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Science Policy Around the Web July 2nd, 2020

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By Mary Weston, PhD

Source: Wikimedia

The line is forming for a COVID-19 vaccine. Who should be at the front?

With the possibility of COVID vaccines becoming available as soon as next fall, the debate over who will receive the initial doses has begun. Last week, a committee that provides vaccine recommendations to the CDC met to deliberate vaccine prioritization. 

Those risking their health for others in essential roles, such as high-risk health care workers and first responders, will receive the earliest vaccine doses. However, for subsequent groups, the ethics surrounding vaccine prioritization are difficult and complicated. Prioritization is a balance between what is best for society and protecting the health of an individual says Dr. Bruce Gellin, former director of the US National Vaccine Program and current lead at the nonprofitSabin Vaccine Institute

Who else should get these early doses? The virus has disproportionately affected the elderly, arguing they should be high on the list. However, older people typically have the weakest immune response to vaccines and ensuring those who get the early doses develop immunity is important. Alternatively, perhaps groups working in professions/environments that drastically increase their infection risk should be vaccinated early. However, these groups tend to be younger and healthier, such as prisoners, meat packers, and grocery store workers. Additionally, there is the complex issue surrounding the disproportionate effect of COVID-19 on certain ethnic groups.  Should they get special consideration? What about those who are poor, who likely have less access to healthcare and live in more crowded conditions, or teachers that work indoors with big groups of children?

One conclusion made by the committee is that pregnant women, who typically are last to get a new vaccine because of concerns of possible harm to the fetus, may be high on the list due to an increased risk of severe illness from COVID-19. 

Both the CDC and the WHO are rapidly working to develop their own schemes for vaccine distribution. Initial outlines indicate they are listing high-risk healthcare workers as the first group. The WHO’s plan has subsequent tiers involve prioritize select groups including general health care workers, the elderly, pregnant women, and people with co-morbidities that increase their COVID-19 risk. However, these are just guidelines and many of the details/classifications need to be established. Additionally, since data surrounding COVID-19 changes so rapidly, these recommendations could be modified to reflect current knowledge.

Vaccine prioritization debates are challenging and the “right” answer is difficult to determine. These conversations have just started and will likely continue until vaccines are widely available. 

(Jon Cohen, Science Magazine)

Written by sciencepolicyforall

July 2, 2020 at 6:17 pm

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