Essential frontline workers and the elderly are next in line for COVID-19 vaccines in the US.

Essential frontline workers and people age 75 and older in the United States should receive COVID-19 vaccines in the next wave of immunizations, recommended an independent committee from the Centers for Disease Control and Prevention. That group includes about 49 million people.

After those groups are vaccinated, the Advisory Committee on Immunization Practices (ACIP) said doses should go to people between 65 and 74 years old, people between 16 and 65 years old with underlying health conditions, and other essential workers who are not in groups considered first line.

Vaccinations will be limited for at least the next few months. The CDC expects doses to be available to vaccinate 20 million people in December, 30 million people in January, and 50 million people in February. “In this environment, tough decisions have to be made,” said Kathleen Dooling, CDC medical officer, in a presentation to ACIP.

States and local jurisdictions ultimately make the final decisions about vaccine distribution and prioritization, but the CDC’s recommendations help shape their approaches.

The first phase of the vaccines is directed at healthcare workers and residents of long-term care facilities. Those groups began getting vaccinated last week, and more than 500,000 people have been vaccinated in the US so far.

The ACIP balanced two main goals in making recommendations for the second wave of vaccinations: preventing death and disease and preserving social function. Adults over the age of 75 have the highest risk of hospitalization and death from COVID-19. Essential frontline workers, which the committee says include firefighters, teachers, supermarket workers, manufacturing workers and others, cannot work from home and often have to interact with the public, putting them at risk. exposure to the virus. Keeping those groups healthy will help keep key services going.

Centers for Disease Control and Prevention

“This approach mitigates health inequities, as racial and ethnic minorities are disproportionately represented in many essential industries,” said Dooling.

The third group the committee says should get vaccinated includes essential workers like people who work in food service, construction, transportation, wastewater and the media. People between the ages of 65 and 74 are also at high risk of hospitalization and death from COVID-19, as are younger people with underlying health conditions like heart disease or diabetes.

While the CDC has a list of workplaces that it considers essential and top-of-the-line, different states will establish those designations in different ways. Various interest groups are pressuring states to include their workers in early vaccination groups; Uber, for example, asked states to prioritize their drivers.

It will be difficult to distribute vaccines to the second and third wave of priority groups. Determining eligibility, for example, is difficult and reaching essential workers (who may not be able to take time off work or who live in rural areas) is challenging. Committee members highlighted the importance of adequate funding for vaccine distribution. The money was funneled into vaccine development, leading to overwhelmingly effective end products. Local health departments need the same level of investment in vaccination programs. Vaccines are Cadillacs, Jeffrey Duchin, a health officer in King County, Washington, said during the meeting. “But they have come with empty gas tanks,” he said.

More than 200,000 people are diagnosed with COVID-19 in the US each day, and more than 2,500 people die from the disease every day.