When it comes to deciding which group should receive the COVID-19 vaccine first, one of the proposals that troubled me was that over-90s should be prioritized.
This seemed to make no sense, in that, while this group is far more vulnerable to the disease, they have many fewer years of life remaining.
A 90-year-old can expect, on average, to live another four to five years. A 50-year-old has, again on average, 33 years of life ahead.
For this reason, I believed, ethically speaking, that it was wrong to place 90-year-olds ahead of 50-year-olds, in that the latter have so much more to lose.
There are, of course, other points of debate and controversy in deciding who goes first.
Shouldn’t front-line health-care workers be given priority, both because of the increased risks they run, but also to avoid their passing the disease on to patients?
What about first responders, school teachers, bus drivers and so on?
But the question I want to focus on is purely the age-related matter. And a new study by researchers at the University of California at Berkeley, Joshua R. Goldstein and colleagues, shows conclusively that I was wrong.
It goes like this.
Vaccinating the elderly both prevents more deaths (you would expect this), and strikingly, saves more years of life.
How, you might ask, can this be true?
Here’s how. It’s evident that a 50-year-old has a longer life expectancy than a 90-year-old. If he or she isn’t vaccinated, and dies of COVID-19, 33 years of life are lost.
But, and this is the critical point that changes the equation, 50-year-olds are highly unlikely to die of COVID-19, even if they contract the disease.
As of Feb. 20, out of 1,340 COVID-19 deaths in B.C., only 15 were in the 40- to 50-year old group, even though there are 650,000 people in this cohort.
It turns out that the chance of vaccination saving many years of life among average members of this group is minimal, because it is extremely unlikely they will die.
However there have been 420 deaths in people 90 and over, despite the fact there are only 50,000 people in this group. Vaccination stands to save more years of life here, because members of this group are far more likely to die if not vaccinated.
In other words, the benefit of vaccination for any group, or any average individual within that group, is the number of years they have left times the chance that vaccination will save their life.
Moreover, what the research also showed, remarkably, is that the benefit of vaccination increases the older you get, no matter how old. Indeed the older, the better, both in reducing deaths, but also in saving extra years of life.
One qualification: We’re talking about COVID-related deaths. If someone is vaccinated, then dies of a heart attack or some other unrelated condition, that death doesn’t count in working out the math.
But that aside, if what we are trying to accomplish is a reduction in fatalities, plus the highest number of years saved, the conclusion is indisputable.
The oldest should be vaccinated first.
