Dilemma surrounds second rounds
Who should be higher on priority list, the elderly or some essential workers?
California is poised to make a hard and controversial choice amid limited supplies of the coronavirus vaccine: whether to prioritize essential workers for vaccination over the elderly.
Such a step, to be debated by a state advisory committee today, would help return schools and many businesses to some semblance of normalcy.
But it would delay protection for those at greatest risk of dying. The deliberation comes as the state must decide how to divvy up the second round of vaccines, following the current campaign to protect 2.4 million health care workers as the first priority.
These next groups are much larger, which makes the prioritization much more difficult.
Only 2 million new vaccine doses are slated to arrive in January, although supplies will climb with each passing month.
California is home to 11.9 million essential workers, of which 5.9 million are considered highest priority, not including health care workers. About 6 million people are over the age of 65.
“These are tough decisions. And the best hope is that this phase of scarcity is as short as possible,” said Anthony Wright, executive director of Oakland- based consumer advocacy organization Health Access and a member of the state’s Community Vaccine Advisory Committee, a group of 60 community- based organizations that are helping guide the state’s policies.
As currently drafted, California’s guidelines say that the vaccine should go to workers in three groups: education and child care workers ( 1.4 million), emergency services personnel ( 1.1 million), and people who work in high- priority essential businesses ( 3.4 million), ranging from agriculture and grocery services to plant nurseries and sawmills.
Other criteria — such as age and underlying medical conditions — are “sub- priorities” of these three main groups.
This differs from the U. S. Centers for Disease Control
and Prevention’s recommendation on Sunday asserting that adults 75 and older, as well as front- line essential workers, both belong in the next vaccination group.
On Wednesday, the state was scheduled to discuss whether to adjust its criteria to include elders too, reflecting the new CDC recommendation. Wright expects California to align itself with the CDC guidelines. Gov. Gavin Newsom’s administration will make the final call.
So far, a state work group has focused on essential workers, said Dr. Robert Schechter, chief of the Immunization Branch of the California Department of Public Health and co- chair of the group. But over the next days and weeks, the committee will consider those with medical conditions, including advanced age, that put them at higher risk, he added.
If not included in this second stage, elders and people with high- risk medical conditions, as well as additional essential workers, will almost certainly be included in the third phase of vaccination.
Across the nation, there is near- universal consensus on who belonged in the first round, called Phase 1A: front- line health care workers and residents of nursing facilities. Only Florida included adults over age 65 in its first wave of vaccinations.
But states are divided over who belongs in the next phase, called 1B.
Alabama, Delaware, Florida, Maryland, North Carolina and Tennessee each prioritize elders and those with high- risk medical conditions over non- health essential workers. North Carolina and Tennessee prioritize those with high- risk medical conditions over those ages 65 and older, according to an analysis by the Kaiser Family Foundation.
The trade- off depends on what a state is trying to achieve, according to Dr. Scott Gottlieb, the former Food and Drug Administration commissioner. To reduce deaths, he said, you’d prioritize the elderly. To reduce the rate of infection and bolster the economy, you’d prioritize essential workers.
In California, parents and educators celebrated the addition of teachers to the proposed 1B list.
Among those not on the list: the Space X scientists who care for the four astronauts currently on the space station; Lyft and Uber drivers; the people who collect and process municipal solid waste; longshoremen and other Pacific maritime workers and employees of the California Independent System Operator, responsible for maintaining the reliability of one of the largest and most modern power grids in the world.
And while public transit workers are on the CDC’s list, they’re not on the proposed state list. “Our frontline workers sit alongside other essential workers: grocery clerks, health care workers, caregivers and emergency services personnel and therefore deserve equal prioritization in receiving the COVID- 19 vaccine,” argues Robert Lyles of AC Transit.
In contrast, many elders are retired, so they can stay sheltered at home, some noted.