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(CNN) – Vaccines that protect against covid-19 are on the way. What should older adults expect?
The first candidates, from Pfizer and Moderna, could arrive before Christmas, according to Alex Azar, who heads the US Department of Health and Human Services.
Both vaccines are remarkably effective in preventing coronavirus diseases, according to information released by companies, although much of the data from clinical trials is yet to come. Both have been tested in adults 65 and older, who developed a strong immune response.
Older people in nursing homes and care facilities will be among the first Americans to be vaccinated, following this week’s recommendations from a federal advisory panel. Older adults living at home will have to wait a little longer.
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Many uncertainties remain. Among them: What side effects can older adults anticipate and how often will they occur? Will vaccines offer meaningful protection to older people who are frail or have multiple chronic diseases?
Here’s a look at what’s known, what’s not, and what’s to come:
The decision-making calendar
Pfizer’s vaccine will be evaluated by a 15-member advisory panel from the US Food and Drug Administration on December 10. Moderna’s vaccine is expected to appear before the panel on December 17.
At least two days before each meeting, an analysis by FDA staff will be released. This will be the first opportunity to see extensive data on the performance of vaccines in large phase 3 clinical trials, including more details on their impact on older adults.
So far, summary results released in press releases indicate that Pfizer’s vaccine, produced in association with BioNTech, has an overall efficacy rate of 95% and an efficacy of 94% in people 65 years of age and older. Moderna’s overall efficacy is 94%, with 87% effective in preventing moderate illness in older adults, according to Moncef Slaoui, chief scientific advisor to Operation Warp Speed, the government’s Covid-19 vaccine development program. from USA
If the advisory panel gives the go-ahead, the FDA will decide in days or weeks whether to authorize the Pfizer and Moderna vaccines for emergency use. Distribution of the vaccine has already begun, and healthcare providers are expected to begin administering it immediately after the FDA acts.
Who gets the vaccine first
In a December 1 meeting of the Advisory Commission on Immunization Practices, which guides the U.S. Centers for Disease Control and Prevention on vaccines, experts recommended that people living in nursing homes ( mainly nursing homes and assisted living facilities) and healthcare workers are the first groups to receive covid-19 vaccines.
This recognizes the extraordinary burden of covid-19 in nursing homes. Although its residents represent less than 1% of the US population, they account for 40% of COVID deaths, more than 100,000 deaths to date.
The commission’s decision comes despite a lack of evidence that the Pfizer and Moderna vaccines are effective and safe for frail and vulnerable older people receiving long-term care. No vaccines were tested in this population. Federal officials insist that side effects will be carefully monitored.
Who gets vaccinated after the elderly?
Next in line would likely be essential workers unable to work from home, such as police, firefighters, teachers, and people employed in food processing and transportation, according to the commission’s Nov.23 deliberations that they have not reached a formal vote.
Then it would be adults with high-risk medical conditions like diabetes, cancer, kidney disease, obesity, heart disease, and autoimmune diseases and all adults 65 and older.
Although states typically follow ACIP guidelines, some states may choose, for example, to vaccinate high-risk older adults before some essential worker categories.
Not on the list are family caregivers, who provide essential support to vulnerable older adults living in the community, an unpaid workforce of tens of millions.
“If someone provides daily care, it makes sense that they also have access to the vaccine, to keep everyone safe,” said Beth Kallmyer, vice president of care and support for the Alzheimer’s Association.
