Alan Cobo-Lewis, Ph.D., is an associate professor of psychology and director of the Center for Community Inclusion and Disability Studies at the University of Maine. He is also the parent of two adult children, one of whom has a disability. His views are his own.

During the pandemic, Maine followed many science-based recommendations. But there was a lapse — in data analysis and ethics — putting people with certain disabilities and other conditions at unfairly high risk of death. This must be addressed before I could support Dr. Nirav Shah for governor.

Maine initially prioritized people in congregate settings for COVID vaccines — including
nursing homes and group homes supporting people with significant disabilities. This was good policy based on science and federal guidance.

But then Maine adopted a “keep it simple” approach, prioritizing age alone — staging vaccinations, first to the oldest adults, then to people a decade or so younger, then somewhat younger, etc. This seemed to have some justification, as the risk of COVID death escalated sharply with age.

While many in the disability community expressed great concern about no longer prioritizing anyone with a disability unless they were old, I advised advocates to respect the data. But it turned out that Maine’s analysis, presented by Dr. Shah as Maine Center for Disease Control and Prevention director in February 2021, fell short.

After conducting a deeper analysis, I reached out to Dr. Shah to share important results: that certain conditions, including hematological malignancy and Down syndrome, had elevated risk of COVID death by more than the risk associated with a decade of age. I suggested Maine could maintain the “keep it simple” approach if, for example, people with Down syndrome got vaccine access with other people 10 or 20 years older.

After he agreed to review the analysis and recommendation, radio silence ensued. And
Maine still refused to vaccinate people who the data showed had elevated risk of COVID
death.

Strictly age-based prioritization had already come under assault as being unethical. Even before COVID, in a document reviewed and retained by the first Trump administration, the U.S. Department of Health and Human Services advised that under the Affordable Care Act’s nondiscrimination provisions, a state is “only permitted to consider age as one factor as part of its overall decision-making.”

Maine’s inequitable decision was fortunately reversed by the Biden administration, which ordered vaccines available to everyone by April 2021. My data analysis and recommendations are published in a peer-reviewed journal.

The paper showed risk of COVID death was higher — sometimes much higher — in people with Down syndrome (tenfold elevation), organ transplantation (3.5- to 6.5-fold), severely reduced kidney function (2.5-fold) and intellectual or developmental disability (where risk may also depend on living condition) than from a 10- or 20-year increase in age.

The article “Equitable vaccine access within an age-based framework” appears in the
Developmental Disabilities Network Journal. While I am proud to have it published there, I first tried a public health journal. But the public health editor said my recommendations were too obvious.

And yet they weren’t obvious to Maine’s chief public health officer.

In March 2022, Dr. Shah spoke with a UMaine audience about his communications strategy. Makes sense: he is an excellent communicator. Asked by a student about lessons learned (where he might have communicated differently), Dr. Shah replied somewhat off-topic (focusing on policy rather than communications) by saying other states should have followed Maine’s lead in prioritizing vaccines solely based on age.

It is troubling that Maine’s public health leadership devalued the lives of people with disabilities and significant health risks when data was available and analyzed to make the issue plain. And that, a year later, Maine’s public health director doubled down on defending the discriminatory policy.

We should all learn from our mistakes. But sometimes some people don’t. In the next crisis, how can I know Dr. Shah won’t throw people with disabilities under the bus again?