Health care workers and elderly people living in long-term care facilities should receive top priority for COVID-19 vaccines in the United States if, as expected, one or more becomes available next month in limited supply. That’s what a group that advises the U.S. Centers for Disease Control and Prevention (CDC) on such fraught issues decided today in a near unanimous vote.
After hearing detailed presentations from CDC scientists who explained the rationale for this specific prioritization scheme, the Advisory Committee on Immunization Practices (ACIP) voted 13 to 1 to support their proposal. Under the scheme, the first phase of vaccination, known as 1a, would begin with about 21 million healthcare workers and about 3 million adults who live longterm care facilities. As spelled out in the four-hour long virtual meeting, these groups are at highest risk of becoming seriously ill or even dying from COVID-19, and protecting them first, in turn, reduces the burden on society.
“I agree strongly with the decision of the committee,” says Stanley Perlman, a veteran coronavirus researcher and clinician at the University of Iowa who advised the ACIP but is not part of it. “The discussions were incredibly thoughtful with everyone recognizing that we needed to make difficult choices. Of course these allocation issues will become irrelevant once there are enough doses of useful vaccines.”
CDC representatives spelled out the allocation plans for Phase 1b and 1c, but the advisory committee did not discuss those today. The proposed phase 1b would target “essential workers”—for example, school staff, police, grocery workers, and bus drivers–while phase 1c would target adults over 65 and adults of any age who have high-risk medical conditions. The CDC now must decide on whether to accept the phase 1a recommendation, and then states and local jurisdiction will make the final decisions about this and later prioritizations.