US panel: 1st vaccines to health care workers, nursing homes

Health care workers and nursing home residents should be at the front of the line when the first coronavirus vaccine shots become available, an influential government advisory panel said Tuesday.

Posted: Dec 2, 2020 12:54 PM

NEW YORK (AP) — Health care workers and nursing home residents should be at the front of the line when the first coronavirus vaccine shots become available, an influential government advisory panel said Tuesday.

The panel voted 13-1 to recommend those groups get priority in the first days of any coming vaccination program, when doses are expected to be very limited. The two groups encompass about 24 million people out of a U.S. population of about 330 million.

Later this month, the Food and Drug Administration will consider authorizing emergency use of two vaccines made by Pfizer and Moderna. Current estimates project that no more than 20 million doses of each vaccine will be available by the end of 2020. And each product requires two doses. As a result, the shots will be rationed in the early stages.

The Advisory Committee on Immunization Practices will meet again at some point to decide who should be next in line. Among the possibilities: teachers, police, firefighters and workers in other essential fields such as food production and transportation; the elderly; and people with underlying medical conditions.

Tuesday’s action merely designated who should get shots first if a safe and effective vaccine becomes available. The panel did not endorse any particular vaccine. Panel members are waiting to hear FDA’s evaluation and to see more safety and efficacy data before endorsing any particular product.

Experts say the vaccine will probably not become widely available in the U.S. until the spring.

The panel of outside scientific experts, created in 1964, makes recommendations to the director of the Centers for Disease Control and Prevention, who almost always approves them. It normally has 15 voting members, but one seat is vacant.

The recommendations are not binding, but for decades they have been widely heeded by doctors, and they have determined the scope and funding of U.S. vaccination programs.

It will be up to state authorities whether to follow the guidance. It will also be left to them to make further, more detailed decisions if necessary — for example, whether to put emergency room doctors and nurses ahead of other health care workers if vaccine supplies are low.

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 rocketing in recent weeks.

As the virtual meeting got underway, panel member Dr. Beth Bell of the University of Washington noted that on average, one person is dying of COVID-19 per minute in the U.S. right now, “so I guess we are acting none too soon.”

About 3 million people are living in nursing homes, long-term chronic care hospitals, and other U.S. long-term care facilities. Those patients and the staff members who care for them have accounted for 6% of the nation’s coronavirus cases and a staggering 39% of the deaths, CDC officials say.

Despite the heavy toll, some board members at Tuesday’s meeting said they hesitated to include such patients in the first group getting shots.

Dr. Helen Keipp Talbot, an infectious diseases researcher at Vanderbilt University who was the lone committee member to vote against the proposal, cited flu research that found vaccinating the staff of such facilities has a greatest impact on preventing its spread there.

Dr. Richard Zimmerman, a University of Pittsburgh flu vaccine researcher who watched the meeting online, echoed Talbot’s concerns.

“I think it was premature” to include nursing home residents as a priority group, said Zimmerman, a former ACIP member. “Their vote seems to assume that these people will respond well to the vaccine. ... I don’t think we know that.”

Committee members were unanimous in voicing support for vaccinating health care workers — about 21 million people, according to CDC officials.

That broad category includes medical staff who care for — or come in contact with — patients in hospitals, nursing homes, clinics and doctor’s offices. It also includes home health care workers and paramedics. Depending on how state officials apply the panel’s recommendations, it could also encompass janitorial staff, food service employees and medical records clerks.

The government estimates people working in health care account for 12% of U.S. COVID-19 cases but only about 0.5% of deaths. Experts say it’s imperative to keep health care workers on their feet so they can administer the shots and tend to the booming number of infected Americans.

For months, members of the immunization panel had said they wouldn’t take a vote until the FDA approved a vaccine, as is customary. But late last week, the group scheduled an emergency meeting.

The panel’s chairman, Dr. Jose Romero, said the decision stemmed from a realization that the states are facing a Friday deadline to place initial orders for the Pfizer vaccine and determine where they should be delivered. The committee decided to meet now to give state and local officials guidance, he said.

But some panel members and other experts had also grown concerned by comments from Trump administration officials that suggested differing vaccine priorities.

Dr. Deborah Birx of the White House coronavirus task force said in a meeting with CDC officials last month that people 65 and older should go to the head of the line, according to a federal official who was not authorized to discuss the matter and spoke to The Associated Press on condition of anonymity.

Then last week U.S. Health and Human Services Secretary Alex Azar stressed that ultimately governors will decide who in their states gets the shots. Vice President Mike Pence echoed that view.

Asked whether Azar’s comment played a role in the scheduling of the meeting, Romero said; “We don’t live in a bubble. We know what he said. But that wasn’t the primary reason this is being done.”

Jason Schwartz, a professor of health policy at the Yale School of Public Health, said it makes sense for the panel to take the unusual step of getting its recommendation out first.

“Without that formal recommendation, it does create a void from which states could go off in all sorts of different directions,” said Schwartz, who is not on the panel.

HHS officials have said they will distribute initial doses to states based on population, and it’s possible that some states won’t receive enough to cover all of their health care workers and nursing home residents.

