ACIP: HCP, Nursing Home Residents May Get COVID Vax First

Healthcare workers and care facility residents are first vaccinated with COVID-19 vaccine, then essential workers, then adults and the elderly with high-risk medical conditions, and members of the CDC Advisory Committee on Immunization. ACIP) Monday meeting..

These new groups are Phase 1a, Phase 1b, and Phase 1c, respectively, and have “gate criteria” to move from one phase to the next. This can be similar to the airline’s system for boarding an aircraft. Group 2 is allowed to board even if some members of Group 1 have not yet appeared at the gate.

There were no votes, but ACIP members strongly supported this allocation strategy. The Commission has previously stated that it will hold an emergency meeting to vote for distribution after a particular vaccine has been approved or approved by the FDA.

Nancy Mesonier, MD, director of the CDC’s National Vaccination and Respiratory Center, said 40 million vaccinations were possible in December, enough for 20 million people to be vaccinated twice, and then 2500 each month. Estimated enough to immunize everyone. ..

ACIP chairs José Romero, MD, said that “front-line” workers, or workers at the highest risk of getting sick, “may also include housekeeping staff who need to be treated quickly.” It is important to prioritize which healthcare professional is vaccinated first. Look back at the emergency department room. “

There was debate about prioritizing health care workers who could not work from home. Dr. Bethbel, MD, an ACIP member of the University of Washington in Seattle, emphasized the importance that even healthcare professionals do not necessarily have 100% coverage in all groups.

“We don’t want to be in a situation where we aren’t using the vaccines we have available as efficiently as possible,” she said.

A brief discussion was held with Dr. Helen Cape Talbot of Vanderbilt University in Nashville on the inclusion of care facility residents in Phase 1a, despite the high mortality and vaccination of these facilities. He mentioned the unfortunate possibility that many residents would die.

Citing hypotheses such as “my grandmother got the vaccine and died,” she feared “significant backlash” and could undermine the credibility of the vaccine early on. Talbot also noted that caregivers had not been specifically studied in randomized trials.

However, most other members pointed out that the burden of illness in this population is disproportionately high and that it is efficient to vaccinate residents at the same time as facility staff.

“From an infrastructure perspective, it’s difficult to get back to some places. [and] I would support it because of its small population, “said Grace Lee, MD, MD, Stanford University.

ACIP members praised the placement of essential workers in Phase 1b, which said it was based on the recently announced ACIP by Dr. Kathleen Douring of the CDC. Ethical principles To allocate an initial supply of COVID-19 vaccine. Vaccination of essential workers in Phase 1b “strongly supports maximizing profits and minimizing harm. [promoting] With justice [mitigating] Health inequality. “

Limberta (RN), an ACIP member of the Minnesota Department of Health, said: “The intersection of key workers and the community is where we see the most illnesses.”

Dooling also referred to the updated modeling data It was announced at the meeting in October. If researchers assumed 90% efficacy of the vaccine in young adults and the elderly, they found that there was no substantial difference in avoided infections and deaths, regardless of the next vaccinated group. ..

She said that a group of qualified key workers was determined by the Department of Homeland Security, and that certain jurisdictions could choose to prioritize some workers over others.

Meissonier addressed the group at the end of the afternoon, praising their diligence in considering these issues.

“There is no perfect decision,” she said. “ACIP has made many excellent recommendations that the CDC has trusted over the years and I trust you … make the right decision now.”