Government advisory panel to decide who gets shots
Health care workers, residents at nursing homes given priority
An influential government advisory panel convened Tuesday to answer one of the most pressing questions: Who should be at the front of the line when the first vaccine shots become available?
— Health care workers and nursing home residents should be at the front of the line when the first coronavirus vaccine shots become available, an influential government advisory panel said Tuesday.
The panel voted 13-1 to recommend priority be given to those groups in the first days of any coming vaccination program, when doses are expected to be limited. The two groups encompass about 24 million Americans out of a U.S. population of about 330 million.
This month, the Food and Drug Administration will consider authorizing emergency use of two vaccines made by Pfizer and Moderna. Current estimates project that no more than 20 million doses of each vaccine will be available by the end of 2020. And each product requires two doses.
As a result, the shots will be rationed in the early stages.
Tuesday’s action by the Advisory Committee on Immunization Practices designated who should get shots first if a safe and effective vaccine becomes available. The panel did not endorse any particular vaccine. Panel members are waiting to hear FDA’s evaluation and to see more safety and efficacy data first.
Experts say the vaccine will probably not become widely available in the U.S. until the spring.
The panel of outside scientific experts, created in 1964, makes recommendations to the director of the Centers for Disease Control and Prevention, who almost always approves them. It normally has 15 voting members, but one seat is vacant.
The recommendations are not binding, but for decades they have been widely heeded by doctors, and they have determined the scope and funding of U.S. vaccination programs.
It will be up to state authorities whether to follow the guidance. It will also be left to them to make further, more detailed decisions if necessary — for example, whether to put emergency room doctors and nurses ahead of other health care workers if vaccine supplies are low.
The outbreak in the U.S. has killed more than 270,000 people and caused almost 13.7 million confirmed infections, according to Johns Hopkins University, with deaths, hospitalizations and cases rocketing in recent weeks.
As the virtual meeting got underway, panel member Dr. Beth Bell of the University of Washington noted that on average, one person is dying of COVID-19 per minute in the U.S. right now, “so I guess we are acting none too soon.”
About 3 million people are living in nursing homes, long-term chronic care hospitals, and other U.S. longterm care facilities. Those patients and the staff members who care for them have accounted for 6% of the nation’s coronavirus cases and 39% of the deaths, CDC officials say.
Despite the toll, some board members said they hesitated to include such patients in the first group getting shots. They wanted more information about the safety and effectiveness of new vaccines on the old and fragile people living in such facilities. And some noted research that suggested that if the staff at such facilities are fully vaccinated, that
would likely have a greater impact of stopping spread of the virus in those places.
But committee members were unanimous in voicing support for vaccinating health care workers — about 21 million people, according to CDC officials.
That category includes medical staff who care for — or come in contact with — patients in hospitals, nursing homes, clinics and doctor’s offices.
It also includes home health care workers and paramedics. Depending on how state officials apply the panel’s recommendations, it could also encompass janitorial staff, food service employees and medical records
clerks.
Experts say it’s imperative to keep health care workers on their feet so that they can administer the shots and tend to the booming number of infected Americans.
For months, members of the panel had said they wouldn’t take a vote until the FDA approved a vaccine. That is customary procedure for the panel, with some exceptions, such as during a flu outbreak in 2009. But late last week, the group scheduled an emergency meeting for Tuesday.
The panel’s chairman, Dr. Jose Romero, said the decision stemmed from a realization that the states are
facing a Friday deadline to place initial orders for the Pfizer vaccine and determine where they should be delivered.
The committee decided to meet now to give state and local officials guidance, he said.
Jason Schwartz, a professor of health policy at the Yale School of Public Health, said it makes sense for the panel to take the unusual step of getting its recommendation out first.
“Without that formal recommendation, it does create a void from which states could go off in all sorts of different directions,” said Schwartz, who is not on the panel.