ABSTRACT
Early in the coronavirus disease 2019 (COVID-19) pandemic, guidelines providing initial recommendations for ethical distribution of COVID-19 vaccines were released for public use before vaccines were available. Almost all these initial guidelines placed high-risk health workers in the first tier of distributions. But as the COVID-19 vaccines inched closer to distribution, it became increasingly clear that there would not be enough vaccines for all high-risk health workers in the initial distributions - raising the question of how health care systems should tier and distribute scarce vaccines to their high-risk health workers specifically. This article overviews our Health System's efforts to appropriately identify and stage our health care workers at highest risk of COVID-19 in order to provide an ethically justifiable allocation process for vaccines until they were no longer scarce. Our allocation algorithm aimed to capitalize on the data we already possessed, avoid violations of employee privacy or confidentiality, remain objective and unbiased, and be automatable. Moreover, our allocation algorithm importantly reflected Centers for Disease Control and Prevention (CDC) guidelines to include Social Vulnerability Indexing factors by including some personal features of our health care workers - such as gender, race-ethnicity, age, and postal code.