On September 1st the National Academy of Sciences, Engineering and Medicine released a draft report on which groups should be given priority against COVID-19, giving detailed advice on the priorities of the population.
114-page report entitled "Preliminary Framework Discussion on The Fair Distribution of COVID-19 Vaccines" is co-chaired by Francis Collins, President of the National Institutes of Health, and Robert Redfield, Director of the U.S. Centers for Disease Control and Prevention (CDC).
a four-day consultation period for the report, and a public online meeting on the report's recommendations will be held on Wednesday afternoon, with the final report to be available in late September.
The draft discussion included exploring lessons learned from the framework for the allocation of past outbreaks, discussing the basic principles underlying the Framework of the Commission, introducing and justifying the overall objectives of the Framework, discussing criteria for determining an equitable distribution framework, an overview of the vaccine distribution phase and the rationale for giving priority to each group in each phase, and examining the application of the vaccine allocation framework in various contexts.
The draft discussion outlines a phased approach (see figure above) and recommends that the first phase of vaccination should include health care workers in high-risk settings, adults of any age with common and potential health problems that significantly increase the risk of severe COVID-19 disease, and older persons living in long-term nursing homes or other crowded environments.
Phase II vaccination should include workers at significant risk (industry personnel vital to social functioning) as well as teachers and school staff; adults of any age with a moderate increase in the risk of serious COVID-19 due to common and potential health problems; all older persons who are not vaccinated at stage I; persons living in homeless shelters and collective homes; prison personnel; and persons working in these facilities.
phase III vaccination should include young people, children and people in key industries who have not previously been vaccinated.
the remaining Americans who are not vaccinated in the first three stages will be immunized in the fourth and final phase.
the report is intended as a more detailed prioritization plan guide for the order in which vaccines are available to the American public.
The Advisory Committee on Immunization Practices, a panel of experts responsible for developing vaccination guidelines for the CDC, and state, local, and tribal health authorities are already working in greater detail to prioritize the actual population in their areas.
has also been considering the priority of people of color who are more affected in a pandemic.
the report does not recommend that blacks, Hispanics, Latinos or Amerindians or Alaska Natives be considered different priorities.
committee recommended that there did not appear to be a biological reason for the serious impact of the pandemic on these communities.
Contrary, the Committee considers that the high rates of infection and mortality in these communities are due to poor health and socio-economic factors resulting from systemic racism, such as the inability to work from home or the need to work in crowded environments.
, the report gives priority to other factors, such as people with potential health problems, people living in crowded environments, rather than giving priority to racial or ethnic groups.
when the COVID-19 vaccine is approved for use, the initial supply will be tight, possibly in the tens of millions.
of the vaccines being developed need to be vaccinated twice: first, and then three to four weeks later.
it is not easy to determine who should be vaccinated first, and decisions must be made without critical information.
is unclear how many vaccines will prove successful, when they will be licensed, and how many.
is critical that some vaccines may be more effective than others in key populations, such as the elderly.
know in advance that this information may affect decision-making recommendations, but team staff who give priority recommendations cannot wait for this information to be available.
According to CDC estimates, there are approximately 17 to 20 million health care workers in the United States;
some overlap between these groups, for example, health care workers are also necessary workers.
National Academies of Sciences, Engineering, and Medicine. 2020. Discussion Draft of The Preliminary Framework for Equitable Allocation of COVID-19 Vaccine. Washington, DC: The National Academies Press.