CDC officials said they are optimistic such shortages would last only a few weeks.

Still, governors and local officials may have to decide which health care workers or regions get shots first, Schwartz said.

“It’s up to states to figure out the more granular detail,” he said.

___

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.

Terre Haute
Clear
86° wxIcon
Hi: 88° Lo: 62°
Feels Like: 85°
Robinson
Clear
82° wxIcon
Hi: 88° Lo: 61°
Feels Like: 82°
Indianapolis
Clear
83° wxIcon
Hi: 85° Lo: 62°
Feels Like: 83°
Rockville
Clear
86° wxIcon
Hi: 88° Lo: 63°
Feels Like: 86°
Casey
Clear
86° wxIcon
Hi: 87° Lo: 61°
Feels Like: 85°
Brazil
Clear
86° wxIcon
Hi: 87° Lo: 62°
Feels Like: 85°
Marshall
Clear
86° wxIcon
Hi: 89° Lo: 61°
Feels Like: 85°
A Breezy, Mild Night
WTHI Planner
WTHI Temps
WTHI Radar

WTHI Events

 

Illinois Coronavirus Cases

(Widget updates once daily at 7 p.m. CT)

Cases: 1612129

Reported Deaths: 27216
CountyCasesDeaths
Cook61543610987
DuPage1042681360
Will876561092
Lake773641061
Kane66108852
Winnebago39170545
Madison38345578
St. Clair35140571
McHenry33177317
Peoria26076363
Champaign25967184
Sangamon24718273
McLean22003208
Tazewell19833326
Rock Island17919348
Kankakee16856235
Kendall15537107
Macon14565244
LaSalle14539278
Vermilion13343190
Adams12733148
DeKalb11729129
Williamson11528160
Whiteside7944176
Jackson774389
Boone762782
Coles7404113
Ogle718087
Grundy704582
Franklin693999
Clinton683798
Knox6715166
Marion6581138
Macoupin6525100
Henry625674
Effingham612882
Jefferson6116132
Livingston574196
Woodford556191
Stephenson549789
Randolph532197
Monroe510199
Christian496380
Fulton491570
Morgan488996
Logan478474
Montgomery470476
Lee460658
Bureau429188
Perry416671
Saline414064
Fayette403459
Iroquois396973
McDonough356656
Jersey324253
Shelby317343
Crawford307930
Douglas307636
Lawrence303431
Union297347
Wayne276057
White267730
Richland264455
Hancock258834
Pike258056
Clark253538
Cass252228
Bond244824
Clay242247
Edgar237545
Ford235956
Warren227161
Carroll226537
Johnson214925
Moultrie212931
Jo Daviess207226
Washington206627
Wabash202616
Greene200939
Mason200351
Massac200144
De Witt196830
Piatt192114
Mercer191234
Cumberland179825
Menard160812
Jasper153418
Marshall135621
Hamilton129821
Brown10228
Pulaski99211
Schuyler9748
Edwards96815
Stark77227
Gallatin7557
Scott6975
Alexander68111
Henderson66114
Calhoun6452
Hardin56414
Putnam5464
Pope4945
Unassigned1812432
Out of IL60

Indiana Coronavirus Cases

(Widget updates once daily at 8 p.m. ET)

Cases: 947918

Reported Deaths: 15377
CountyCasesDeaths
Marion1291181990
Lake635721103
Allen53899761
Hamilton44082449
St. Joseph42122590
Elkhart33803491
Vanderburgh30574449
Tippecanoe26915251
Johnson23727418
Hendricks22410342
Porter21832347
Clark17562231
Madison17492385
Vigo16302285
Monroe14545191
LaPorte14389239
Delaware14183222
Howard13971273
Kosciusko11498135
Hancock10935166
Warrick10737178
Bartholomew10635170
Floyd10514208
Wayne10077226
Grant9213204
Morgan8928160
Boone8463111
Dubois7791123
Dearborn769490
Henry7691133
Noble7466101
Marshall7409128
Cass7219118
Lawrence7026153
Shelby6647111
Jackson661386
Gibson6190107
Harrison609386
Huntington604495
Montgomery5853105
DeKalb581091
Knox5535104
Miami548888
Putnam543268
Clinton537465
Whitley529354
Steuben501768
Wabash488692
Jasper483861
Jefferson474492
Ripley457777
Adams446068
Daviess4231108
Scott409165
Clay394957
White393858
Greene393392
Wells389884
Decatur388797
Fayette378578
Posey362341
Jennings356056
Washington334747
LaGrange325175
Spencer321136
Fountain318455
Randolph317190
Sullivan309449
Owen287064
Starke282864
Fulton280454
Orange277859
Jay257038
Perry254152
Carroll245229
Franklin242838
Rush237030
Vermillion235050
Parke221420
Tipton212055
Pike211740
Blackford170534
Pulaski168551
Crawford147318
Newton145845
Benton143916
Brown135846
Martin130217
Switzerland126910
Warren115616
Union98511
Ohio80511
Unassigned0482