Last month the Chair of the Livingston County Board of Commissioners¹ examined the algorithm used by Lansing to allocate vaccines to local health departments in Michigan. This examination was prompted by questions as to whether Livingston County citizens were receiving their fair share of COVID vaccine.

During this examination, it was discovered that Lansing allocates vaccine based upon social needs, not medical needs. To this day many citizens are unaware that Lansing's allocation formula is based upon 14 Social Factors and just 1 Medical Factor. Further, the sole Medical Factor, being 65 years or older, only accounts for 6.25% of the total factor weight. Using its Social Vulnerability Index, vaccine doses are allocated to each jurisdiction² in proportion to their target population³ and their Social Vulnerability Index (SVI) number.^{4, 5} 

While the Livingston County Board of Commissioners has argued that vaccine allocation should be based on medical factors, not social factors, it appears that the argument has fallen on deaf ears in Lansing. Given Lansing's preference to using SVI, another examination of the data was undertaken. The results of this second examination are presented in the report.

The objective of this second examination was to answer the question, "Are Livingston County citizens receiving their fair share of COVID vaccine?" In other words, using Lansing's SVI scheme, is Livingston County receiving its fair share? The answer is a resounding NO. As of March 3, 2021, Lansing has provided Livingston County with only 65% of its fair share.⁶  A score of 65% would earn a Michigan student a grade of "D". Citizens have a right to expect better than a "D".

This near failing grade prompted another question, "Which jurisdictions are receiving more than their fair share and which are receiving less?" Before presenting data from all jurisdictions here is a quick overview of the findings.

• By a more than 2:1 ratio, more jurisdictions are not receiving their fair share of COVID vaccine.
• 56 jurisdictions are not receiving their fair share, 27 are receiving more than their fair share.
  
• At 9.14%, Presque Isle County has received the lowest percentage of its fair share. (less than 1/10 of its share)
• At 444.65%, Otsego County has received the highest percentage of its fair share. (more than 4 times its share)
• Wayne County (excluding Detroit) has the biggest deficit in vaccine doses at -83,656.
• Oakland County has the biggest surplus in vaccine doses at 98,712 does. 

Data for all jurisdictions are shown in Tables 1, 2, and 3. These tables display the exact same data, however, each table is sorted differently. Table 1 is sorted alphabetically by jurisdiction name. Table 2 is sorted numerically by Social Vulnerability Index score. Table 3 is sorted numerically by the variance in vaccine doses.

The data used to construct these tables can be downloaded in an Excel spreadsheet by clicking here. Note that the data used for this analysis were downloaded from the COVID-19 Vaccine Dashboard on March 3, 2021. Up-to-date data can be found at Michigan's COVID-19 Vaccine Dashboard. After arriving at this dashboard, click on the link named "COVID-19 Vaccines Shipped To Providers."

Discussion

Lansing has been remarkably inconsistent in delivering vaccine doses to Michigan citizens. The data shows that citizens in some counties would be very happy with Lansing's performance, while citizens in a majority of counties would view Lansing's performance as somewhere between sub-par and woefully inadequate.

It is puzzling as to why the variance in vaccine allocations is so large given that vaccine distribution is centrally controlled by "experts." Additional investigation is needed to determine what is failing in Lansing's distribution process. This report does not speculate as to the reasons for this Lansing's inconsistent performance. Rather, this report focuses on quantifying the magnitude and the location(s) of the problem(s). 

The convoluted SVI allocation formula along with a lack of media attention has helped obscure the fact the Lansing has failed in its task of fairly distributing the COVID vaccine. Armed with the data in this report, it is hoped that more and more Michigan citizens will speak out on behalf of vulnerable citizens in their counties. Speaking out could include contacting the Governor's office, contacting your State Representative and State Senator, contacting your local county officials, and contacting your local media outlets.

Comparing Jurisdictions with Similar SVI

Lansing incorporated SVI into its vaccine allocation plan to provide more doses to jurisdictions it sees as more socially vulnerable (or more socially deserving). As discussed in Footnote 4, twice as many doses are provided to a jurisdiction having an SVI of 2 than a jurisdiction having an SVI of 1.

