USA TODAY US Edition

Ad­vi­sory panel re­leases first vac­cine guide­lines

- John Ba­con

A some­what ob­scure group of med­i­cal and public health pro­fes­sion­als known as the Ad­vi­sory Com­mit­tee on Im­mu­niza­tion Prac­tices is de­bat­ing the cru­cial ques­tion on the minds of mil­lions of Amer­i­cans: When can I get a COVID-19 vac­cine?

ACIP de­vel­ops rec­om­men­da­tions on the use of vac­cines, and at least two big phar­ma­ceu­ti­cal firms could be just weeks away from fun­nel­ing their prod­ucts across the U.S. On Mon­day, the com­mit­tee un­veiled its eth­i­cal prin­ci­ples for an or­derly dis­tri­bu­tion of the vac­cines, be­gin­ning with an es­ti­mated 21 mil­lion health care work­ers.

Other groups at or near the front of the line in­clude other es­sen­tial work­ers such as first re­spon­ders, teach­ers, farm­work­ers and en­ergy in­dus­try work­ers; peo­ple with high-risk med­i­cal con­di­tions; and peo­ple over 65.

The rec­om­men­da­tions are de­signed to max­i­mize ben­e­fits, min­i­mize harm, pro­mote jus­tice and mit­i­gate health in­equities, the com­mit­tee says.

“I know our na­tion looks to you all to give your thought­ful and wise rec­om­men­da­tion,” CDC Direc­tor Robert Red­field said at the start of the meet­ing. “I want to take a mo­ment to un­der­score how im­por­tant your work is.”

The ACIP rec­om­men­da­tions pro­vide public health guid­ance. The Cen­ters for Dis­ease Con­trol and Pre­ven­tion then uses that guid­ance to set the U.S. adult and child­hood im­mu­niza­tion sched­ules based on those rec­om­men­da­tions.

The com­mit­tee won’t ac­tu­ally vote on al­lo­ca­tion guid­ance un­til a vac­cine is ap­proved or au­tho­rized by the Food and Drug Ad­min­is­tra­tion. Mon­day’s meet­ing was an in­for­ma­tional meet­ing.

A re­cent Gallup poll showed only 58% of Amer­i­cans were will­ing to get the COVID-19 vac­cine. Vac­cine “hes­i­tancy” nor­mally ac­com­pa­nies a coun­try’s ef­forts to con­tain an in­fec­tious dis­ease, said Og­bon­naya Omenka, an as­so­ci­ate pro­fes­sor and public health spe­cial­ist at But­ler Univer­sity who is not di­rectly in­volved with ACIP.

Part of the com­mit­tee’s charge is to in­still con­fi­dence in the vac­cines, Omenka said.

“The role of vac­cines in pop­u­la­tion health is at­tested to by the con­tain­ment of dif­fer­ent in­fec­tious diseases such as

po­lio, small­pox and measles,” Omenka said. “The ACIP is an im­por­tant part of the vac­cine adop­tion process.”

Dr. Mon­cef Slaoui, chief science ad­viser for the fed­eral gov­ern­ment’s Op­er­a­tion Warp Speed ef­fort to quickly pro­vide a vac­cine, stressed this week that the fi­nal de­ter­mi­na­tion on the or­der of dis­tri­bu­tion will go to in­di­vid­ual states.

“Each state will in­de­pen­dently de­cide, tak­ing into ac­count the guid­ance, who to im­mu­nize,” Slaoui said.

ACIP con­sists of 15 ex­perts who are vot­ing mem­bers pri­mar­ily re­spon­si­ble for the vac­cine rec­om­men­da­tions. The sec­re­tary of the U.S. Depart­ment of Health and Hu­man Ser­vices se­lects the com­mit­tee through an ap­pli­ca­tion and nom­i­na­tion process.

Four­teen of them have ex­per­tise in vac­ci­nol­ogy, im­munol­ogy, pe­di­atrics, in­ter­nal medicine, nurs­ing, fam­ily medicine, vi­rol­ogy, public health, in­fec­tious diseases or pre­ven­tive medicine. One mem­ber is a con­sumer ad­vo­cate pro­vid­ing per­spec­tives on the so­cial and com­mu­nity as­pects of vac­ci­na­tion.

In ad­di­tion to the vot­ing mem­bers, there are 30 non-vot­ing rep­re­sen­ta­tives from pro­fes­sional or­ga­ni­za­tions that are highly re­garded in the health field. They com­ment on ACIP’s rec­om­men­da­tions and of­fer the per­spec­tives of groups that will im­ple­ment the rec­om­men­da­tions.

Pfizer/BioN­Tech has al­ready ap­plied for U.S. Food and Drug Ad­min­is­tra­tion emer­gency au­tho­riza­tion for a vac­cine that could move for­ward by mid-De­cem­ber. Moderna says it will seek FDA au­tho­riza­tion for its can­di­date soon. Other can­di­dates are not far be­hind. Slaoui says 20 mil­lion Amer­i­cans could be vac­ci­nated next month.

ACIP de­vel­ops vac­cine rec­om­men­da­tions for chil­dren and adults, in­clud­ing the ages when the vac­cine should be given, the num­ber of doses needed, the amount of time be­tween doses and pre­cau­tions and con­traindi­ca­tions.

“The in­flu­ence or role of ACIP in vac­cine ap­proval is sort of in­di­rect,” Omenka said. “Their rec­om­men­da­tions are still weighed fur­ther be­fore fi­nal de­ci­sions are made.”

“Each state will in­de­pen­dently de­cide, tak­ing into ac­count the guid­ance, who to im­mu­nize.” Dr. Mon­cef Slaoui Chief science ad­viser for the fed­eral gov­ern­ment’s Op­er­a­tion Warp Speed

 ?? JEFF BLACK­MAN/SE­NIOR VIS­UAL COM­MU­NI­CA­TIONS SPE­CIAL­IST AT ROCHESTER RE­GIONAL HEALTH ?? The guid­ance places groups of es­sen­tial work­ers near the front of the line for im­mu­niza­tion.
JEFF BLACK­MAN/SE­NIOR VIS­UAL COM­MU­NI­CA­TIONS SPE­CIAL­IST AT ROCHESTER RE­GIONAL HEALTH The guid­ance places groups of es­sen­tial work­ers near the front of the line for im­mu­niza­tion.

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