Who should be next in line for the vaccine?

NEW YORK (AP) – The US COVID-19 vaccination campaign has begun, and the few doses available are mostly in the arms of health care workers and nursing home residents.

But what happens in January, February and March, when more photos are expected to be available? Who should receive these doses?

A federal group of vaccination experts is addressing this question at an emergency meeting this weekend. Whatever the committee decides, there will be differences from state to state.

Panelists are bent on putting “essential workers” first, as bus drivers, grocery store officials and similar employees cannot work from home. These are the people who become infected most often and where concerns about racial inequities are more evident.

But other experts say that people aged 65 and over should be next, along with people with certain medical conditions. These are the people who die at the highest rates, they say.

The group is scheduled to vote on the proposal on Sunday, a day after discussing a vaccine made by Moderna.

“I think we know this will not be perfect. We don’t have a vaccine for everyone right away, so we will have to make difficult decisions, “said Claire Hannan, executive director of an organization that represents state vaccination program managers.

If key workers do follow, states already have different ideas about which of them should be closer to the front line.

In Nevada, for example, teachers and child care staff will be in front of public transportation workers, according to the state’s current immunization plan.. Then come agriculture and food workers, then retail and utilities.

In South Dakota, teachers may have access before those working in food and transportation. In Arkansas, the list of essential workers includes teachers, guards, police officers, packaging factory workers and mayors.

The advice of the expert group – the Advisory Committee on Immunization Practices – is almost always approved by the US Centers for Disease Control and Prevention. This was the case earlier this month, when the group said that maximum priority should be given to health workers and long-term care home residents for the initial vaccination of 20 million this month.

But it is not clear that things will go the same way in the next phase. The director of the CDC, Dr. Robert Redfield, said he believes that priority should be given to people aged 70 and over who live with children or grandchildren.

The chairman of the advisory committee, Dr. Jose Romero, told the Associated Press that he was aware of Redfield’s previous comments, but did not speak directly to him about it.

Redfield declined to say whether he would prioritize the elderly over essential workers, even though the group recommends the opposite. “I look forward to listening to the advisory group’s discussions and receiving its recommendation for analysis,” he said in an e-mailed statement to the PA.

States must not follow the guidelines.

After the CDC said health workers and nursing home residents should receive the first doses, most states followed these recommendations. But there were a few exceptions. He said Utah Long-term care residents should be behind the health care workers, instead of sharing the front with them. Massachusetts included first-class prisoners and homeless people, while Nevada, New Hampshire and Wyoming did the same for police officers.

Variations from state to state are likely to increase in the following priority groups, said Jennifer Kates, Kaiser Family Foundation, which looked at state vaccination plans.

“I think we’ll see states collapse in different ways,” with some prioritizing seniors over key workers, Kates said.

Things could get messy. For example, some experts have said that it is possible that if a state gives priority to certain key workers and a neighboring state decides to give priority to the elderly, people could try to cross state lines in hopes of getting vaccinated.

“This is one of the problems with the lack of a comprehensive national immunization plan,” said Romero, who is also the head of the Arkansas state health department.

The proposal before the advisory committee is based on a broad definition of key workers established in August by the US Department of Homeland Security. Hundreds matter of the different types of jobs as critical infrastructure workforce, including first responders, teachers, communications technicians, weather forecasters, treatment plant employees and people working in animal shelters.

According to estimates submitted to the Advisory Committee, up to 87 million people can be considered key non-health workers.

The government expects to be able to start vaccinating only 80 million new people in the first three months of 2021.

The committee may consider giving equal status to essential workers and the elderly, similar to the way it said that both health workers and nursing home residents should be together right in front of the line. . But this would create a priority group that is much, much larger than the number that can be vaccinated before spring.

The nation has more than 53 million seniors. The CDC also counts more than 100 million Americans as having underlying medical conditions that put them at higher risk for serious COVID-related illnesses, although there is an overlap between the two groups.

In the meantime, various trade associations and groups of workers have sent e-mails and other communications to the committee, arguing that they should be given priority.

Julie Russell, representing the Coronado Unified School District in California, called for the priority of teachers and other school workers. “Please recognize the importance of the safety of our staff and how many young lives each of us is reaching,” she said at a meeting last weekend with the same CDC group.

Dr. Charles Lee of the American College of Correctional Physicians has advocated for those working in prisons and jails, plus inmates. “There are a lot of essential workers in the correctional facilities. Please, don’t leave them out, “he said at the same meeting.

Romero said the advisory committee is likely to discuss ways to help states restrict which key workers should go first. For example, people who are considered essential but can work from home may be placed lower on the list than people who cannot stay six meters away from others while working.

What about Atlanta-based CDC staff? In a note to AP employees, Redfield said the agency would not receive a direct vaccine allocation. However, Georgia’s plan allows certain public health and laboratory workers to be in the state’s highest priority group. Some CDC employees also work in hospitals and clinics and may be a priority with staff at these locations.

Of course, when more vaccine comes out, “the issue of priority becomes less important,” said Dr. Eric Toner, a Johns Hopkins University scientist who wrote about possible vaccination priority frameworks.

“The bottom line is that we just need to vaccinate as many people as possible,” he said.


AP writers Candice Choi and Jason Dearen of New York City and Jonathan Poet of Philadelphia contributed to this report.


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