The COVID-19 vaccine shortage is a reality. Even if more vaccines are available in the end of April as state and federal leaders allege, thousands of vulnerable Livingston County residents who are otherwise eligible will continue to be ignored unless the social vulnerability plan is replaced with a medical vulnerability plan immediately.
There is significant confusion about the issues related to the distribution of vaccines, vaccine eligibility, and even vaccine administration. Addressing those three topics in reverse order provides insight into the problem that many, including the State of Michigan, are ignoring.
Vaccine administration: Getting shots in arms is mainly being handled at a local level. If Livingston County had its fair-share of vaccines, more than 4,000 vaccines could be distributed per day in the county. This is due, in large part, to partnerships between our health department, our local health systems, the national guard, our local schools, and others. We are prepared with strike teams to vaccinate the home-bound. In a matter of a day, we can deploy vaccines in pop-up clinics. But, we do not have our fair-share of vaccines to serve those who are deemed eligible by the State.
Vaccine eligibility: The state is controlling eligibility. More than 18,000 eligible seniors have expressed their interest in getting a Covid-19 vaccine. More than 75% of those the state has deemed eligible in our county have likewise expressed an interest. Despite being deemed eligible, the state decided the vaccine is more appropriately distributed to counties where currently-ineligible populations reside based on their “social vulnerabilities.”
Vaccine distribution: Vaccines are being distributed based on “social vulnerability” rather than medical vulnerability, when the CDC, the state, 75% of those dying of Covid-19 across the country are senior citizens, and common sense all indicate that the greatest metric of mortality is age. Using the “social vulnerability” formula, Livingston County has the lowest priority of all 83 Michigan counties. Had the State of Michigan elected to fairly distribute vaccines based on a county’s population of its most vulnerable — e.g., its senior citizens — Livingston County would have moved from 83rd to 11th. The plan unfairly denies Livingston County’s most vulnerable citizens their fair share of the vaccine.
The CDC said that “We do know that older adults and people who have severe underlying medical conditions like obesity, diabetes, or heart or lung disease are at higher risk for developing more serious complications when they have COVID-19.” The CDC, in fact, only recommends one factor of the 15-factor social vulnerability index. Can you guess which one? That’s right… the population of those 65 years of age or more. The best available health information shows that compared to young, healthy individuals, senior citizens over 65 years of age have a relative risk of death increase of between 90- and 630-times. Compared to young, healthy individuals, those with co-morbidities have an increased risk ranging from 2X to 3X. Compared to healthy, non-minority groups, minorities have an estimated risk of hospitalization increase of 4X and a relative risk of death increase of 3X.
The selected Covid-19 vaccine distribution plan DOES NOT prioritize these medically vulnerable individuals as one would reasonably expect. Instead, the plan identifies the importance of vaccinating citizens who are incarcerated, non-English speaking citizens, and even non-citizens, all of whom have little, if any, cause of Covid-19 risk or connection protecting Michigan’s and Livingston County’s most vulnerable population.
The table below tells the story. Of these counties, Livingston County has the second-highest population and has received the lowest number of vaccines. We have nearly three times the number of seniors (and overall population) as Marquette, yet we have received more than 5,000 fewer vaccines. Our population and number of seniors are nearly the same as Saginaw, but Saginaw has received more than 3X the number of vaccines.
Why is this happening? Frankly, the state’s approach appears political. All of the other counties listed above were Democrat counties in the 2020 election. It sure does not seem like a coincidence. Recall at the beginning of the COVID-19 lockdown, Livingston County was considered high-risk when selecting counties to lockdown, being grouped in the same region as Wayne, Macomb, and Oakland counties. Yet, when it comes time to pass out vaccines, Livingston County suddenly has the lowest COVID-19 priority. Another coincidence?
The process of selecting the “social vulnerability” plan was seemingly arbitrary and without a public process. Democrats and Republicans agree – Democrat Mark Hackel of Macomb County and Democrat Warren Evans of Wayne County agree that the fair way to distribute vaccines would most heavily consider age. The metric of mortality does not lie. In their words, the state should stop using vaccines as a social justice tool and provide vaccines based on the most medically vulnerable population. I agree.
On Monday, Feb. 22, the Livingston County Board of Commissioners will vote on my resolution calling on Gov. Whitmer to retract her “social vulnerability” plan and replace it with a medical vulnerability plan to distribute COVID-19 vaccines fairly.
Mitchell Zajac is a County Commissioner from Livingston County representing Marion Township and the Village of Pinckney along with portions of Putnam and Hamburg townships.