The Social Vulnerability Index, COVID-19 vaccines, and why it makes some Republicans mad

There has been much discussion recently about a tool the state of Michigan uses to decide where to send COVID-19 vaccines – called the Social Vulnerability Index (SVI). This formula is a factor the state uses in allocating vaccine doses across Michigan.

Some elected officials, mostly Republicans, are upset about this. They say the state has nothing to do with using a tool like SVI, which takes a number of demographics into account to determine how vulnerable a population is.

Listen to reporter Sarah Cwiek discussing the Social Vulnerability Index and COVID-19 Vaccine Allocation on Stateside

State Senator Jim Runestad (R-Oakland County) raged in the Senate this week over the SVI. He said vaccine distribution should be limited to just two factors: population size and age.

“Almost 90 percent of COVID deaths are over 60 years old,” ranted Runestad. “And that’s not enough for us to address this population and not use how much money you earn or what type of apartment do you live in?”

Here are some facts about the SVI, how the state uses it, and why the issue has been hotly politicized.

What is the Social Vulnerability Index?

The SVI is a tool developed and used by the U.S. Centers for Disease Control and other federal agencies to essentially determine how vulnerable a population is to an emergency situation – from a hurricane to a pandemic like COVID -19.

The SVI takes into account 15 variables about the population at the district and census tract level:

• Below the poverty line
• Unemployed
• income
• No high school diploma
• 65 years or older
• 17 years or younger
• Older than 5 years with a disability
• Single parent households
• minority
• Do you speak English “Less Than Well”
• Multi-unit structures
• Mobile accommodations
• hustle
• No vehicle
• Group quarters

A formula then weighs this data to give each county (or census area) a rating that indicates how socially vulnerable it is – with 0 being the lowest (least at risk) possible rating and 1 being the highest.

Michigan did not create or use this formula itself. Nor is it the only factor the state uses to allocate vaccines. The state also takes into account the size of the population and the percentage of a population that serves what are known as priority groups – groups that the state has designated as “first in line” for receiving the COVID vaccine. This includes people 65 and older, the number of key frontline workers, educators, and correctional officers (this applies to local public health institutions such as the county health authorities and hospital systems based on the population they serve).

The SVI data is then combined with these factors to make vaccine distribution decisions, said Linda Vail, Ingham County’s health officer. “It’s kind of a multiplier,” she said. “The higher your Social Vulnerability Index, the higher the vaccine surge.”

Vail supports the use of the SVI for this purpose. She said public health is about targeting and caring for the most vulnerable populations, and it wouldn’t make sense to ignore that type of data.

“What we can say is that we really need to make sure we are reaching these populations and knowing where they are based on the Social Vulnerability Index in our communities so that we don’t leave the most vulnerable in an often accessible situation on privileges, ”said Vail.

Vail said we know that certain groups, ranging from people of color to people with disabilities, are more likely to suffer from poor outcomes from COVID-19. “We really need to take into account the fact that with such a vaccine we cannot establish a system that makes certain populations definitely more susceptible without taking that into account,” she said.

The pushback

But some elected officials, especially Republicans, are angry that the state is using SVI in this way.

Senator Runestad made his objections very clear in the Senate this week. Its rationale is that less vulnerable communities like affluent Oakland County are short of vaccines, while communities like Detroit have expanded access because SVI gives them so many more doses of vaccine to work with.

Runestad claims that many Oakland County seniors are “angry” because they cannot get vaccination appointments, while a hypothetical 40-year-old Detroit resident with a disability can. Rejecting objections from some Democratic colleagues suggesting that Oakland County actually vaccinated a greater percentage of its population than Detroit, he said, “The number of people who refused to be vaccinated is not the point.” He also claimed that Detroit is receiving greater numbers of vaccine doses than Oakland County, although Oakland County has consistently administered more shots than Detroit in the past four weeks.

Nonetheless, the state’s use of SVI tends to do things proportionally in Detroit’s favor. And that had literally driven Runestad crazy. He noted that age is the biggest risk factor for death from COVID-19 and that vaccine allocation should be a simple statement based on that factor.

“The state of Michigan is failing [seniors] with their social engineering guidelines, ”said Runestad.

“It shouldn’t be controversial to prevent the state from using race, gender and socio-economic factors in place of actual harm, possible death. [in] decide to distribute this vaccine. “

It is important to note that while race and poverty are SVI variables, they are not the only ones – and the formula does not necessarily favor urban areas over rural areas. Wayne County, home of Detroit, has a high SVI score. But also some rural, mostly white counties like Oceana County, Lake County, and Clare County.

Turn SVI into a political negotiation chip

State Republican lawmakers this week have been more than vocal about the SVI’s role in vaccine distribution. They added a corresponding amendment to an important law that resulted in a firestorm.

That legislation would split a portion of the billions of dollars the Michigan federal government has recommended for COVID-19 relief, including assistance with vaccine distribution. The Republicans sat on the money to force Governor Gretchen Whitmer to give up some of her powers.

The change would prohibit the state from using SVI as a factor in vaccine allocation and prohibit the use of demographics such as “race, gender, color, national origin, religion, gender or socio-economic status”.

The amendment was approved by the Republican majority on a party-political basis. Senators like Runestad said it was about simple fairness and not about people “jumping the line” in front of vulnerable seniors. Some Democrats pointed out that SVI does indeed favor many poorer rural areas, and Senator Erika Geiss (D-Taylor) called Republican objections to SVI “racist bullsh * t”.

Some local governments have also targeted SVI. Livingston County’s officials passed a toothless resolution criticizing 11th highest instead of lowest, or 83rd “(Livingston County has Michigan’s lowest SVI).

But other local government officials have praised it.

“The state of Michigan appears to be taking a justice-based approach to vaccine distribution,” said Evan Bonsall, a commissioner for the city of Marquette, at a meeting this week. “Which in my opinion treats northern Michigan and the UP very fairly. The UP and the rest of Northern Michigan actually did very well compared to the rest of the state, according to these stock metrics. “