Rare coronavirus vaccine should be sent to frontline health workers first, report suggests

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People working to manufacture and distribute the vaccine should also be the first to get one, recommends the team at the Johns Hopkins Center for Health Security.

“The main reason why these candidate groups are included in level 1 is that their prioritization would probably avoid the greatest overall harm,” the Center report says.

According to the World Health Organization, 29 vaccines are being tested in humans worldwide; four of them in the United States. Federal health officials say they expect to know if one or more of them are working safely by the end of the year and hope to start distribution early next year. But while companies are already ramping up production in case a vaccine works, there won’t be enough to get everyone vaccinated right away.

“It may take several months for most US residents to have access to the vaccination; bottlenecks at various stages of the vaccine manufacturing process (eg, supply of vials or syringes, filling and finishing process) could cause further delays in vaccine availability, ”the report says. .

The U.S. Centers for Disease Control and Prevention’s Advisory Committee on Immunization Practices and the National Academy of Medicine are investigating who should get one first.The Johns Hopkins team, which included health safety experts, vaccine researchers, bioethicists, and specialists in patient safety and vaccine access, wanted to inform the discussion.

“It is important to stress that we are not providing a set of definitive recommendations on who should be prioritized for vaccination,” they warned. But they said their candidate groups should be given serious consideration.

Even within priority groups, it will take rankings. “There will likely not be enough vaccines for all members of the Tier 1 candidate groups to be offered vaccines simultaneously,” the report said.

First: “Those who are most essential to supporting the ongoing COVID-19 response,” they suggested. Next would come those most essential to maintaining “basic social functions”, such as teachers, public transport workers and food supply workers.

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Also in the foreground: those most at risk of serious illness or death and their caregivers. It might be more important to vaccinate caregivers, they said, because some people at risk might not be able to be vaccinated safely or not develop a robust immune response.

In the second level should come health workers not directly involved in the response to the coronavirus; pharmacy staff; people living far from health care; electricity, sanitation and other key workers; delivery staff; deployed military; and the police.

“Vaccination will not eradicate SARS-CoV-2 from the planet, and COVID-19 is likely to become an endemic disease, even after widespread vaccination, due to the occurrence of sporadic cases and occasional epidemics “, Warns the report.

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There are also cost considerations. “While the vaccine itself does not come at a cost for most people (this has not yet been established), the associated costs – such as travel to a vaccination site or the need to leave work – could create a financial obstacle for some ”, notes the report. “More investment and innovation is needed to deliver vaccinations in non-traditional sites that are convenient, familiar and feel safe for many vulnerable and under-represented populations. ”

The federal government must coordinate vaccination efforts and ensure that policies are also enforced. It is essential that people have confidence that the process is fair and safe, the report says.

Getting it right is essential, the Johns Hopkins team said.

“What is done at the start of a vaccination campaign will have implications for all aspects of our personal and public life,” they wrote.

“We risk reducing trust in government, as well as in our public health and health systems if the allocation, distribution and administration of the vaccine is not handled appropriately and clearly communicated,” they said. added.

“If, on the other hand, an allocation strategy is ethical, nationally consistent, fair, and informed by major constituency groups, then the vaccination campaign is more likely to run smoothly and be successful. accepted by the public, which would translate into many lives saved and faster economic recovery. ”

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