Strategic COVID-19 vaccine distribution can simultaneously elevate social utility and equity

Abstract: Balancing social utility and equity in distributing limited vaccines represents a critical policy concern for protecting against the prolonged COVID-19 pandemic. What is the nature of the trade-off between maximizing collective welfare and minimizing disparities between more and less privileged communities? To evaluate vaccination strategies, we propose a novel epidemic model that explicitly accounts for both demographic and mobility differences among communities and their association with heterogeneous COVID-19 risks, then calibrate it with large-scale data. Using this model, we find that social utility and equity can be simultaneously improved when vaccine access is prioritized for the most disadvantaged communities, which holds even when such communities manifest considerable vaccine reluctance. Nevertheless, equity among distinct demographic features are in tension due to their complex correlation in society. We design two behavior-and-demography-aware indices, community risk and societal harm, which capture the risks communities face and those they impose on society from not being vaccinated, to inform the design of comprehensive vaccine distribution strategies. Our study provides a framework for uniting utility and equity-based considerations in vaccine distribution, and sheds light on how to balance multiple ethical values in complex settings for epidemic control.