Who will get the coronavirus vaccine first?

© Stefani Reynolds for The New York Times
If CDC director Dr Robert R. Redfield approves the group’s recommendations, they will be shared with states.

After months of deliberation and debate, a panel of independent experts advising the Centers for Disease Control and Prevention is set to decide on Tuesday which Americans it will recommend to get the coronavirus vaccine first, as the supply is still short.

The committee, the Advisory Committee on Immunization Practices, will vote in a public meeting Tuesday afternoon, and is expected to advise that healthcare workers be the first in line, along with nursing home residents and other long-term care facilities. If CDC director Dr. Robert R. Redfield approves the recommendations, they will be shared with states, which are preparing to receive their first vaccine shipments as early as mid-December, if the Food and Drug Administration approves a request for ’emergency. the use of a vaccine developed by Pfizer.

States do not have to follow the CDC’s recommendations, but most likely will, said Dr. Marcus Plescia, chief medical officer of the Association of State and Territory Health Officials, which represents health agencies. States. The committee will meet again soon to vote on which groups should be given priority next.

Here are answers to some common questions about the vaccine and its distribution.

Who will get the vaccine first?

Based on its recent discussions, the CDC committee will almost certainly recommend that the country’s 21 million healthcare workers be eligible before anyone else, along with three million people, mostly elderly, living in nursing homes. and other long-term care facilities.

According to the committee, 39% of deaths from the coronavirus have occurred in long-term care facilities. But there won’t be enough doses at the start to vaccinate everyone in these groups; Pfizer and Moderna, the two companies closest to getting approval for their vaccines, estimated they will have enough to not vaccinate more than 22.5 million Americans by January. Each state will therefore have to decide which health workers will start.

They may choose to prioritize ICU doctors and nurses, respiratory therapists and other hospital workers, including cleaning staff, who are most likely to be exposed to the coronavirus. Or they can offer the vaccine first to older healthcare workers, or those who work in nursing homes, who are at higher risk of contracting the virus. Gov. Andy Beshear of Kentucky said on Monday that most of his state’s initial allowance would go to residents and employees of long-term care facilities, with a smaller amount going to hospital workers.

It’s important to remember that anyone who receives a vaccine made by Pfizer or Moderna will need a second vaccine – three weeks later for Pfizer, four weeks for Moderna.

Who will get it next?

The CDC committee hinted last week that it would recommend essential workers to be next on the list. About 87 million Americans work in food and agriculture, manufacturing, law enforcement, education, transportation, corrections, emergency response, and other sectors. They are at increased risk of exposure to the virus because their work prevents them from working from home. And these workers are disproportionately black and Hispanic, populations that have been particularly affected by the virus.

Individual states may decide to include in this group employees from industries that have been particularly affected by the virus. Arkansas, for example, has proposed including workers in its large poultry industry, while Colorado wants to include ski industry workers who live in collective housing.

After essential workers, the priority groups likely to be recommended by the CDC committee are adults with medical conditions that put them at high risk of coronavirus infection, and people over 65. But again , some states may diverge to some extent, choosing, for example, to vaccinate residents over 75 years of age before certain types of essential workers. All the other adults would follow. The vaccine has not yet been thoroughly studied in children, so they would not yet be eligible.

Who will make state-level decisions about priority groups?

Each state has a task force, largely made up of public health officials, that has been planning and making decisions on vaccination campaigns for months. The senior health official and governor of each state will likely sign the final plans.

How long will states focus on one priority group before moving on to the next?

States do not need to reach out to everyone in one priority group before moving on to the next, according to the CDC’s advisory committee. But more federal guidance is expected on the subject.

When will the first doses of a vaccine be shipped and where will they go?

Federal officials have said they plan to ship the first 6.4 million doses within 24 hours of FDA clearance for a vaccine, and the number each state receives will be based on a formula that takes into account its adult population. Pfizer will ship special coolers, each containing at least 1,000 doses, directly to locations determined by the governor of each state. At first, almost all of these sites will likely be hospitals that have confirmed they can store shipments at minus 94 degrees Fahrenheit, as the Pfizer vaccine requires, or use them quickly.

When will a vaccine be available to the general public and where will people get it?

Federal officials have repeatedly suggested that people who are not in priority groups – healthy adults under the age of 65 who do not work in the health sector or are not qualified as essential workers – should have access to the vaccine by May or June, as there will be sufficient supply by then. But we will have to do well to make this happen. One factor is whether, or when, vaccines other than Pfizer and Moderna are approved.

Can employers like hospitals or grocery stores require their employees to be vaccinated?

Employers have the right to require their workers to be vaccinated. Many hospital systems, for example, require an annual influenza vaccine. But employees can request exemptions for medical reasons or religious beliefs. In such cases, employers are expected to provide “reasonable accommodation”; with a coronavirus vaccine, a worker might be allowed to wear a mask in the office instead or work from home.

Three companies have announced preliminary data indicating that their vaccines are effective, and dozens of more candidates are in clinical trials. Can I choose which vaccine I get?

It depends on a number of factors, including the supply in your area at the time you are vaccinated and whether certain vaccines are more effective in certain populations, such as the elderly. At first, the only choice is probably Pfizer’s vaccine, provided it is approved. Moderna applied to the FDA for emergency clearance on Monday; if approved, it will likely become available in the weeks following that from Pfizer.

Are there any side effects?

Some participants in the Pfizer and Moderna trials reported experiencing symptoms such as fever, muscle aches, headaches, and fatigue after receiving the injections, but the side effects usually did not last for more than a day. Still, preliminary data suggests that, compared to most flu shots, coronavirus vaccines have a somewhat higher rate of such reactions, which are almost always normal signs that the body’s immune response is underway. . At the CDC’s advisory committee meeting last week, some members said it would be important for doctors to warn their patients of possible side effects and assure them of vaccine safety.

How do you know it’s safe?

Each company’s application to the FDA includes two months of follow-up safety data from phase 3 clinical trials conducted by universities and other independent bodies. In this phase, tens of thousands of volunteers get vaccinated and wait to see if they are infected, compared to others who receive a placebo. In September, the Pfizer trial had 44,000 participants; no serious security issues were reported.

The FDA will also review the data for each vaccine seeking authorization and share it with its advisory committee, which will meet publicly – in the case of the Pfizer vaccine, on December 10 – to ask questions and make a recommendation to the agency. The FDA will then decide whether or not to approve the vaccine for emergency use.

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