CDC experts voted: Here you should receive your first dose of COVID-19 vaccine


Zoom in / COVID-19 vaccine-labeled vaccine with the logos of the pharmaceutical company Pfizer and the German biotechnology company B BioNTech.

The very first dose of any approved COVID-19 vaccine should be given to both cutting-edge healthcare workers and residents of long-term care facilities, as recommended by the Committee of Expert Advisers of the Center for Disease Prevention and Control at an emergency meeting on Tuesday evening.

The committee’s recommendation is now being approved for CDC director Robert Redfield before it becomes official federal guidance. Ultimately, it will be up to the states themselves to make their final decisions on how to distribute the first coveted vaccine shipments.

Nevertheless, the committee, the Advisory Committee on Immunization Practices (ACIP), has been making such vaccination policy recommendations for decades, and states are unlikely to try to finalize their plans to settle their guidelines. States only have to submit their first vaccination order to the federal government by the following Friday, December 4th. Orders determine which facilities in each state receive vaccine shipments and how much vaccine each facility receives from the state’s limited benefits.

Dizziness distribution

The urgent planning expects the Food and Drug Administration to be just days away from granting emergency use authorization for the emergency use of the COVID-19 vaccine developed by pharmaceutical giant Pfizer and the German biotechnology company BioNTech. The FDA is now reviewing the companies ’EUA application and will hold an advisory committee meeting to review the application on Dec. 10. If the request is met, the delivery of vaccine doses to states could begin as early as December 11th or 12th. Moderna has also requested an EUA for its COVID-19 vaccine, which will be reviewed at a meeting on 17 December. The federal government expects to have enough vaccine doses available to vaccinate about 20 million people by the end of December, with five to ten million doses distributed weekly.

At last week’s press conference, senior officials at Operation Warp Speed ​​- the federal government’s program to rapidly develop and deliver COVID-19 vaccines and therapies – said the first 6.4 million doses of COVID-19 vaccine would be distributed to one state. per capita fund – to “keep this simplicity”. The decision was a reversal of Warp Speed, which had previously proposed that vaccinations be distributed based on high-risk groups in each state – in line with ACIP recommendations. Program officials have also previously indicated that they will wait for ACIP’s final guidance before deciding how to distribute vaccines.

ACIP planned to finalize its guidelines after the FDA approved the vaccine. But with Warp Speed’s sudden distribution decision last week, the committee convened an emergency meeting on Tuesday to finalize their recommendations and help guide states.

Recommendations

The committee finalized its recommendation for the earliest stage of the distribution of vaccines, the so-called 1a. Phase. The final wording of the recommendation is as follows:

When the FDA approves the COVID-19 vaccine and is recommended by the ACIP, in the initial phase of the COVID-19 vaccination program (Phase 1a), vaccination should be offered to both 1) health care personnel and 2) long-term care equipment.

The committee defined medical staff as paid or unpaid people who serve in health care facilities and who have direct or indirect exposure to patients or infectious substances. Residents of long-term care institutions are adults living in institutions that provide a variety of services, including medical and personal care for those who are unable to live independently. The definition includes primarily skilled nursing homes, but also supported residences, residential care communities and other residences where medical care is provided.

The committee noted that it is estimated that approximately 21 million frontal health workers and approximately 3 million residents of long-term care facilities will be affected by the 1a. In phase distribution. The total number of people affected is barely in excess of an estimated 20 million doses of vaccine expected to be available this month.

With limited access to early vaccination, the committee went one step further in recommending the ranking of subgroups. Special attention should be paid to medical staff who have direct contact with patients, those working in long – term care facilities, and those who have not previously been infected with the pandemic coronavirus in the previous 90 days (re – infection appears to be rare within 90 years). justified by the committee.)

For those living in long-term care facilities, special attention should be paid to those in vocational care facilities who tend to care for the most medically vulnerable residents. Once these facilities have been vaccinated, government officials can extend the distribution to other types of facilities, including subsidized residences and veterans ’homes.

Argument

It was easy to decide if the front-line health workers were ahead of the vaccinations at the beginning of the line. Front-line workers are endangering their own health and lives in treating patients amid a devastating epidemic. In addition, their health and ability to work is critical to saving the lives of others. By November 30, at least 243,000 health workers had been infected with the new coronavirus and 858 had died, the committee noted.

It was a more difficult decision to include residents of long-term care facilities alongside health care workers on the priority list. Overall, the committee was affected by the oversized impact of the epidemic on the residents of these facilities. Residents and staff account for 6% of all U.S. cases and 40% of all U.S. deaths. Of the people aged 85 and older who were hospitalized using COVID-19, nearly 66 percent were in long-term care.

Nevertheless, the data were not enough to shake the whole committee. The only member of the committee who He voted against Phase’s recommendation because of the involvement of residents in long-term care. Helen Talbot, an infectious disease expert at Vanderbilt University, expressed concern that the COVID-19 vaccines developed so far have not been studied specifically enough in people living in these facilities.

Although committee members pointed to data showing that older adults tend to have milder vaccination side effects than younger age groups, Talbot was not convinced. He also noted that weaker side effects may also indicate weaker immunity, raising the question of whether vaccinating residents maximizes public health benefits. (Early vaccination data suggest high efficacy in older age groups). The lack of certainty that the vaccine will work and be safe in this group “occupies many levels,” Talbot said. Instead, he suggested that only employees of long-term care institutions be vaccinated.

Nevertheless, the other 13 members of the committee were not concerned, noting that the disease had a huge impact on the residents of the facilities.

Tuesday’s recommendation maximizes the benefits, minimizes harm, promotes justice and reduces health inequalities, committee chairman José Romero stressed in his post-vote closing statement.

1a. Following the completion of section 1, the committee recommended that the vaccination of key workers be continued in accordance with Article 1b. Section, then those over 65 years of age and 1c. Stage high-risk patients.