电子游戏软件的经济学家Tayfun Sönmez和Utku Ünver一直在努力确保政策制定者有办法确保冠状病毒疫苗在所有人群中公平分配, including the most disadvantaged communities.
States like Massachusetts and Tennessee have taken notice, 将他们的“储备”系统纳入分配工作，以确保疫苗有效地到达最需要的社区.
在各州寻求将疫苗公平地分配给所有有需要的人的过程中，他们开发的机制可以作为公平的基准. While it cannot overcome the myriad political and supply chain issues that have arisen, they note, 这是政策制定者可以用来指导整个疫苗接种行动决策的杠杆.
他们在疫苗分配方面的工作只是在大流行期间将资源与受助者配对的一系列项目中的最新项目. At first, Ünver, Sönmez, and fellow BC Professor of Economics Bumin Yenmez, in a joint paper with MIT economist Parag Pathak, developed a new mechanism to equitably distribute ventilators and proposed therapeutics.
Since then Sönmez, Ünver, and Pathak have been communicating and collaborating with various groups of bioethicists, clinical care physicians, and policy makers. 他们的最新工作旨在为卫生官员提供一种工具，以确保向社会各阶层提供疫苗.
On December 4, the group delivered a keynote presentation program “COVID-19: Priorities in Health,” 这是为期两天的在线会议的一部分，会议的重点是疫苗分配和社会正义. The virtual event was hosted by Boston College, as well as Ariadne Labs, the Harvard T.H. Chan School of Public Health, the International Society for Priorities in Health, MIT, O’Neil Institute/Georgetown, The University of Pennsylvania’s Department of Medical Ethics and Health Policy, and the Leonard Davis Institute of Health Economics.
As the researchers expected, 安全有效的COVID-19疫苗的分发面临着限制，例如生产瓶颈或供应链延误，这些问题将延长完全满足需求之前的时间, according to researchers. Those supply limits lead to rationing.
In collaboration with Pathak, Sönmez和Ünver撰写了几份新的政策报告，展示了如何以减少不平等的方式分配疫苗. More specifically, 疫苗分配需要积极响应已经受到疾病严重打击的弱势群体——特别是种族和少数民族群体, deaths, and unemployment when compared to their wealthier, white peers, they say.
“一个令人担忧的问题是，尽管弱势社区承担了大部分COVID影响负担, 在疫苗推出过程中，他们将无法足够快地根据任何一个指标获得自己的份额,” said Ünver, whose December 4 remarks were aimed at a wide-ranging audience of policy makers, public health workers, community leaders, activists, researchers, news media, and the general public. “Thus, we argue that a reserve allocation can alleviate their burden to some degree.”
他补充说:“从我们的角度来看，我们的目标是向从业者和州卫生部门代表解释如何使用我们最近概述的经济‘储备’框架 paper, 能否向“情况较差的社区”——按照若干标准的定义——提供公平获得疫苗的机会，并在合理的生物伦理原则的指导下促进技术上透明的实施.”
Tayfun Sönmez
Utku Ünver
这组科学家开发了一种分配疫苗的机制，其中包括一个“储备”系统，该系统为属于社会经济指数(如地区剥夺指数或社会脆弱性指数)的社区留出一定比例的可用疫苗.
Sönmez和Ünver讨论了他们最近与同事合作撰写的两篇政策论文: “配给安全有效的COVID-19疫苗:按人口比例分配给各州可能会破坏减轻健康差距的承诺” and “优先考虑情况较差的少数群体接种COVID-19疫苗在数量上意味着什么:实用, Legal and Ethical Implications.”
Their current study simulates National Academies of Sciences, Engineering, and Medicine guidelines for distribution of the COVID-19 vaccine. To adjust to demand outpacing supply, NASEM根据个人的职业风险群体确定了整个人口的优先阶段, ages, health status, and other demographics.
NASEM also adopted the recommendation from the BC economists, Pathak, and their co-author, University of Pennsylvania bioethicist Harald Schmidt, 电子游戏正规平台人员在最近的工作论文中概述了这种分配方法，该方法采用了一种针对受灾严重/社会脆弱地区的储备分配方法.
Ünver和Sönmez表示，核心问题是:哪些群体面临的风险最大，以及电子游戏正规平台人员如何以标准化的方式客观地识别他们? The ADI, developed by University of Wisconsin researchers, and the SVI, developed by the Centers for Disease Control and Prevention, are the two leading indices that measure disadvantage. SVI uses “minority percentage of a geographic region’s population" as a direct component, 而社会价值指数的所有其他14个组成部分和可持续发展指数的所有17个组成部分都是社会经济措施. NASEM recommended SVI to determine at-risk groups.
“We find in the simulations that if there is no reserve set aside for disadvantaged areas, 尽管随着时间的推移，少数民族社区开始从疫苗分配中获得他们的人口份额, that share is nowhere close to their proportion of COVID-19 fatalities, of 49 percent.”
不列颠哥伦比亚大学的经济学家进行了模拟，测试了这两个指标在帮助最弱势群体方面的有效性.
“我们在模拟中发现，如果没有为弱势地区留出储备金, 尽管随着时间的推移，少数民族社区开始从疫苗分配中获得他们的人口份额, that share is nowhere close to their proportion of COVID-19 fatalities, of 49 percent,” said Ünver.
Furthermore, without a reserve, after 48 million doses of vaccine are allocated, 少数民族人口的份额低于其人口份额的34%至39%，并且在美国3.23亿疫苗的疫苗推广结束之前一直保持较低水平, Ünver said.
模拟为每个州最弱势的四分之一提供10%的储备金的效果, the economists tested both the SVI and ADI indices. While pairing both indices with a reserve appeared effective, they found the SVI can deliver more vaccines to at-risk communities. However, no matter which index is used, 当2.6亿支疫苗投入使用时，弱势社区——包括由少数种族组成的社区和以白人为主的社区——将完全获得疫苗, around 65 million vaccines before the entire U.S. population is innoculated.
While SVI has the potential to be more helpful than ADI in the minority impact dimension, both are much better than not using any reserve, said Ünver. Moreover, ADI does not have a racial component in its calculation, 因此，与包含SVI的系统相比，可能更不容易受到法律挑战.
“Prior to our efforts, 在大流行期间，储备制度从未用于配给医疗资源。”Sönmez说. ”Due to the urgency of the need, 我们的努力已经在马萨诸塞州和田纳西州等州初见成效, which have adopted reserves in their Covid-19 vaccine allocation policies. 我们的希望是，储备制度最终将成为一种主流工具，有助于实现有助于维持社会结构的妥协结果."
Ed Hayward | University Communications | December 2020