• Wednesday, Sep 30, 2020
  • Last Update : 10:54 pm

Covid-19: Who should be vaccinated first?

  • Published at 10:41 pm August 2nd, 2020
covid-19 vaccine
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The issue of how to prioritize vaccines is not limited to the US, and the World Health Organization will be posed with the same dilemma when they try to ensure fair distribution of vaccines to poorer countries while the wealthier nations corner the market for the first doses

Numerous pharmaceutical companies are conducting massive trials to find a vaccine for Covid-19 and the time to take a decision on who should be vaccinated first may be fast approaching. Health authorities in the US hope to provide some draft guidance on the matter by late next month, but the decision is more complicated than in previous disease outbreaks.

Usually, frontline health workers and people most vulnerable to infection are prioritized in the distribution of a new vaccine.

"Not everybody's going to like the answer," Dr Francis Collins, director of the National Institutes of Health in the US, recently told one of the advisory groups the American government asked to help decide, according to AP as quoted by UNB.

"There will be many people who feel that they should have been at the top of the list," he added, suggesting vaccine distribution be focused on areas hit hardest by the outbreak.

Dr Collins also suggested giving priority to volunteers in the final stage of vaccine testing who received placebos. “We owe them … some special priority.”

Moderna Inc and Pfizer Inc last week began trials that will eventually include 30,000 volunteers each. in the next few months, equally large calls for volunteers will go out for vaccine trials by AstraZeneca, Johnson and Johnson and Novavax.

Some vaccines made in China are in smaller late-stage studies in other countries. 

Most potential vaccines will require two doses, further stretching supply amid already high demand.

The issue of how to prioritize vaccines is not limited to the US, and the World Health Organization will be posed with the same dilemma when they try to ensure fair distribution of vaccines to poorer countries while the wealthier nations corner the market for the first doses.

In the US, the Advisory Committee on Immunization Practices established by the Centers for Disease Control and Prevention is supposed to recommend who to vaccinate and when. However, the decision is so tricky this time that ethicists and vaccine experts from the National Academy of Medicine, chartered by Congress to advise the government, are being asked to weigh in

Setting priorities will require "creative, moral common sense," said Bill Foege, who devised the vaccination strategy that led to the global eradication of smallpox. Foege is co-leading the academy's deliberations, calling it "both this opportunity and this burden." 

With vaccine misinformation abounding and fears that politics might intrude, CDC Director Robert Redfield said the public must see vaccine allocation as "equitable, fair and transparent."

The CDC’s initial suggestion is to first vaccinate 12 million of the most critical health, national security and other essential workers. Next would be 110 million people at high risk from the coronavirus, such as people over 65 or those who are in poor health.

A further complication is posed by the changing levels of risk for health workers with the increasing duration of the pandemic. Health workers in Covid-19 treatment units are now among the best protected and others may be in greater need of the vaccine, members of the US Advisory Committee said according to AP.

Furthermore, a decision needs to be taken on who specifically qualifies as an essential worker, and the effectiveness of the vaccine on various age groups may impact distribution as well.

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