Note: I will be away from my computer most of Sunday. Q&A will resume on Monday.

Question: Can this be right? I was reading on CNN that “The CDC estimates there are 21 million health care personnel, 3 million long-term care residents, 87 million essential workers, 100 million adults with high-risk medical conditions and 53 million others 65 and older.”  This is saying 264M people fall into some type of priority group. There’s only 330M people in the US, and 74M of the US population is children. Seems like there’s some double counting in these groupings. 

Answer: You’re right.  There’s double and triple counting going on here (Figure 1).  The challenge is that– to my knowledge– we don’t really have a good estimate of the overlap because we don’t have a good way to disaggregate the data.  We have to look to multiple different data sources.  For example, as of 2018, 64% of US adults ages 65+ had two or more chronic conditions (~34M).  Meanwhile, nearly 1/3 of the nation’s physicians are ages 60+ (totaling >290K) and according to research using the American Community Survey published earlier this year in JAMA, ~500K healthcare workers, including physicians, are ages 65+.  Estimates of essential workers vary in size depending on the data source used.  In addition to CDC’s 87 million estimate, I’ve also seen estimates as low as 55 million and as high as 101 million.  The essential worker category includes all healthcare personnel.  It’s also estimated that about 8% of essential workers are ages 65+ (Table 1). All that to say, there is indeed much overlap between prioritized groups.

Figure 1.Phase 1 Vaccine Prioritized Groups (from ACIP Slides)

Table 1. Essential Worker Characteristics (from JAMA, Economic Vulnerability of Households With Essential Workers)