Debate begins for who gets to be first in line for COVID-19 vaccine - AOL
musognaol.blogspot.com
Who gets to be first in line for a COVID-19 vaccine? U.S. health authorities hope by late next month to have some draft guidance on how to ration initial doses, but it’s a vexing decision.
“Not everybody’s going to like the answer,” Dr. Francis Collins, director of the National Institutes of Health, recently told one of the advisory groups the government asked to help decide. “There will be many people who feel that they should have been at the top of the list.”
Traditionally, first in line for a scarce vaccine are health workers and the people most vulnerable to the targeted infection.
But Collins tossed new ideas into the mix: Consider geography and give priority to people where an outbreak is hitting hardest.
And don’t forget volunteers in the final stage of vaccine testing who get dummy shots, the comparison group needed to tell if the real shots truly work.
“We owe them ... some special priority,” Collins said.
Huge studies this summer aim to prove which of several experimental COVID-19 vaccines are safe and effective. Moderna Inc. and Pfizer Inc. began tests last week that eventually will include 30,000 volunteers each; in the next few months, equally large calls for volunteers will go out to test shots made by AstraZeneca, Johnson & Johnson and Novavax. And some vaccines made in China are in smaller late-stage studies in other countries.
For all the promises of the U.S. stockpiling millions of doses, the hard truth: Even if a vaccine is declared safe and effective by year's end, there won’t be enough for everyone who wants it right away -- especially as most potential vaccines require two doses.
It’s a global dilemma. The World Health Organization is grappling with the same who-goes-first question as it tries to ensure vaccines are fairly distributed to poor countries -- decisions made even harder as wealthy nations corner the market for the first doses.
In the U.S., the Advisory Committee on Immunization Practices, a group established by the Centers for Disease Control and Prevention, is supposed to recommend who to vaccinate and when -- advice that the government almost always follows.
But a COVID-19 vaccine decision is so tricky that this time around, ethicists and vaccine experts from the National Academy of Medicine, chartered by Congress to advise the government, are being asked to weigh in, too.
Setting priorities will require “creative, moral common sense,” said Bill Foege, who devised the vaccination strategy that led to global eradication of smallpox. Foege is co-leading the academy’s deliberations, calling it “both this opportunity and this burden.”
With vaccine misinformation abounding and fears that politics might intrude, CDC Director Robert Redfield said the public must see vaccine allocation as “equitable, fair and transparent.”
How to decide? The CDC’s opening suggestion: First vaccinate 12 million of the most critical health, national security and other essential workers. Next would be 110 million people at high risk from the coronavirus -- those over 65 who live in long-term care facilities, or those of any age who are in poor health -- or who also are deemed essential workers. The general population would come later.
CDC’s vaccine advisers wanted to know who’s really essential. “I wouldn’t consider myself a critical health care worker,” admitted Dr. Peter Szilagyi, a pediatrician at the University of California, Los Angeles.
Related: Coronavirus epicenter in Miami
21PHOTOS
Coronavirus epicenter in Miami
See Gallery
MIAMI, FLORIDA - JULY 27: Vice President Mike Pence takes off his mask before speaking during a press conference at the the University of Miami Miller School of Medicine on July 27, 2020 in Miami, Florida. The Vice President participated in a roundtable with university leadership and researchers on the progress of a Coronavirus vaccine. (Photo by Joe Raedle/Getty Images)
Cars line up for Covid-19 test at a "walk-in" and "drive-through" coronavirus testing site in Miami Beach, Florida on July 22, 2020. - The United States on July 21 recorded 68,524 new coronavirus cases in the previous 24 hours, Johns Hopkins University reported in its real-time tally. The United States has seen a resurgence of cases, particularly in the so-called Sun Belt, stretching across the south from Florida to California. (Photo by CHANDAN KHANNA / AFP) (Photo by CHANDAN KHANNA/AFP via Getty Images)