Proponents of SVI argue jurisdictions that are more socially vulnerable deserve more vaccine doses because their constituents have been hit harder by COVID. While this SVI rationale is still open for debate, let's examine how well Lansing is doing with providing vaccine doses to socially vulnerable communities.

There are 14 jurisdictions with SVI scores of above 1.90. These jurisdictions include the City of Detriot along with 13 counties (see Table 2 for a list of jurisdictions sorted by SVI score). According to Lansing, these jurisdictions are the most socially vulnerable in Michigan. Therefore, after adjusting for target population differences, shouldn't these jurisdictions receive approximately the same quantity of doses? Clearly, they do not! For unknown reasons, Lansing has decided to treat these similarly vulnerable communities differently. 

For example, Detroit with an SVI of 2.00, has received 16.42% more than its allocated share. In contrast, Van Buren County, with an SVI of 1.96 has received only 37.87% of its allocation, and neighboring Cass County also with an SVI of 1.96 has received only 49.49% of its allocation.

With respect to the number of vaccine doses, Detroit has a surplus of 34,941 doses, Van Buren County has a deficit of 17,062 doses, and Cass County has a deficit of 10,613 doses. The combined deficit of these two neighboring counties (27,675 doses) is less than the Detroit surplus. If Lansing had a reasonably functioning distribution system then all three of these jurisdictions could have received their allocated amounts.

As Lansing espouses its belief in social fairness, it doesn't want you to know that it treats equally vulnerable communities unequally.

Lansing's inequality also exists among communities deemed to be less socially vulnerable. Let's examine the three communities with the lowest SVI scores in Michigan. Livingston County, Oakland County, and Washtenaw County have SVI scores of 1.02, 1.04, and 1.07 respectively. In addition to similar SVI scores, these counties are located in the same geographic region, with Livingston County sharing a border with the other two counties.

With similar SVI scores and similar geographic locations, one might expect these three counties to be similarly treated by Lansing. Again, this is not the case. Livingston County has received 65.02% of its SVI adjusted allocation while Oakland County and Washtenaw County have received 141.93% and 178.49% respectively.

With the examples provided, one might question how Lansing defines the word "fair".

 ___________________________________________________________________

1. Wes Nakagiri is the Chair of the Livingston County Board of Commissioners. Upon his election in 2018, Mr. Nakagiri retired from his engineering management position at an automotive supplier where, among other duties, he directed Six Sigma activities for his division. He holds a Bachelor of Mechanical Engineering from General Motors Institute in Flint, Michigan. He also holds a Masters Degree in Applied Statistics from Oakland University in Rochester, Michigan.
2. Lansing distributes vaccine to Michigan's 83 counties plus the City of Detroit. Collectively, this report refers to these 84 local units of government as jurisdictions. It should be noted that vaccine quantities are published for all jurisdictions except Keweenaw County. It is not clear why this county does not show up in published reports.
3. The target population is the number of citizens meeting any of these criteria: a) 70% of the total citizens 65 years and older, b) frontline essential workers, c) school and child care staff
4. A jurisdiction's SVI number ranges from a low of 1 to a high of 2. A jurisdiction's target population is multiplied by its SVI to determine its share of vaccine doses. Jurisdictions with a lower SVI will receive fewer doses than jurisdictions with a higher SVI. Example: Jurisdiction A and Jurisdiction B have equal target populations, but A has an SVI of 1, while B has an SVI of 2. Therefore, A will receive one-half the number of doses of B. Each jurisdiction's SVI number is shown in Table 1. For a more complete discussion of SVI and how it impacts vaccine allocation please read the report "Social Equity vs. Vaccine Fairness" and the State of Michigan publication "Population Estimates for Allocation Planning." 
5. The merits of using SVI in the allocation of vaccine doses will not be discussed in this report. Rather, this report examines the extent to which Lansing is fairly following its chosen vaccine allocation plan.
6. SVI provides cover for Lansing to redistribute vaccine doses from less socially favored jurisdictions to more socially favored jurisdictions. In the case of Livingston County, Lansing can claim it has delivered 65.02% while in fact, it has only delivered 45.5%.
   
   
   

 Table 1 - Sorted by Jurisdiction

Table 2: Sorted by SVI

 Table 3: Sorted by Variance, Doses