The CDC panel says key frontline staff, individuals age 75 and older, ought to get a Covid vaccine subsequent

A panel of the Centers for Disease Control and Prevention voted 13: 1 Sunday to bring “Frontline Essential Workers” and people 75 and over to get a vaccine against Covid-19.

This so-called Phase 1b group comprises an estimated 49 million people, or nearly 15% of Americans, according to the CDC Advisory Committee on Immunization Practices. The committee included key frontline personnel such as firefighters, police officers, teachers, proofreaders, and others in the phase 1b group, but removed “other key personnel” from phase 1c.

The full list of key frontline workers, as per the list provided by ACIP, also includes all education workers, including daycare, grocery and farm workers, manufacturing workers, U.S. postal workers, public transit workers, and grocery store workers. These workers “are in sectors that are essential to the functioning of society and are at much higher risk of exposure,” ACIP told Covid.

“I’d like to point out that those aged 75 and over make up 8% of the population, 25% of hospital stays, and a very high mortality rate. Basic frontline workers are highly exposed. They comprise a disproportionate proportion of racial and ethnic people who have too a disproportionate share of hospital stays, “said Dr. Katherine Poehling, a member of the committee, after the vote.

Phase 1c should include people between 65 and 74 years of age, people between 16 and 64 years of age with underlying medical conditions, and the remaining essential workers. ACIP also recommended Sunday. That’s 129 million Americans, or more than a third of the country, according to ACIP.

The remaining essential workforce includes transportation and logistics workers, food service workers, construction workers, finance workers, IT and communications workers, energy workers, media workers, lawyers, engineers and sewage workers, ACIP said. Underlying conditions for prioritization purposes include obesity, cancer, smoking and more per ACIP.

The committee’s recommendations now go to CDC Director Dr. Robert Redfield, who usually accepts the committee’s recommendations and sets federal guidelines on how states should implement the distribution of the scarce doses. But state officials have the final say in the distribution. The CDC earlier this month recommended that states give priority to health workers and residents of long-term care facilities when first introducing vaccines.

Deciding which groups to take precedence over others is intolerable, many voting committee members said Sunday, but there is a need to ensure that justice and the plans of the newest science leader in the states are included. The committee was asked to pull the needle between competing values ​​of the need to prioritize critical workers who keep society going and the need to protect the most vulnerable members of society, the elderly.

Dr. However, Kathleen Dooling of the CDC noted that the order in which these groups are vaccinated will ultimately have little impact on the dynamics of the outbreak, based on the latest models.

“The differences between the strategies are minimal,” she said. “Vaccinating older adults prevents a little more deaths at first, while vaccinating younger adults, essential workers and younger high-risk adults prevents a little more infections.”

She added that the most important factor “is actually the timing of vaccine introduction related to the increase in Covid-19 cases”. She further stressed the need to practice social distancing and wearing masks to reduce the spread while scarce doses of vaccines are being distributed.

“We are faced with the situation, at least in the short term, that we have only a limited vaccine available,” said Dr. Nancy Messonnier, director of the National Center for Immunization and Respiratory Diseases of the CDC, on Sunday for the opening of the vaccine all-day meeting. “That means there will be tough decisions to be made about who gets this vaccine first.”

The U.S. is currently planning to have enough vaccine doses for 20 million people in December, 30 million in January and 50 million in February, Messonnier said. Phase 1a will include at least 24 million people, Phase 1b will add an additional 49 million people, and Phase 1c will expand eligibility to an additional 129 million.

Dr. The CDC’s Amanda Cohn noted that projections should not be considered accurate and that many factors could alter vaccine availability.

While older adults are more likely to die from Covid, they are also more likely to isolate and protect themselves from infection than key frontline workers, some committee members said. Dr. Peter Szilagyi of the University of California at Los Angeles said one reason key workers were prioritized was because minority communities were disproportionately represented among key workers. The color communities in the US were hit disproportionately by Covid and died much more often than white Americans.

However, the committee found that racial and ethnic minorities are less represented in the foremost sub-group of essential workers than in the broader group. However, the broader group of the essential workforce includes an additional 57 million people, and inclusion in Phase 1b would mean that the demand for vaccines would far exceed supply, passing the tough prioritization decisions down to stressed state and local officials.

Dr. Jeff Duchin, Seattle and King Counties, Washington health officer, stressed the need to properly fund the local health departments that actually convert vaccines into vaccinations.

“Public health vaccination clinics need resources to ensure equitable access to vaccines in all communities and populations,” he said. “There is a critical and immediate need for adequate funding and resources to implement the vaccination program.”

Several committee members said they don’t expect all states to absolutely adhere to federal guidelines and that they should actually be adjusted to the state of the local outbreak. For example, while proofreaders have priority in Phase 1b, Dr. Kathleen Dooling of the CDC that depending on local outbreaks, it might make sense to vaccinate inmates at the same time.

Dr. Christine Hahn, of the Council of State and Territorial Epidemiologists, said local and state officials will no doubt deviate from federal guidelines. The most important thing, Hahn said, is that the CDC provide enough guidance to avoid “paralysis through analysis” at the local level.

“There is no way we will all be able to stay in step and we have to say clearly that there will be local decisions because the worst that can happen is we leave vaccines in the freezer because we are scared have before. ” Go to the next group and move on, “she said.” We have to have faith in our local health and state health departments to do the right thing. “

“This is not black and white,” added Dr. Amanda Cohn of the CDC added. “They will be absolutely different depending on the local context.”

The committee can review the recommended prioritization at any time. Dr. Grace Lee of Stanford University School of Medicine said the committee may need to be flexible if, for example, vaccine manufacturers are exposed to interruptions and unable to deliver as many doses as planned.

“I hope we will have enough doses by stage 1c but I wanted to think about it if for some reason we don’t have enough doses,” said Lee, “I think we need to be ready to adjust in future stages as we don’t know where we’ll be in another month when these phases are introduced. “

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