With #COVID19 vaccine supply ramping up, there is lots of discussion about #Ontario's vaccine distribution plan and how individuals are being prioritized.

Ontario's ethical framework is clear that prevention of illness/death is not the only priority: https://www.ontario.ca/page/ethical-framework-covid-19-vaccine-distribution

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These multiple and divergent priorities (reduce illness/death vs. promote economic/social wellbeing) aren't clearly ranked.

e.g., 1.5 million essential workers have similar priority to 3.5 million older adults (who account for 96% of COVID19 deaths): https://files.ontario.ca/moh-covid-19-vaccine-technical-briefing-en-january-13-2021-2021-01-13.pdf

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This leads to frustration, anger and fear for older adults who are at highest risk of death and see other vaccination programs like the UK's focus on age and have the singular goal of "prevention of mortality and supporting the [healthcare system]": https://www.gov.uk/government/publications/priority-groups-for-coronavirus-covid-19-vaccination-advice-from-the-jcvi-30-december-2020/joint-committee-on-vaccination-and-immunisation-advice-on-priority-groups-for-covid-19-vaccination-30-december-2020

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Using age to determine vaccine priority (like the U.K.) respects the KISS principle (e.g. "systems should be as simple as possible") and has been used by other countries like Israel to vaccinate as fast as possible to reduce morbidity and mortality: https://covid19-sciencetable.ca/sciencebrief/lessons-learned-from-israels-vaccine-rollout/

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A simple framework also ensures that those who have the hardest time getting vaccinated aren't unintentionally deprioritized—when there are multiple groups within one priority category, the easiest to vaccinate will go first (e.g. those without mobility & cognitive issues).

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Prioritizing vaccine distribution based on age clearly prevents the most #COVID19 deaths, which I think should be the #1 goal.

Importantly, an age-based approach will require explicit attention to promoting health equity to further reduce mortality: https://jamanetwork.com/journals/jama/fullarticle/2776053

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This weekend #Ontario announced that adults ≥80 will be among the next priority groups for vaccines: https://www.cbc.ca/news/canada/toronto/ontario-government-vaccine-rollout-next-priority-1.5914068

This is welcome news, but there is remaining uncertainty for other older adults, including those aged 70-79 (18.7% of all Ontario #COVID19 deaths).

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I think most people appreciate that vaccine supply is limited—the current frustration is caused by the multiple unranked priorities of #Ontario's vaccine program, meaning that those at highest risk of #COVID19 death will not always be first in line to receive the vaccine.

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