Staff Contact: Mat Reidhead or Jackie Gatz
Missouri, like all other states, has followed guidance from the Centers for Disease Control and Prevention to inform its strategy on prioritizing high-risk individuals for the early distribution of severely supply-constrained COVID-19 vaccines. As of Feb. 15, 886,800 doses have been administered to 641,376 individuals in phases 1A and 1B — front-line health care workers, long-term care facility residents, elderly Missourians, and adults with one or more of 10 high risk conditions identified by the CDC’s Advisory Committee on Immunization Practice. Included in the list are individuals with type II diabetes, a late onset insulin-inhibiting chronic disease that is linked to body mass and inactivity that affects 8.6% of the adult population in the U.S. Absent from the list are individuals with type I diabetes, a genetic or autoimmune response that prevents the pancreas from producing insulin, typically occurring in childhood and affecting just 0.55% of adults in the U.S.
Numerous studies have quantified the risk of severe reactions from COVID-19 associated with type I diabetes.
- 3.5 times the risk of death (versus 2.0 times for individuals with type II)
- 2.4 times the risk of needing ICU-level care (versus 1.4 times for individuals with Type II)
- 3.9 times the risk of hospitalization (equivalent to individuals with type II)
- 4.0 times the risk of ketoacidosis for Black individuals with type I diabetes
A recent analysis of HIDI claims data found 867,415 individual Missourians ages 18 to 64 are eligible for a vaccine under the state’s phase 1B, tier 2 criteria (above). Including Missourians with type I diabetes (as other states have done) would grow this number by less than 20,000 individuals after accounting for multiple comorbidities. In other words, expanding the high-risk criteria to include adults with type I diabetes would require less than 4.5% of vaccines administered in the state to date, while extremely moderating the risk of hospitalization, ICU admission and death for 20,000 Missourians.