Coronavirus vaccine should be sent to health workers first, committee recommends

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People with diseases that put them at a significantly higher risk of poor performance and the elderly living in dense environments are said to be in second place, the committee of the National Academies of Science, Engineering and Medicine said in a draft framework released on Tuesday to help policymakers equitably allocate and distribute a coronavirus vaccine.

Any vaccine that receives FDA approval should be in limited supply initially, before production ramps up and sufficient doses become widely available.

“As major efforts are being made to have a significant supply of COVID-19 vaccine as soon as possible, the committee has been tasked with examining the difficult choices that will need to be made to allocate the very limited initial supplies,” the committee co- the president, Dr Helene Gayle, chief executive officer of the Chicago Community Trust and former HIV / AIDS expert with the Centers for Disease Control and Prevention, said in a statement.

Dr Eric Toner, a senior researcher at the Johns Hopkins Center for Health Security, who was not involved in this report, said the committee had received direction from the government that it should only assume 10 to 15 million doses of vaccine initially available.

“So given that we have a population of 330 million people in the country, that’s a very small fraction of people who could have access to the vaccine right away,” Toner told CNN.The 115-page report recommends a breakdown into four phases.

In the first phase, vaccines would be sent to first responders, high-risk workers in healthcare facilities as well as people of all ages with conditions that put them at significantly higher risk of poor outcomes and the elderly. living in dense environments.

In the second phase, the vaccine would be distributed to critical-risk workers – workers who work both in industries essential to the functioning of society and at a substantially high risk of exposure, as well as teachers and staff. school staff.

The second phase would also include people of all ages with conditions that put them at moderately higher risk; all elderly people not included in phase 1; people living in homeless shelters or group homes for people with physical or mental disabilities or who are recovering; and persons in prisons, prisons, detention centers and other similar establishments, as well as the staff who work there.

Phases one and two combined would cover about 45% to 50% of the U.S. population, the report notes.

Phase three would include young adults; children; and workers in industries essential to the functioning of society and at increased risk of exposure who were not included in phases 1 or 2.

And phase four would include everyone.

The draft report explains in detail why the vaccine should be given first to people most at risk of catching it and passing it on to others – for example, frontline health workers.

The framework document weighs four different criteria.

  • The risk of acquisition and infection:A higher priority is given to people who are more likely to be in settings where Covid-19 is circulating and who are exposed to a sufficient dose of the virus.
  • The risk of severe morbidity and mortality:Higher priority is given to people who have a greater likelihood of serious illness or death if infected.
  • The risk of negative societal impact:Higher priority is given to people with a social function and on whom the lives and livelihoods of other people directly depend and who would be in danger if they fell ill.
  • The risk of transmitting the disease to others:Higher priority is given to people who have a higher likelihood of transmitting the disease to others.
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Minority communities, who are at higher risk than whites, have not been placed in particular phases based on race / ethnicity, but the underlying circumstances that make many vulnerable have been. taken into account.

“People of color – particularly Blacks, Hispanics or Latinxes, and Native Americans and Alaska Natives – have been disproportionately affected by COVID-19 with higher rates of transmission, morbidity and mortality. ”indicates the draft report.

The report makes recommendations similar to those from other groups. The Toner group at the Johns Hopkins Center for Health Security released a report last week recommending that frontline healthcare workers, emergency service personnel and those most vulnerable to the virus be the first to receive a possible vaccine. because “their prioritization would probably avoid the greatest overall damage. ”

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The Centers for Disease Control and Prevention also suggested that healthcare workers should be the first to get vaccinated, followed by essential non-medical workers, and then adults with health conditions who are at higher risk of Covid-19. severe and people aged 65 and over. The CDC’s Advisory Committee for Immunization Practices is expected to release its own report.

Toner said he had “nothing but praise” for the framework project.

“I think they do a very credible job, going through ethical principles and the reasons for prioritizing certain groups over others,” he said.

“They’re talking about doing the most good – maximizing the benefits of the vaccine – by giving it to people who are essential for providing care to others during the pandemic, so health workers for example. And by prioritizing those people who are at greatest risk – and that is the greatest risk of contracting the disease or transmitting the disease or dying from the disease if they are infected. ”

The committee was formed in July at the request of the National Institutes of Health and the CDC to help advise the federal government on how to allocate vaccines. The agencies wanted an outside voice; national academies are independent, non-governmental expert organizations that advise the federal government on policy.

There will be a public comment period open until 11:59 p.m. on Friday, September 4. The NAS will hold a five-hour listening session on Wednesday for the public to ask questions directly to the study committee.

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