People relax on the beach in Miami Beach, Florida on July 28, 2020, amid the coronavirus pandemic. (Photo by CHANDAN KHANNA / AFP) (Photo by CHANDAN KHANNA/AFP via Getty Images)
A couple eat dinner at a restaurant in Miami Beach, Florida on July 28, 2020, amid the coronavirus pandemic. (Photo by CHANDAN KHANNA / AFP) (Photo by CHANDAN KHANNA/AFP via Getty Images)
A group of men play music on the beach in Miami Beach, Florida on July 28, 2020, amid the coronavirus pandemic. (Photo by CHANDAN KHANNA / AFP) (Photo by CHANDAN KHANNA/AFP via Getty Images)
MIAMI, FLORIDA - JULY 27: An exterior view of Don Soffer Clinical Research Center at the University of Miami Miller School of Medicine on July 27, 2020 in Miami, Florida. Phase III trials for a COVID-19 vaccine are scheduled to begin at the research center. (Photo by Johnny Louis/Getty Images)
MIAMI, FLORIDA - JULY 27: An aerial drone view of Marlins Park on July 27, 2020 in Miami, Florida. The Miami Marlins' home opener against the Baltimore Orioles was postponed after a number of players tested positive for COVID-19. (Photo by Cliff Hawkins/Getty Images)
A man walks past the Aardvark Mobile Health's Mobile Covid-19 Testing Truck in Miami Beach, on July 24, 2020. (Photo by CHANDAN KHANNA / AFP) (Photo by CHANDAN KHANNA/AFP via Getty Images)
Nurse practitioner Raciel Gomez (L) swabs the nose of Jeewan Prabha Mehta through a glass pane at the Aardvark Mobile Health's Mobile Covid-19 Testing Truck in Miami Beach, on July 24, 2020. (Photo by CHANDAN KHANNA / AFP) (Photo by CHANDAN KHANNA/AFP via Getty Images)
Medical staff look at a form at the Aardvark Mobile Health's Mobile Covid-19 Testing Truck in Miami Beach, on July 24, 2020. (Photo by CHANDAN KHANNA / AFP) (Photo by CHANDAN KHANNA/AFP via Getty Images)
MIAMI, FLORIDA - JULY 24: Dr. Rubin Vercus prepares to place a box of food and a gallon of milk in the back of a vehicle at drive-thru food distribution site set up at the First Church of the Brethren on July 24, 2020 in Miami, Florida. 500 boxes of food were donated by Farm Share for those in need to help people trying to make ends meet during the pandemic. The United States economic recovery is showing signs of weakness as a renewed outbreak of COVID-19 has caused some business owners to lay employees off again, four months after the initial outbreak of coronavirus in March. (Photo by Joe Raedle/Getty Images)
MIAMI, FLORIDA - JULY 24: Dr. Rubin Vercus places a box of food and a gallon of milk in the back of a vehicle at a drive-thru food distribution site set up at the First Church of the Brethren on July 24, 2020 in Miami, Florida. 500 boxes of food were donated by Farm Share for those in need to help people trying to make ends meet during the pandemic. The United States economic recovery is showing signs of weakness as a renewed outbreak of COVID-19 has caused some business owners to lay employees off again, four months after the initial outbreak of coronavirus in March. (Photo by Joe Raedle/Getty Images)
Narendra Mehta (C) completes a form for testing at the Aardvark Mobile Health's Mobile Covid-19 Testing Truck in Miami Beach, on July 24, 2020. (Photo by CHANDAN KHANNA / AFP) (Photo by CHANDAN KHANNA/AFP via Getty Images)
FLORIDA, USA - JULY 24: A healthcare worker collects samples using a nasal swab at a mobile COVID-19 testing facility, in Miami Beach, Florida, United States on July 24, 2020. (Photo by MARCO BELLO/Anadolu Agency via Getty Images)
Florida, Miami Beach, Covid 19, mobile testing facility, FDEM Division of Emergency Management with long lines. (Photo by: Jeffrey Greenberg/Education Images/Universal Images Group via Getty Images)
Vice Admiral Jerome Adams, the U.S. Surgeon General, with health workers Gabriel Appoh, left, and Varaiaia Barkus at the COVID-19 drive-thru testing center at Miami-Dade County Auditorium in Miami on Thursday, July 23, 2020. (David Santiago/Miami Herald/Tribune News Service via Getty Images)
MIAMI, FLORIDA - JULY 23: Health care workers direct people to use a nasal swab for a self administered test at the new federally funded COVID-19 testing site at the Miami-Dade County Auditorium on July 23, 2020 in Miami, Florida. Vice Admiral Jerome Adams, the U.S. Surgeon General, visited the site, as the state of Florida experiences a spike in coronavirus cases, to encourage people to wear a mask and take other precautions to fight the pandemic. (Photo by Joe Raedle/Getty Images)
