Thread by @emzorbit

One thing that might be hampering vaccine supply/demand in Missouri is that the vaccine is being distributed by percentage of population. However, the priority populations (based on Missouri’s Phases and Tiers) are NOT proportionately distributed throughout the state. /1

The disparities I’m going to focus on fall along two main categories: Employment classifications and race. First, let’s deal with employment classifications. Currently eligible for vaccination in Missouri are people in the following jobs: /2

But as you can see from these maps pulled from the BLS, employment in these occupations are not evenly distributed throughout Missouri. /3

The broad categories on these maps do include some occupations that are not currently eligible for the COVID vaccine in Missouri but the difference, IMO, is negligible. A deeper dive into the numbers would be provide a more accurate picture. /4

Now let’s tackle how race could be affecting vaccine supply/demand in Missouri. People with sickle cell disease are currently eligible for the vaccine under Phase 1B. Sickle cell disease, according to the CDC affects 1 in 365 Black births. /5

This is the percentage of Blacks living in each county in Missouri according to the 2010 census. Using the map of the Highway Patrol/Vaccination Distribution Regions in Missouri and a map from the 2010 census showing the percentage of blacks living in each county, /6

I was able to calculate that there are approx. 402K Blacks living in Region C vs. 25K living in Region E. If 1 out of every 365 Blacks has sickle cell disease, that is about 1200 doses needed in Region C vs. 68 doses needed in Region E. /7

Another priority group currently eligible for vaccination are people with Type II Diabetes. According to the CMS, Type II diabetes is more prevalent among minority beneficiaries and is highest among Blacks (30%). /8

So again, the Highway Patrol/Vaccination Regions with a higher number of Black residents will need MORE vaccine because there is likely to be a higher number of people with Type II Diabetes. /9

If Missouri is going to use a priority, tiered system to decide who gets the vaccine and when, it seems to me that they shouldn’t use a straight up percentage of population living in a given region to allocate the vaccine. /10

Because a) density matters - there are more LE, healthcare workers, first responders living in certain areas of the state and b) race matters - certain demographics are hit harder by certain disease processes (the reasons for which are a topic for another time). /11

Caveat - I’m not a public health expert and in general I suck with numbers. I could be wrong. I’m just tired of watching my community struggle. I’m hoping someone smarter than me will take this up and run with it. See if my theory holds water. @chrisprener @SharkFu @lisadclancy

Update - I looked at hospitals in ea area because healthcare workers are currently eligible for the COVID-19 vax in 1A.
In Region C there are 49 hospitals with 9,825 beds.
In Region E there are 10 hospitals with 1491 beds.

(This data is from the Missouri Dept. of Health).

The only stat I could find on this said non-military hospitals employ about 16 people/hospital bed (seems high but the error would benefit both regions). Using this the number of hospital employees per region are:

Region C = 157,200 employees
Region E = 23,856 employees

This does not include dentists; any outpatient settings like labs, MDs, PTs, rehab centers; urgent care centers; nursing homes or the medical schools (2 in Region C). It also does not include VA centers because their vax allocation is coming directly from the federal govmt.