NEW YORK — An influential scientific panel on Tuesday voted to recommend to the CDC that when a COVID-19 vaccine becomes available, both front line health care workers and residents in long-term care facilities should be prioritized first.
The Advisory Committee on Immunization Practices voted 14-1 in favor of adopting the following recommendation: When a COVID-19 vaccine is authorized by FDA and recommended by ACIP, vaccination in the initial phase of the COVID-19 vaccination program (Phase 1a) should be offered to both 1) health care personnel and 2) residents of long-term care facilities.
"About one (American) dies every minute from COVID-19. During this ACIP meeting, about 120 people will die," Dr. Beth Bell said during initial remarks at the beginning of the virtual meeting Tuesday.
The ACIP met Tuesday afternoon in an open-to-the-public, virtual meeting to vote on the proposal that gives priority to health care workers and patients in nursing homes and other long-term care facilities.
The two groups together represent around 23 million Americans out of a population of about 330 million; about 21 million in health care professions and less than 3 million adults living in long-term care facilities.
Current estimates project around 40 million doses combined available by the end of 2020. And each vaccine product requires two doses.
The CDC said Tuesday they expect 5-to-10 million doses available each week after a vaccine is authorized by the FDA. They say these numbers necessitate the need for sub-group prioritizing, since not all health care workers or long-term care facilities can be vaccinated at once.
Another consideration the panel discussed is not having an entire unit or group get vaccinated at once; if there are side effects like fatigue or other symptoms that necessitates taking a day or two off, this could leave a unit critically short-staffed.
During Tuesday's presentation, Dr. Kathleen Dooling talked about statistics from COVID-19 patients in the US and how it lead to health care workers and long-term facility staff and patients to be at the top of the vaccine list. Long-term care facilities are responsible for six percent of COVID-19 cases and 40 percent of COVID-19 deaths in this country, she said.
Later this month, the Food and Drug Administration will consider approval of two vaccines made by Pfizer and Moderna. The panel meeting Tuesday said they hope to learn more about the safety and effectiveness of the vaccines as more information is released by the FDA.
Dr. Dooling said one of the questions they hope to ask about the Phase 3 trial data of both Pfizer and Moderna is how effective one dose of the vaccine has shown to be. They will also be taking a deeper look at the age groups of those included in the trial, and the efficacy of the vaccines on older people.
Some of the comments during the public comment section referenced the lack of transparency released at this time about the vaccines and the panel trying to make vaccination decisions without it. However, the panel, while voting, expressed faith in the FDA's process of approving the vaccine as safe for all Americans.
Dr. John Ervin, principal investigator with the Alliance for Multispecialty Research in Kansas City, Missouri, said he hopes states will follow the recommendations.
"I hope it isn't a Republican or Democrat decision," Ervin said. "I hope that the governors will follow the science and not be political about these decisions."
Ervin said he was disheartened to learn that a recent study showed nearly 40% of Americans would not get a COVID-19 vaccine.
"You need about a 70% vaccine rate or infection rate to acquire the herd immunity, and I think it's just selfishness and an ignorance," Ervin said. "We give our kids 15 vaccines the first year-and-a-half of life, and we've wiped out all of these illnesses."
With much of the country dealing with controlled spread, including Kansas and Missouri, many believe vaccinations are the only hope for the U.S. to get a handle on the COVID-19 pandemic.
Once vaccines are given, the CDC and FDA will be asking all health care providers and facilities to use the existing Vaccine Adverse Event Reporting System, VAERS, to monitor any side effects and adverse reactions to the COVID-19 vaccines.
The advisory panel will meet again at some point to decide who should be next in line. Among the possibilities: teachers, police, firefighters and workers in other essential fields such as food production and transportation; the elderly; and people with underlying medical conditions.
Experts say the vaccine will probably not become widely available in the U.S. until the spring.
ACIP is a 15-member panel of outside scientific experts, created in 1964, that makes recommendations to the director of the Centers for Disease Control and Prevention, who almost always approves them. Childhood vaccine schedules are one example of the work of this group.
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.
