The Advisory Committee on Immunization Practices also voted to recommend that the third stage of the national immunization program focus on adults 65 to 74 years old, people 16 to 64 years old with high risk health conditions and essential workers not included in the second phase of vaccination.
The committee defined essential front-line workers as first responders, teachers and other education workers, including child care workers, food and agriculture workers, facility staff. correctional workers, postal workers, transit workers and people who work in manufacturing and grocery stores.
The vote came after hours of data presentations and debate, and calls from members of the public to move individual groups up the priority list.
“I voted for this recommendation because in my opinion it follows the evidence on the risk of coronavirus and the ethical principles we have developed on ACIP to maximize benefits and minimize harm, promote justice and minimize inequalities in health, ”said Peter Szilagyi, pediatrician at UCLA.
“We’re trying to thread the needle here.”
Szilagyi and several members of the committee said the work to decide who gets priority access to Covid-19 vaccines is agonizing.
“This is without a doubt the toughest vote I have taken in my 6.5 years on this committee,” said President Jose Romero, Arkansas health secretary.
The committee voted 13 to 1 to approve the groups to be included in phases 1b and 1c of the immunization program. Phase 1a, currently underway, gives top priority to healthcare workers, residents and nursing home staff.
Le dissident solitaire, Henry Bernstein, a pediatrician and professor at the Zucker School of Medicine in Hofstra / Northwell, said he believes adults aged 65 and over should have been in phase 1b. The virus’s toll on people 65 to 74 is not significantly different from its impact on people 75 and older, he argued.
ACIP’s recommendations now go to CDC Director Robert Redfield, who must approve them to become CDC guidelines. However, national and local health authorities make the final decisions on how to roll out vaccination in their localities.
At the end of Sunday’s meeting, it was announced that more than half a million people in the country had already been vaccinated with the Pfizer Covid-19 vaccine. Moderna’s vaccine, which received emergency use clearance from the Food and Drug Administration on Friday evening, will begin rolling out this week.
ACIP’s Covid Vaccine Task Force, which proposed priority groups, explained that it was trying to balance disease and death prevention by trying to maintain societal functioning as well as fairness. . Essential front-line workers have jobs where they cannot work from home; they may not even be able to practice social distancing due to the demands of their job.
Previously, the committee had talked about putting all essential workers ahead of seniors – an idea that drawn pushback Health and Social Services Secretary Alex Azar, among others.
But the whole group of essential workers, which rests on a list developed by a division of the Department of Homeland Security, represents about 87 million people – too large a group at a time when vaccine stocks are scarce. Essential workers who will have to wait until Phase 1c to get vaccinated include people who maintain water and sewer systems, people who work in the IT and communications industry, members of the media and workers in the public security.
Operation Warp Speed, the federal government’s program to speed up vaccine production, estimates that there will be enough vaccines to immunize 20 million people in December, an additional 30 million in January and an additional 50 million by end of February.
Phase 1a of the immunization effort, which began last week, is to deliver the vaccine to 24 million people. In phase 1b, 49 million people will be eligible to receive the vaccine. Phase 1c is a much larger group, comprising around 129 million people. In total, the first three priority groups will cover 202 million people, double the number of people the country expects to be vaccinated by the end of February.
Many committee members stressed that more funding for immunization work needs to flow to states by the federal government. Groups like the Association of Immunization Managers have estimated the vaccine deployment will cost more than $ 8 billion, but states have so far received less than half a billion dollars for the work.
“Today, state and local public health services are on life support. We are crippled and blocked by the lack of federal funding needed to allow us to take advantage of these newly available vaccines, ”said Jeffrey Duchin, non-voting member of the committee representing the Infectious Disease Society of America.
“Operation Warp Speed delivered two Cadillac vaccines to us,” he said. “But they came with empty gas tanks and we have a long and difficult road ahead of us.”
This story has been updated with more details from Sunday’s meeting.