Healthcare workers and long-term-care facility residents should get a coronavirus vaccine first, according to US health officials
- The Centers for Disease Control and Prevention's Advisory Committee on Immunization Practices voted on Tuesday to recommend that healthcare workers and residents of long-term-care facilities receive a coronavirus vaccine first.
- Vaccinating healthcare workers first would allow them to continue to respond to the pandemic.
- Those living in nursing homes and assisted-living facilities have experienced high rates of COVID-19 cases and deaths.
- The committee's recommendation will help the government decide who gets the first doses of a vaccine once it is authorized.
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Healthcare personnel and residents of long-term-care facilities should be the first to receive a coronavirus vaccine, the Centers for Disease Control and Prevention's Advisory Committee on Immunization Practices (ACIP) said in a meeting on Tuesday.
The committee of medical and public-health experts voted 13-1 to allocate initial supplies for vaccinating these two high-risk populations. It is ultimately up to state governments to decide how vaccines will be distributed.
Because they provide care to those infected, healthcare workers are at a high risk of coming into contact with the coronavirus, getting sick with COVID-19, and spreading it to others. The committee's members and representatives were overwhelmingly in favor of providing the first doses of the vaccine to healthcare personnel: physicians, nurses, technicians, EMTs, pharmacists, and anyone else who may be exposed in a healthcare setting.
Frontline healthcare workers could get their first shots as soon as mid-December, Business Insider's Aria Bendix reported.
A Food and Drug Administration advisory committee is scheduled to review Pfizer's request for emergency-use authorization on December 10. If the FDA green-lights the authorization, Americans can start receiving shots 24 to 48 hours later, and ACIP's recommendation will help determine who is first in line.
Those who live and work in skilled-nursing and assisted-living facilities should also have priority, according to the ACIP decision. As of November 24, residents and staff of long-term-care facilities made up 6% of the country's COVID-19 cases and 40% of deaths, according to Kaiser Family Foundation data.
Some ACIP members questioned whether residents of long-term-care facilities should be included in the first phase of the rollout. Keipp Talbot, an ACIP member and associate professor of medicine at Vanderbilt University, expressed concern about how older adults would react to the vaccine and whether it would be effective, given the limited clinical-trial data for that age group. Talbot voted against the recommendation.
"We have traditionally tried a vaccine in a young healthy population and then hoped it works in our frail, older adults," Talbot said in the meeting. "That concerns me on many levels, particularly for this vaccine."
Talbot added that prioritizing workers in long-term-care facilities rather than residents could have a greater effect on those communities, as demonstrated with influenza vaccines in past years.
Within healthcare settings and long-term-care facilities, there may be a need to initially prioritize certain subgroups, Sara Oliver, a CDC officer, said in the meeting. About 40 million doses of the vaccine will be available by the end of December, but they won't be accessible everybody at once.
"We anticipate 5 million to 10 million doses per week post-authorization, which could lead to a need for subprioritization of the initial populations, at least for the first several weeks," Oliver said.
Healthcare workers who have direct contact with patients and are unable to work remotely are recommended to get first priority, as are those working in long-term-care facilities where residents and staff can get vaccinated at the same time. Skilled-nursing facilities, which serve the most medically vulnerable older people, should also be considered before other long-term-care settings, according to the recommendation.
Oliver also said that people who have had COVID-19 were unlikely to be reinfected within 90 days after their first symptoms, so people who have not recently been infected should come first. But ACIP did not recommend testing for antibodies before vaccination.
Other groups that could be prioritized in the early phases of the vaccine rollout are essential workers who do not work in healthcare settings — such as teachers, food-service workers, and first responders — those with high-risk medical conditions, and adults who are 65 and older. According to ACIP's previous discussions, those groups could make up phases 1b and 1c of vaccine distribution.
Dr. Celine Gounder, a member of President-elect Joe Biden's COVID-19 advisory board, told CNN on Friday that the Biden administration planned to heed the advice of public-health experts and scientists when it came to prioritizing who should get a vaccine first.
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