distribution of a future COVID-19 vaccine. Delivered in response to an NASEM draft framework for the equitable distribution of coronavirus immunizations, the comments also stressed the importance of ensuring age is never used to exclude someone categorically from care, including prevention for a pandemic as pernicious as COVID-19.
"We appreciate that older adults, people with chronic conditions, and others at high risk of dying from COVID-19 are prioritized in the draft framework. However, the AGS [is concerned]...that portions of the underlying analysis that informed these recommendations lean on stereotypes that potentially devalue older adults," noted Timothy W. Farrell, MD, AGSF, vice chair of the AGS Ethics Committee, which developed the recent AGS position statement on resource allocation strategies during COVID-19 and beyond.
"We refer specifically to the idea that age in and of itself is a potential criterion for making allocation decisions," Dr. Farrell added in oral testimony before the NASEM committee responsible for the draft framework. "Our current reality is that, due to advances in our understanding of diseases and how to treat them, people are living healthy lives even when they have heart disease or other chronic conditions. Resting these recommendations on an analysis that does not reflect the complexity of how we age runs the risk that older people will be discriminated against because of their age when this framework is implemented," he concluded.
Developed by an interprofessional group of experts, the discussion draft includes a summary of lessons learned from past allocation frameworks for mass vaccination campaigns, as well as from recent guidance during the COVID-19 pandemic for the allocation of scarce resources, such as medical resources and supplies.
Drawing from these lessons, the committee defined the foundational principles, primary goal, and criteria for determining an equitable allocation framework. The criteria include:
- Risk of acquiring infection.
- Risk of severe morbidity and mortality.
- Risk of negative societal impact.
- Risk of transmitting disease to others.
In Dr. Farrell's oral testimony, as well as written comments submitted to the committee but the AGS, geriatrics experts strongly recommend that our national vaccine allocation strategy:
- Prioritize the health workforce, broadly defined to cover workers across care settings, including in long-term care, assisted living and other congregate living facilities, and in home and community-based settings.
- Prioritize access for high-risk populations, including older adults, those living in congregate settings, people with chronic health conditions, and communities of color.
- Avoid using age as a criterion, given the diversity of the older adult population.
"When it comes to how we all age, it behooves us all to remember that it is often the 'ninth inning' of life that is the most important," Dr. Farrell remarked.
For more information on the draft framework and AGS responses to COVID-19, visit AmericanGeriatrics.org/Where-We-Stand/COVID-19.
About the American Geriatrics Society
Founded in 1942, the American Geriatrics Society (AGS) is a nationwide, not-for-profit society of geriatrics healthcare professionals that has—for more than 75 years—worked to improve the health, independence, and quality of life of older people. Its nearly 6,000 members include geriatricians, geriatric nurses, social workers, family practitioners, physician assistants, pharmacists, and internists. The Society provides leadership to healthcare professionals, policymakers, and the public by implementing and advocating for programs in patient care, research, professional and public education, and public policy. For more information, visit AmericanGeriatrics.org.