People working to make and distribute the vaccine should also first be in the line to get one, advises the team at the Johns Hopkins Center for Health Security.
“The primary reason for including these candidate groups in Tier 1 is that their prioritization would likely prevent the greatest overall damage,” the center’s report read.
According to the World Health Organization, 29 vaccines are in human trials around the world; four of them in the US. Federal government health officials say they expect to know if one or more of them will work safely by the end of the year and hope to begin distribution by next year. But even though companies are already increasing production in case a vaccine works, there will not be enough to vaccinate everyone immediately.
“It can take many months before most U.S. residents have access to vaccination; bottlenecks at various stages of the vaccine production process (e.g., supply of bottles such as spraying, filling, and completion) can cause further delays in the availability of the vaccine. fax, “read the report.
The advisory committee of the U.S. Centers for Disease Control and Prevention on Immunization Practices and the National Academy of Medicine are studying the issue of who should get one first.
The Johns Hopkins team, which included health safety experts, vaccinators, bioethicists and specialists in patient safety and access to vaccines, wanted to inform the discussion.
“It is important to emphasize that we do not provide a set of definitive recommendations on who should be prioritized for vaccination,” she warned. But they said their candidate groups should be taken seriously.
Even within priority groups there will have to be ranking. “There will probably not be enough vaccine provision for all members of Tier 1 candidate groups to be offered vaccines at the same time,” the report reads.
First in line: “Those who are most essential to sustaining the sustained COVID-19 response,” they suggest. Next would come those who are most essential to maintaining “core social functions,” such as teachers, public transportation workers, and food delivery workers.
Also up front: people who are most at risk for serious illness like death and their caregivers. It would be more important to vaccinate caregivers, they said, because some people at risk may not be able to get a vaccine, or may not develop a robust immune response.
In the second tier come health workers who are not directly involved in the response of the coronavirus; pharmacy staff; people living far away from health care; electricity, sanitation and other important workers; delivery staff; military deployment; and police.
“Vaccination will not remove SARS-CoV-2 from the planet, and COVID-19 is likely to become an endemic disease, even after widespread vaccination, due to the occurrence of sporadic cases and accidental outbreaks,” the report warns.
There are also cost considerations. “Although for most people there are no low-threshold costs for the vaccine itself (this has not yet been determined), related costs – such as travel to a vaccination site or the need to get off work – would be a financial hurdle for some. , “notes the report. “More investment and innovation is needed to offer vaccinations on non-residential sites that feel convenient, well-known and safe for many vulnerable and underrepresented populations.”
The federal government must coordinate vaccination efforts and ensure that policies are applied equally. It is essential that people trust the process to be honest and safe, the report says.
It’s vital to do it right, the Johns Hopkins team said.
“What is done early in a vaccination campaign will have implications for every aspect of our personal and public lives,” she wrote.
“We risk reducing confidence in the government, as well as in our public health and health care systems if the allocation, distribution and administration of the vaccine is not handled appropriately and clearly,” she added.
“If, on the other hand, an allocation strategy is ethical, nationally consistent, honest, and informed by key constituency groups, then vaccination campaigns are more likely to be flexible and accepted by the public, which would result in many lives being saved and faster economic recovery. . “
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