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A federal vaccine advisory committee is recommending health care workers and residents of long-term care facilities receive the first COVID-19 vaccines.
“Health care personnel have high exposure to COVID-19 and need to be available to meet the increasing health needs of all Americans,” said Katherine A. Poehling, M.D., M.P.H., FAAP, a member of the Centers for Disease Control and Prevention’s (CDC’s) Advisory Committee on Immunization Practices (ACIP).
Vaccination could begin later this month if the Food and Drug Administration (FDA) grants emergency use authorization (EUA) to one or both products awaiting review. On Dec. 10, its Vaccines and Related Biological Products Advisory Committee will review an EUA application from Pfizer and BioNTech for a vaccine that can be used in patients 16 and older that the companies say is 95% effective. On Dec. 17, the committee will review an EUA application from Moderna for a vaccine it says is 94% effective.
About 40 million doses of the vaccines are expected to be available this year, which could immunize 20 million people. The doses will be distributed to states and territories based on their population. Each jurisdiction has created its own playbook for implementing a vaccination program.
ACIP’s recommendation to prioritize health care personnel and long-term care facility residents in phase 1a of distribution followed months of discussion and will need approval from the CDC director to become CDC policy.
Roughly 21 million people are included in the health care personnel group. They include people working in hospitals, outpatient settings, long-term care facilities, home health care, pharmacies, emergency medical services and public health. At least 243,000 health-care personnel have been diagnosed with COVID-19 and 858 have died, according to the CDC. Health care workers also are in high demand as hospitals around the country try to keep up with the surge in cases.
“Phase 1a, I think, enables us to hopefully preserve health care capacity before it’s too late,” said ACIP member Grace M. Lee, M.D., M.P.H. “I really wanted to thank all of our frontline workers for all of their service to date. It’s been an exhausting nine months and all of us are in it together.”
In the early weeks of vaccination when supply is limited, the CDC suggests priority go to those who have direct contact with patients or infectious material, long-term care facility personnel and workers not known to have been infected in the past 90 days.
It recommends health care systems and public health officials work together to ensure workers not affiliated with hospitals can access vaccines. Health systems also will need to plan for the possibility that workers who experience systemic reactions after vaccination like fever, headaches, body aches may need time off work.
The second group included in phase 1a includes about 3 million adults in skilled nursing facilities and assisted living facilities. Residents and staff of these facilities have accounted for about 6% of COVID-19 cases in the U.S. and 40% of deaths, according to the CDC.
ACIP has not decided which group will receive the next round of vaccines but is considering a proposal that include essential workers such as those in food service, transportation, education, manufacturing and public safety. Adults with high risk medical conditions and those ages 65 and older likely would follow.
The timing of when COVID-19 vaccines may become available for children is not yet clear. Pfizer’s EUA includes people as young as age 16, and its trials include children age 12 and older. The AAP is advocating for more manufacturers to include children in trials as more than 1.3 million children have been infected. They also have suffered from emotional impacts of the pandemic and disruption to their education.