Evaluation of Rhode Island's Early Geographic COVID-19 Vaccine Prioritization Policy.

Abstract

<b>Objectives.</b> To determine whether geographic prioritization of limited COVID-19 vaccine supply was effective for reducing geographic disparities in case rates. <b>Methods.</b> Rhode Island allocated a portion of the initial COVID-19 vaccine supply to residents of Central Falls, a community already affected by structural policies and inadequate systems that perpetuate health inequities and experiencing disproportionately high COVID-19 morbidity and mortality. The policy was implemented with a culturally and linguistically appropriate community engagement plan and was intended to reduce observed disparities. Using a Bayesian causal analysis with population surveillance data, we evaluated the impact of this prioritization policy on recorded cases over the subsequent 16 weeks. <b>Results.</b> Early geographic prioritization of Central Falls accelerated vaccine uptake, averting an estimated 520 cases (95% confidence interval = 22, 1418) over 16 weeks and reducing cases by approximately 34% during this period (520 averted vs 1519 expected without early prioritization). <b>Conclusions.</b> Early geographic prioritization increased vaccine uptake and reduced cases in Central Falls, thereby reducing geographic disparities. <b>Public Health Implications.</b> Public health institutions should consider geographic prioritization of limited vaccine supply to reduce geographic disparities in case rates. (<i>Am J Public Health</i>. 2024;114(S7):S580-S589. https://doi.org/10.2105/AJPH.2024.307741).