An influential government advisory board met on Tuesday to answer one of the most pressing questions in the U.S. coronavirus epidemic: Who should be at the beginning of the line when the first vaccines become available?
The Advisory Committee on Immunization Practices is scheduled to vote on a proposal that favors healthcare workers and patients in nursing homes.
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Together, the two groups represent about 23 million Americans out of a population of about 330 million Americans.
As the virtual discussion began, Dr. Beth Bell, a member of the University of Washington panel, noted that there is currently an average of one person dying in COVID-19 in the United States per minute. “
At the end of the month, the Food and Drug Administration will review the approval of two vaccines for Pfizer and Moderna. It is currently estimated that by the end of 2020, up to 20 million doses of each vaccine will be available. Each product requires two servings.
As a result, the shots will be proportionate in the early stages.
The advisory board will meet again sometime to decide who will be next in line. Among the options are: teachers, police officers, firefighters and those working in other key areas such as food production and transport; the elderly; and those with the underlying disease.
Experts say the vaccine is unlikely to become widely available in the United States until the spring.
Established in 1964, the 15-member panel of external scientific experts makes recommendations to the Director of the Center for Disease Prevention and Control, who almost always approves them.
The recommendations are not mandatory, but have been widely monitored by physicians for decades and have defined the scope and funding of U.S. vaccination programs.
It is up to the public authorities to follow the guidelines. If necessary, they are also left to make further, more detailed decisions – such as whether to prevent emergency department doctors and nurses from outpacing other health workers when supplies of vaccines are scarce.
The outbreak in the U.S. has killed nearly 270,000 people and caused more than 13.5 million confirmed infections, with deaths, hospitalizations and cases rampant in recent weeks.
About 2 million people live in nursing homes and other American long-term care facilities. Those patients and staff caring for them accounted for 6 percent of the country’s coronavirus cases and a staggering 39 percent of deaths, CDC officials say.
The number of health workers affected by the board’s recommendation would be about 21 million.
This is a broad category that includes health care professionals who care for or come into contact with patients in hospitals, nursing homes, clinics, and doctor’s offices. This includes home health workers and ambulances. Depending on how government officials apply the panel’s recommendations, this may include porter staff, catering staff, and health record administrators.
The government estimates that health care workers make up 12 percent of U.S. Covid-19 cases, but only about 0.5 percent of deaths. Experts say it is imperative to keep health workers on foot to administer the shots and be prone to a growing number of infected Americans.
For months, members of the immunization board have said they will not vote until the FDA approves the vaccine. This is the normal procedure of the body, with a few exceptions, such as during the 2009 influenza pandemic. But late last week, the group suddenly scheduled an emergency meeting for Tuesday.
The chairman of the board, Dr. Jose Romero, said the decision stemmed from the recognition that states had Friday’s deadline for placing their first order for the Pfizer vaccine and determining where they should be delivered. The committee has decided to meet now to provide guidance to state and local officials, he said.
But some members of the panel and other experts were also concerned about comments from Trump administration officials suggesting different vaccination priorities.
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Last week, U.S. Secretary of Health and Human Services Alex Azar stressed that ultimately, governors will decide who is out of their state. Vice President Mike Pence agreed with this view.
The remarks have long worried the Trump government that vaccination decisions are dictated by political concerns rather than science.
Asked if Azar’s remark played a role in the schedule of the meeting, Romero said; – We don’t live in bubbles. We know what he said. But that was not the primary reason for this. “
Jason Schwartz, a health policy professor at Yale School of Public Health, said it makes sense for the board to take an unusual step to get the recommendation first.
“Without this official recommendation, it will create a void from which states can leave in all sorts of different directions,” said Schwartz, who is not on the board.
Dr. William Schaffner, an infectious disease expert at Vanderbilt University Medical Center in Nashville, Tennessee, who is also not a member of the panel, agreed that the decision to make recommendations before the FDA meeting is unusual.
“As you can see, the chariot here is a little ahead of the horse as we don’t have a licensed vaccine yet,” Schaffner said. “But ACIP is already considering who should get this vaccine and when it will be approved.”
HHS officials said initial doses will be distributed to states based on population, and some states may not receive enough money for all of their health workers and those living in nursing homes.
As a result, governors may have to decide which health workers or regions get shots first, Schwartz said.
“It’s up to the states to figure out the finer details,” he said.
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