My View: Oregon's COVID vaccination plan discriminates against senior men
On Jan. 15, Oregon Gov. Kate Brown announced a revised COVID-19 vaccination sequencing plan. The state plan 1a already has qualified health care workers and those in long-term settings. As of Jan. 25, it qualifies teachers and child care providers.
Then, beginning Feb. 8, vaccinations would be available to seniors in four "waves" — seniors age 80 and older first, followed later by seniors who are 75 and older, then seniors who are 70 and older and, lastly, Oregonians 65 and older.
This plan implicitly assumes that the risk of death from COVID-19 only increases with age. Although the plan states that "health equity" explicitly requires consideration of gender's contribution to risk, the plan ignores gender altogether. It implicitly assumes that risk of death from COVID-19 is the same regardless of gender. This is not true.
In fact, men face dramatically higher relative risks of death than women from COVID-19 at all ages. First, a worldwide meta-analysis of more than 3 million COVID-19 cases found that men are almost three times more likely than women to require admission to an intensive care unit.
That study found that for the average Oregonian, the COVID-19 death risk to men is 1.57 times higher than women.
But that is the average across all ages. When disaggregated to 10-year age cohorts, The picture for senior males looks markedly worse, especially in the Oregon data. According to CDC data, the relative male/female death risk to Oregon men 55 to 64 years is about 2.267 times higher; for men 65 to 74 years, the risk is about 3.308 times; men 75 to 84 years, the risk is 2.605 times; and men 85 and older, the risk is about 1.892 times.
Vaccine access is being rationed and already has been delivered to the highest risk cohorts. This data suggests that men should be prioritized over women in the senior cohorts. Although this may seem preferential to men, this is not the case. It is following the risk-based allocation principles.
For example, because men are almost three times more likely to require hospital ICU services, reducing their high risk of infection through vaccination will sharply reduce the demands on hospital capacity.
Everything else being equal, vaccination of a male will reduce ICU capacity demand by three times that of a vaccinated female. This benefits all potential hospital patients — both COVID-19 and non-COVID-19 patients.
Research suggests that the greater risk of death by males is biological in origin. Indeed, women already enjoy a six-year advantage in lifespan over men, independent of COVID-19. There already are almost 100,000 fewer men than women in the senior cohorts in Oregon. Thus, prioritizing men for COVID-19 offsets that health equity disparity to some degree.
Randall Pozdena of Cedar Mill is an economist and statistician, former professor and former research vice president in the Federal Reserve system. He is a senior director of an Oregon consulting firm.
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