NEW YORK (AP) – Deciding that health workers and residents of residences should be the first in line for the initial and limited supply of COVID-19 shots was not that difficult. Now U.S. health officials have to determine who should be next.
What priority should, for example, the elderly, teachers, traffic workers and supermarket employees have in the coming months as more vaccines become available?
A federal group of vaccination experts addresses this issue at an emergency meeting this weekend. Your orientation is not binding and no matter what you decide, there will be differences from state to state.
Panel members opt to put “essential workers” on the side because people like bus drivers, grocery store employees, and others who do vital chores that can’t be done from home are the ones most often infect. Concern for racial inequalities in the crisis is also more evident here. Many essential workers are black and Hispanic.
But other experts say people 65 and older should be the following, along with people with certain medical conditions. These are the ones who die at the highest rates, they say.
The court is scheduled to vote on the proposal on Sunday.
“I think we know this will not be perfect. We don’t have a vaccine for everyone right away, so we’re going to have to make tough decisions, ”said Claire Hannan, executive director of an organization that represents managers of state vaccination programs.
If there are indeed essential workers, states already have different ideas about who should be closer to the front line.
In Nevada, for example, teachers and child care staff will be ahead of public transportation workers, according to the state’s current plan. Then come the agriculture and food workers, and then the retail and utility employees.
In South Dakota, teachers could access it before those working in food and transportation. In Arkansas, the list of essential workers it includes teachers, prison guards, police officers, packaging plant workers and mayors.
The advice of the expert group (the Advisory Committee on Immunization Practices) is almost always endorsed by the U.S. Centers for Disease Control and Prevention. This happened earlier this month, when the group said that the highest priority should be given to health workers and long-term care home residents for the 20 million initial vaccinations this month.
But it is not clear that things will follow the same path in the next phase. The director of CDC, Dr. Robert Redfield, has said he believes that priority should be given to people aged 70 or over living with children or grandchildren.
The chairman of the advisory committee, Dr. Jose Romero, told The Associated Press that he was aware of Redfield’s comments, but had not spoken directly about them.
Redfield declined to say whether he would prioritize seniors over essential workers, even if the group recommended otherwise. “I look forward to hearing from the advisory group’s discussion and receiving their recommendation for consideration,” he said in an email to the AP.
Most states followed the group’s recommendation that health workers and residents of nursing homes receive the first doses. But there have been some exceptions.
He said Utah long-term care residents should be behind health workers, rather than sharing the front with them. Massachusetts included prisoners and homeless people on the first level. Nevada, New Hampshire and Wyoming did the same with police officers.
State-to-state variations are likely to increase in the following priority groups, said Jennifer Kates of the Kaiser Family Foundation, which has been analyzing state vaccination plans.
“I think we’ll see states fall in different ways,” with some putting seniors ahead of essential workers, Kates said.
Things could get tangled up. For example, some experts said that if a state prioritizes certain essential workers and a neighboring state decides to give priority to the elderly, people may try to cross state lines in hopes of getting vaccinated.
“This is one of the problems of not having a fully national immunization plan,” said Romero, who is also the head of the Arkansas state health department.
The proposal to the advisory committee is based on a broad definition of essential workers established in August by the U.S. Department of Homeland Security. It counts hundreds of different jobs as part of the critical infrastructure staff, including first aid, teachers, communications technicians, weather forecasters, employees of wastewater treatment plants and people working in animal shelters.
According to estimates presented to the advisory committee, up to 87 million people who do not work in the healthcare field can be counted as essential employees.
The nation has more than 53 million seniors. The CDC also has more than 100 million Americans with underlying medical conditions that put them at greater risk for serious COVID-related illnesses, although there is an overlap between the two groups.
Trade associations and groups of workers have been sending emails and other communications to the committee, arguing that priority should be given.
Julie Russell, representing the Coronado Unified School District in California, urged prioritizing teachers and other school workers. “We ask you to recognize the importance of the safety of our staff and how many young lives each of us touches,” he said at a group meeting last weekend.
Dr. Charles Lee, of the American College of Correctional Physicians, promoted those who work in prisons and jails, in addition to inmates.
Romero said the committee is likely to discuss ways to help states reduce which key workers should go first. For example, people who consider themselves essential but can work from home may be higher on the list than those who cannot keep within 6 feet of others while working.
What about Atlanta-based CDC staff? In a note to employees obtained by the PA, Redfield said the agency will not obtain a direct vaccine assignment. However, the Georgia plan allows some public health and lab workers to be in the state’s top priority group. Some CDC officials also work in hospitals and clinics, and can be prioritized with staff at these locations.
Of course, when more vaccine comes out, “the issue of priority becomes less important,” said Dr. Eric Toner, a Johns Hopkins University scientist who has written about possible vaccination prioritization frameworks.
“The bottom line is that we just need to vaccinate as many people as quickly as we can,” he said.
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AP writers Candice Choi and Jason Dearen in New York City and Jonathan Poet in Philadelphia contributed to this report.
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The Associated Press Health and Science Department is supported by the Howard Hughes Medical Institute’s Department of Science Education. The AP is solely responsible for all content.