Whether it takes weeks, as US President Donald Trump has hinted, or months, as most health-care experts expect, an approved vaccine against the coronavirus is coming, and it’s hotly anticipated. Still, it will initially be in short supply while manufacturers scale up production. As the pandemic continues to put millions at risk daily, including health-care workers, older people and those with pre-existing diseases, who should get vaccinated first?
This week, a strategic advisory group at the World Health Organization (WHO) weighed in with preliminary guidance for global vaccine allocation, identifying groups that should be prioritized. These recommendations join a draft plan from a panel assembled by the US National Academies of Sciences, Engineering, and Medicine (NASEM), released earlier this month.
Experts praise both plans for addressing the historic scale and unique epidemiology of the coronavirus pandemic. And they commend the NASEM for including in their guidance minority racial and ethnic groups — which COVID-19 has hit hard — by addressing the socio-economic factors that put them at risk. The WHO plan, on the other hand, is still at an early stage and will need more detail before its recommendations can become actionable, others say.
“It’s important to have different groups thinking through the problem,” says Eric Toner, an emergency-medicine physician and pandemics expert who has done similar planning at Johns Hopkins Center for Health Security in Baltimore, Maryland. And although the plans differ somewhat, Toner says he sees a lot of agreement. “It’s great that there’s a consensus of opinion on these issues.”
Head of the line
The WHO’s guidance at this point lists only which groups of people should have priority access to vaccines. The NASEM guidance goes a step further by ranking priority groups in order of who should get a vaccine first (see ‘A tiered approach’).
After health-care workers, medically vulnerable groups should be among the first to receive a vaccine, according to the NASEM draft plan. These include older people living in crowded settings, and individuals with multiple existing conditions, such as serious heart disease or diabetes, that put them at risk for more-serious COVID-19 infection.
The plan prioritizes workers in essential industries, such as public transit, because their jobs place them in contact with many people. Similarly, people who live in certain crowded settings — homeless shelters and prisons, for example — are called out as deserving early access…..
