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First vaccines for health workers, nursing homes

NEW YORK (AP) – Health workers and residents of nursing homes should be on the front line when the first pictures of a coronavirus vaccine become available, an influential government advisory committee said Tuesday.

The panel voted 13-1 to recommend that these groups be given priority in the first days of each upcoming vaccination program, when doses are expected to be very limited. The two groups cover about 24 million people in the United States with a population of about 330 million.

Later this month, the Food and Drug Administration will consider authorizing the emergency use of two vaccines produced by Pfizer and Moderna. Current estimates predict 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 distributed in the early stages.

The Advisory Committee on Immunization Practices will meet again at some point to decide who should be next. Opportunities include: teachers, police, firefighters and workers in other key areas such as food production and transport; the adults; and people with concomitant medical conditions.


7;s action simply determined who should take pictures first if a safe and effective vaccine appeared. The panel did not approve any specific vaccines. Panel members expect to hear the FDA’s assessment and see more safety and efficacy data before approving a product.

Experts say the vaccine is unlikely to become widely available in the United States by spring.

The group of external scientific experts, established in 1964, makes recommendations to the director of the Centers for Disease Control and Prevention, who almost always approves them. There are usually 15 voting members, but one seat is vacant.

The recommendations are not binding, but they have been widely listened to by doctors for decades, and they determine the scope and funding of American vaccination programs.

It is up to the state authorities to follow the instructions. They will also be left to make further, more detailed decisions if necessary – for example, whether to place doctors and nurses in the emergency department in front of other health workers if vaccine stocks are low.

The blast in the United States has killed nearly 270,000 people and caused more than 13.5 million confirmed infections, with missiles growing, hospitalizing and growing in recent weeks.

Since the virtual meeting began, panel member Dr. Beth Bell of the University of Washington noted that an average of one person is dying from COVID-19 per minute in the United States at the moment, “so I guess we’re not acting too soon. ”

About 3 million people live in nursing homes, long-term chronic care hospitals and other American long-term care facilities. Patients and caregivers account for 6% of coronavirus cases in the country and a staggering 39% of deaths, CDC officials say.

Despite the heavy casualties, some board members at Tuesday’s meeting said they were hesitant to include such patients in the first group to take pictures.

Dr Helen Keep Talbot, a researcher on infectious diseases at Vanderbilt University who was the sole member of the committee to vote against the proposal, cites a flu study that says vaccinating staff at such facilities has the greatest impact on preventing the spread. him there.

Dr. Richard Zimmerman, a flu vaccine researcher at the University of Pittsburgh who watched the meeting online, echoed Talbot’s concerns.

“I think it was premature to include nursing home residents as a priority group,” said Zimmerman, a former ACIP member. “Their voice suggests that these people will respond well to the vaccine. … I don’t think we know that. “

The members of the commission unanimously expressed support for the vaccination of health workers – about 21 million people, according to CDC officials.

This broad category includes medical staff who care for – or come into contact with – patients in hospitals, nursing homes, clinics and doctors’ offices. It also includes home health workers and paramedics. Depending on how government officials implement the panel’s recommendations, it may also include household staff, food service staff, and medical records staff.

The government estimates that health care workers account for 12% of COVID-19 cases in the United States, but only about 0.5% of deaths. Experts say it is imperative that health workers be on their feet to be able to deliver the shots and target the growing number of infected Americans.

For months, members of the immunization commission said they would not vote until the FDA approved the vaccine, as usual. But late last week, the group scheduled an emergency meeting.

Panel President Dr Jose Romero said the decision stemmed from the realization that the states were facing a deadline of Friday for initial orders for the Pfizer vaccine and determining where they should be delivered. The committee decided to meet now to give guidance to state and local officials, he said.

But some panel members and other experts have also been concerned about comments from Trump officials who suggest different vaccine priorities.

Dr Deborah Birks of the White House Task Force on Coronavirus said at a meeting with CDC officials last month that people aged 65 and over should head the line, according to a federal official who was not authorized to discuss the issue. spoke to the Associated Press on condition of anonymity.

Then last week, US Secretary of Health and Humanitarian Affairs Alex Hazard stressed that the governors would ultimately decide who in their states would receive the photos. Vice President Mike Pence reiterated that view.

Asked if Hazard’s comment played a role in planning the meeting, Romero said; “We do not live in a bubble. We know what he said. But that was not the main reason for doing so. “

Jason Schwartz, a professor of health policy at Yale School of Public Health, said it made sense for the committee to take the unusual step of putting its recommendation first.

“Without this official recommendation, this creates a void from which states can emerge in all sorts of different directions,” said Schwartz, who is not on the committee.

HHS officials said they would distribute the initial doses to countries based on population, and some countries may not receive enough to cover all of their health workers and residents of nursing homes.

CDC officials said they were optimistic that such a shortage would last only a few weeks.

Still, governors and local officials may need to decide which health workers or regions will receive photos first, Schwartz said.

“States need to understand the details,” he said.


The Associated Press’s Department of Health and Science receives support from the Howard Hughes Medical Institute’s Department of Science Education. The AP is solely responsible for all content.

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