COVID-19, Vaccine and Age Discrimination
By: Dr. Patricia Farrell
Tags: Vaccines, Discrimination, Life, Caregiving, Ageing Population

COVID-19, Vaccine and Age Discrimination

Older adults are being pushed to the back of the line in the planned distribution of the vaccine but that’s changing. Public pressures and media attention have shown their power. Dr. Patricia Farrell Follow Nov 12, 2020 · 5 min read

Photo by Christian Langballe

Old age isn’t a battle; old age is a massacre. — Philip Roth

Discrimination against persons over the age of 60–65 has been written into Federal regulations regarding how to run clinical trials and how to parcel out vaccines and healthcare. It’s not new, but it can mean a lack of resources for older Americans and even death due to these guidelines.

Unfortunately, there is a long history of exclusion of older adults from clinical trials, such as those for heart disease, cancer and diabetes. In fact, this reality resulted in the National Institutes of Health instituting a policy in 2018 requiring inclusion of older adults in clinical trials in order to obtain federal funding.

One problem is that some companies will go it alone and won’t seek Federal funding. They will be free from any age-discrimination requirements.

It’s not new because, seemingly, age discrimination here has already started, and planning for the future and dealing with this dismal reality will not be easy. In an age of medical advances and the lengthening of lifespans, this is the equivalent of not a slap in the face but the possibility of an early grave.

Our results demonstrated that older adults are highly likely to be excluded from 53% of 847 COVID-19 clinical trials that qualified for detailed review.

One physician gave voice to his concerns in a short article of concern he saw published recently. He wrote:

Already, I’m acutely aware of the perverse poignancy with which the outsized impact of Covid-19 on elders has laid bare medicine’s outdated, frequently ineffective or injurious approach to the care of patients who are the planet’s fastest-growing age group and the generations most often requiring health care.

The lifeboats in terms of life-saving vaccines will not have room for this population, and they will be left with their memories and a limited future to envision—what a gift for all they have done for the rest of us.

Photo by eberhard grossgasteiger

Who Gets a Chance at Life and Who Doesn’t?

The “fair policy” approach to vaccine distribution clearly favors the young over the older person. Job discrimination has been around for ages. Anyone over 50 (the Social Security Disability rules say over 50 you’re less likely to get a job) is considered a poor risk for employment. Now it has come to healthcare like a hurricane on the winds of a virus. The actuaries are at work here determining your number of years left to be a contributing citizen.

The policy now is an “ethical” one as well as a triage model for distributing a COVID-19 vaccine, and it will cut through families like the proverbial knife, but mentally this time. The model also offers considerations of country, socioeconomic status, and need. Little is said about age. But, in essence, it means some will die.

Some authoritarian countries may do an excellent job of distributing vaccine to minimize health, economic, and other harms. As long as individuals benefit, fair global distribution among countries should neither require that intranational distribution of a vaccine be perfectly just nor seek to punish unrelated injustices. However, some countries may grossly mismanage their domestic vaccine allocations, by, for instance, hoarding doses for a ruling elite.

Researchers are becoming more verbal in the discrimination we are seeing now and may continue in the future.

As Dr. Sharon Inouye wrote for Next Avenue, when she and her research team reviewed COVID-19 clinical trials registered at Clinicaltrials.gov as of June 1, 2020, they found that people over 65 were highly likely to be excluded from 53% of 847 COVID-19 clinical trials that qualified for detailed review. And older adults were highly likely to be excluded from 100% of 18 vaccine trials.

Excluding any group from clinical trials means the results are biased because they are not represented, nor do the results mean they will benefit from the product. How many ethnic groups have been the target of research bias?

Now we see older adults being included in these left-out groups despite US government rulings on Federal grants required to include older adults.

Leonardo da Vinci, Wikipedia

Tossing the Capable and Contributing Aside

Years ago, there was a TV commercial intended to bring home the idea of racial injustice in education and jobs. The VO (voice-over) said, “A mind is a terrible thing to waste.” How true.

If Leonardo da Vinci were here, would he qualify for a covid vaccine trial or be given the vaccine? He was quite advanced in age when he sketched his self-portrait.

How many others will be sacrificed now, and how do we determine who is worthy of a dose and who must take their chances? Of course, the elite will receive it; we know that for a fact.

The discrimination may even turn over portions of the burgeoning business of healthcare. Families, realizing their loved ones won’t receive adequate care and with stretched resources, may return to the multi-generational family structure. Current caregivers who are older may begin to seek cohabitation in housing and care.

A significant share of adults ages 65 and older — 17% — serve as caregivers for another aging American. These adults, who themselves are advanced in age, are the second most likely age group to be caregivers. Many in this group are caring for a spouse or partner (29%) or a friend or neighbor (33%).

But the “rules” say these caregivers, because of their age, won’t qualify for the vaccine trials or vaccines. Who will take care of those for whom they care?

The challenges aren’t confined to healthcare and medicine. These problems reach out like an octopus into every aspect of our cultures and our economies.

Who has the prescience to view this now before it’s too late?