In a year of twists and turns, one question is being asked with increasing urgency: Who will get the COVID-19 vaccine first?
As pharmaceutical companies dive into phase 3 clinical trials and move at unprecedented speeds to develop a new vaccine, the country is on the brink of facing a new dilemma: Now that we have the vaccines, how should they be distributed, and to who?
Experts and policymakers are working together to find the best answers, but it’s not an easy task.
The First 10 to 15 Million Doses to Frontline Health Workers
In a world where it seems hard to agree on anything recently, most bioethicists agree that the first round of vaccines, predicted to amount to 10 to 15 million doses, should go to frontline health workers.
“Obviously they are being placed at high risk of infection, because they’re taking care of people who are infected and infectious,” said Ruth Faden, a consultant to the World Health Organization on COVID-19 vaccine guidelines.
But even within the category of front line health workers, many significant questions remain unanswered. Mainly, what defines a frontline health worker? Is it strictly doctors and nurses, or hospital and pharmacy staff who regularly come in close contact with patients? What about emergency medical responders and nursing home workers?
According to preliminary guidelines from the CDC, all of the above are considered frontline health workers, in addition to morticians and funeral home workers who handle COVID-19 victims’ bodies.
There’s no doubt that the initial round of 10 to 15 million doses won’t be enough to vaccinate every frontline health worker in the country. State and local authorities may need to ration distribution by restricting vaccinations to the hardest-hit areas of each state until manufacturing catches up with demand.
Who Comes After Frontline Health Workers
Once frontline health workers are vaccinated, it’s difficult to identify the second tier of high-risk people who should receive priority. Should the next batch of vaccines be directed to essential workers who keep public transportation and grocery stores running? Or to the elderly or people with preexisting conditions, who are more likely to catch the coronavirus?
The questions are difficult to answer, but experts have hope that manufacturing won’t take long to catch up to demand. “In a reasonable amount of time, if all goes well, we will have enough vaccines for everyone in the country who wants one,” Faden said.
The National Academies of Sciences, Engineering and Medicine predicts that it will take about 12-18 months after a vaccine’s approval to achieve consistent availability across the country.
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