Who should get COVID-19 vaccine first? Experts weigh in

Experts are trying to determine who should be first to receive a coronavirus vaccine once one becomes available.

Dr. Anthony Fauci, the nation’s top infectious disease specialist, said a vaccine could be ready by the end of the year and distributed to Americans in 2021, NPR reported.

“From everything we’ve seen now — in the animal data, as well as the human data — we feel cautiously optimistic that we will have a vaccine by the end of this year and as we go into 2021,” Fauci said, according to the outlet. “I don’t think it’s dreaming.”

The coronavirus pandemic has killed more than 150,000 people in the U.S. and more than 650,000 globally, according to Johns Hopkins University.

More than 150 vaccines for the virus are in various stages of development across the world, National Geographic reported.

It typically takes years for a vaccine to make it through the three phases of development before it’s handed off to regulatory agencies to be approved, but some COVID-19 vaccines — including those developed by Moderna, Pfizer and the University of Oxford — have already moved into the third phase of clinical testing, which includes administering the vaccine to a wide array of people, according to the outlet.

But as these potential vaccines inch closer to the finish line, experts say determining who should be prioritized when it comes to getting the vaccine is no simple task.

Who should get the vaccine first?

Public health officials pulled together a panel of outside scientists and ethicists saddled with developing an “equitable” framework for how the first doses of a coronavirus vaccine should be distributed, Reuters reported.

The panel is expected to announce its recommendation early this fall, according to the Mercury News.

National Institute of Health Director Dr. Francis Collins told the panel — which includes experts from the National Academy of Medicine and the National Academies of Sciences, Engineering and Medicine — to consider prioritizing healthcare workers, military personnel and other essential frontline workers in areas of the country hardest hit by the pandemic, according to Reuters.

He also directed their focus to people who volunteered for vaccine testing, but received placebo shots, the outlet reported.

“This is going to be controversial,” he told the panel, according to the outlet. “Not everybody’s going to like the answer. There will be many people who feel that they should have been at the top of the list, and not everybody can be.”

A preliminary plan devised by the Centers for Disease Control and Prevention this spring would give priority to medical workers, national security officials, essential workers, older people and those with underlying health conditions, the New York Times reported, with the general population following later.

But people may still need to be prioritized within these larger groups.

“Should immunocompromised patients in the midst of cancer treatment get access to the vaccine before tens of millions of people with Type 2 diabetes?” CNBC asked.

Officials could also need to determine who falls under the “essential worker” umbrella, the Associated Press reported. For instance, would it include teachers or people who work in poultry plants?

Dr. Sharon Frey of St. Louis University said people who are poverty stricken and live in crowded conditions in urban areas should also be considered for priority, as they have less access to healthcare and often can’t work from home, according to the AP.

Dr. Henry Bernstein of Northwell Health suggested vaccinating entire families as opposed to just one high-risk person in the home, the AP reported.

The panel is also considering whether Black and Latino people — two groups among those hardest hit by the COVID-19 pandemic — should be higher on the list than other members of the population, according to the Times.

Some medical experts don’t believe there’s scientific evidence to support the option or fear such a decision could be detrimental to public faith in a coronavirus vaccine, which is seen as essential in bringing an end to the pandemic, the Times reported.

Bioethicists have also said that many of these determinations cannot be made until details of the vaccine are better known, according to CNBC.

“A lot will depend on the vaccine, but also the modeling that we do,” Ezekiel Emanuel, an oncologist and senior fellow at the Center for American Progress, told the outlet. “We might even find that the best way to reduce the spread of the virus is to vaccinate the most common transmitters, like grocery store workers or policemen.”

What about shortages?

If there’s a shortage in vaccines, most people in the U.S. would not be able to receive vaccines from the initial lot under the CDC’s preliminary plan, the Times reported. Because of this, some experts are suggesting a weighted lottery system, which has also been used to dole out remdesivir, a drug that has been used to treat the coronavirus.

Ethicists and doctors would rank patients, determining which groups should be prioritized and to what degree, according to the Times. Douglas White, ethicist and vice chairman of the department of critical medicine at the University of Pittsburgh, said people have been accepting of the results during the use of the lottery system for remdesivir.

“I speculate that is because we are very transparent about the reason and the ethical framework that applies to everyone who comes into hospital, whether that is the hospital president or someone who is homeless,” he told the Times.

The lottery system gave preference to health care and emergency medical workers, according to the outlet, and people from economically disadvantaged areas also received weighted odds. People with shorter life expectancy, such as end-stage cancer patients, were made less likely to win the lottery.

It did not consider factors such as age, race, quality of life or capacity to pay, the Times reported.

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Dawson covers goings-on across the central region, from breaking to bizarre. She has an MSt from the University of Cambridge and lives in Kansas City.

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