An advisory committee on Tuesday said the first COVID-19 vaccines should go to health care workers and residents of long-term care facilities.
The Advisory Committee on Immunization Practices voted 13-1 in a meeting to decide what recommendations to give to the Centers for Disease Control and Prevention (CDC) for how the first vaccines are distributed.
Panel members said the early distribution reflects how health care personnel are at risk of contracting the disease because of their work in facilities that care for COVID-19 patients, and the fact that the elderly are one of the groups most likely to suffer from severe cases of the disease.
There are approximately 21 million health care personnel in the United States and about three million people living in long-term care facilities like assisted living places, according to federal data. The latter group is part of the approximately 53 million adults 65 years and older in the United States.
Officials with Operation Warp Speed, the federal government effort to speed up the development of COVID-19 vaccines, estimates that there will be approximately 40 million doses of the vaccine available in December. Because each person is being dosed twice, that leaves about 20 million being vaccinated this month.
Each population, such as health care personnel, will not be vaccinated entirely before moving onto other groups, panel members said.
Other groups being considered for early vaccines were workers in so-called essential industries and people at high risk because of serious underlying health conditions.
Goals outlined by the advisory committee last month include decreasing death and serious disease as much as possible, preserving the functioning of society, and increasing the chance for everyone to enjoy health and well-being. The committee has four ethical principles guiding its decision-making process: maximizing benefits and minimizing harms, mitigating health inequities, promoting justice, and promoting transparency.
Panel members said the health care personnel group was high in the first three principles. Liaisons also highlighted the importance of vaccinating that group first.
“Amongst state public health officials, there is pretty strong support for vaccinating health care workers,” Marcus Plescia, chief medical officer of the Association of State and Territorial Health Officials, told the committee.
“Health care workers not only are in contact with lots of people, they’re also in contact with people who are very vulnerable,” he added.
Panel members expressed concerns about public backlash to the vaccines if elderly who get them end up dying, but ultimately decided to include the subset of the elderly in the first phase of the vaccine rollout.
Essential workers, such as firefighters, teachers, and farmers, were pushed by some members as the next group to receive vaccines, meaning they won’t get them until next year. The other groups, adults with high-risk medical conditions and adults 65 or older, were placed after that in one slate of recommendations.
“I think that the initial rollout of this vaccination program will set the tone. And I think if we’re serious about valuing equity, that we need to have that baked in early on in the vaccination program,” Dr. Bell Beth of the University of Washington said during the meeting.
“These essential workers are out there putting themselves at risk to allow the rest of us to socially distance and they come from disadvantaged populations, they live in disadvantaged communities, and recognizing that not all of them may want to be vaccinated at this stage, we need to provide them with the opportunity early on in the process,” she added.
The panel won’t decide on which groups come after long-term care facility residents and health care personnel until a future meeting.
Vice President Mike Pence told a press conference in Washington last month that he foresaw the first Americans to receive vaccines as “those most vulnerable and those that are providing health care to the American people.” Pence heads the White House Coronavirus Task Force.
The committee met as the Food and Drug Administration weighs whether to approve emergency use of two COVID-19 vaccines, one from Massachusetts-based Moderna and the other from New York-based Pfizer.
The United Kingdom on Wednesday approved Pfizer’s vaccine.
Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, told WNBC on Tuesday that the recommendations would play a big role in what the CDC ultimately decides.
“I think the people of New York need to realize that even though the CDC will make recommendations based on the advice they got from the committee, the ultimate decision of how it’s distributed in the various batches that come through, is to the local officials,” Fauci said.