MIAMI, FLORIDA - JULY 23: A health care worker directs a person to use a nasal swab for a self administered test at the new federally funded COVID-19 testing site at the Miami-Dade County Auditorium on July 23, 2020 in Miami, Florida. Vice Admiral Jerome Adams, the U.S. Surgeon General, visited the site, as the state of Florida experiences a spike in coronavirus cases, to encourage people to wear a mask and take other precautions to fight the pandemic. (Photo by Joe Raedle/Getty Images)
Cars line up for Covid-19 test at a "walk-in" and "drive-through" coronavirus testing site in Miami Beach, Florida on July 22, 2020. - The United States on July 21 recorded 68,524 new coronavirus cases in the previous 24 hours, Johns Hopkins University reported in its real-time tally. The United States has seen a resurgence of cases, particularly in the so-called Sun Belt, stretching across the south from Florida to California. (Photo by CHANDAN KHANNA / AFP) (Photo by CHANDAN KHANNA/AFP via Getty Images)
MIAMI LAKES, FLORIDA - JULY 22: Dr. Jacqueline Delmont, Chief Medical Officer of SOMOS Community Care, uses a nasal swab to test Eddie Mena for COVID-19 in a medical tent at a testing site locate at the Miami Lakes Youth Center on July 22, 2020 in Miami Lakes, Florida. Testing is being provided by doctors from New York City associated with SOMOS Community Care, as the state of Florida experiences a surge in coronavirus cases. (Photo by Joe Raedle/Getty Images)
MIAMI BEACH, FLORIDA - JULY 20: A man is seen putting away a sign away infront of a closed restaurant on Ocean Drive in the entertainment district of Miami Beach after Miami Dade County imposed a daily 8 p.m. to 6 a.m curfew, on July 20, 2020 in Miami Beach, Florida. The City of Miami Beach put the curfew back into place to fight the spread of the coronavirus (COVID-19), which has spiked in recent days after the Phase 1 reopening of businesses. Florida Gov. Ron DeSantis refused calls to impose a statewide face mask mandate despite the record numbers of coronavirus cases and deaths in the state in recent days. (Photo by Johnny Louis/Getty Images)
Up Next
See Gallery
Discover More Like This
HIDE CAPTION
SHOW CAPTION
of
SEE ALL
BACK TO SLIDE
Indeed, the risks for health workers today are far different than in the pandemic’s early days. Now, health workers in COVID-19 treatment units often are the best protected; others may be more at risk, committee members noted.
Beyond the health and security fields, does “essential” mean poultry plant workers or schoolteachers? And what if the vaccine doesn’t work as well among vulnerable populations as among younger, healthier people? It’s a real worry, given that older people’s immune systems don’t rev up as well to flu vaccine.
With Black, Latino and Native American populations disproportionately hit by the coronavirus, failing to address that diversity means “whatever comes out of our group will be looked at very suspiciously,” said ACIP chairman Dr. Jose Romero, Arkansas’ interim health secretary.
Consider the urban poor who live in crowded conditions, have less access to health care and can’t work from home like more privileged Americans, added Dr. Sharon Frey of St. Louis University.
And it may be worth vaccinating entire families rather than trying to single out just one high-risk person in a household, said Dr. Henry Bernstein of Northwell Health.
Whoever gets to go first, a mass vaccination campaign while people are supposed to be keeping their distance is a tall order. During the 2009 swine flu pandemic, families waited in long lines in parking lots and at health departments when their turn came up, crowding that authorities know they must avoid this time around.
Operation Warp Speed, the Trump administration’s effort to speed vaccine manufacturing and distribution, is working out how to rapidly transport the right number of doses to wherever vaccinations are set to occur.
Drive-through vaccinations, pop-up clinics and other innovative ideas are all on the table, said CDC’s Dr. Nancy Messonnier.
As soon as a vaccine is declared effective, “we want to be able the next day, frankly, to start these programs,” Messonnier said. “It’s a long road.”
___
The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Department of Science Education. The AP is solely responsible for all content.
0 Response to "Debate begins for who gets to be first in line for COVID-19 vaccine - AOL"
Post a Comment