- University of California, San Francisco United States
- Harvard University United States
- University of California System United States
- University of Minnesota United States
- Stanford University United States
- University of California, Berkeley United States
- University of Minnesota System United States
- National Institute for Demographic Studies France
COVID-19 mortality increases markedly with age and is also substantially higher among Black, Indigenous, and People of Color (BIPOC) populations in the United States. These two facts can have conflicting implications because BIPOC populations are younger than white populations. In analyses of California and Minnesota—demographically divergent states—we show that COVID vaccination schedules based solely on age benefit the older white populations at the expense of younger BIPOC populations with higher risk of death from COVID-19. We find that strategies that prioritize high-risk geographic areas for vaccination at all ages better target mortality risk than age-based strategies alone, although they do not always perform as well as direct prioritization of high-risk racial/ethnic groups. Vaccination schemas directly implicate equitability of access, both domestically and globally.