Who would get a vaccine first? U.S. considers race in plans

Federal health officials are trying to decide who will get the first doses of any effective coronavirus vaccines, which could be on the market this winter but could require many additional months to become widely available to Americans.

The Centers for Disease Control and Prevention and an advisory committee of outside health experts in April began working on a ranking system for what may be an extended rollout in the United States. According to a preliminary plan, any approved vaccines would be offered to vital medical and national security officials first, then to other essential workers and those considered at high risk — the elderly instead of children, people with underlying conditions instead of the relatively healthy.

Agency officials and the advisers also are considering what has become a contentious option: putting Black and Latino people, who have disproportionately fallen victim to COVID19, ahead of others in the population.

In private meetings and a recent public session, the issue has provoked calls for racial justice. But some medical experts are not convinced there is a scientific basis for such an option, foresee court challenges or worry that prioritizing minority groups would erode public trust in vaccines at a time when immunization is seen as crucial to ending the outbreak.

“Giving it to one race initially and not another race, I’m not sure how that would be perceived by the public, how that would affect how vaccines are viewed as a trusted public health measure,” said Claire Hannan, executive director of the Association of Immunization Managers, a group represented on the committee.

While there is a standard protocol for introducing vaccines — the CDC typically makes recommendations, and state and local public health departments decide whether to follow them — the White House has pressed the agency at times to revise or hold off on proposals it found objectionable.

Since the beginning of the pandemic, almost every aspect of the administration’s response has involved scarce resources, high demand and claims that the privileged were receiving unfair advantage. The White House recently created Operation Warp Speed, a multiagency effort to accelerate vaccine development that has invested billions of federal dollars in a growing number of companies. At the public advisory committee hearing, held in mid-June, a Defense Department representative said the operation would address the distribution plans in coming weeks.

But there will be a gap between the first doses coming off the manufacturing lines and a stockpile large enough to vaccinate the U.S. population. “I would say months,” said Dr. José Romero, the chairman of the Advisory Committee on Immunization Practices.

As they come up with a multitiered schedule for the first 1.2 million vaccine doses and the next 110 million, they have focused on who should be considered essential workers, what underlying conditions should be taken into account and what kinds of living environments — nursing homes, homeless shelters — put people at high risk.

But for the broader committee, questions of whether to prioritize race and ethnicity sparked the most debate.