Frontline healthcare workers, emergency services personnel and the most vulnerable to the virus should be the first to get any eventual coronavirus vaccine, experts recommend in a new report released Wednesday.
People working to make and distribute the vaccine should also be first in line to get one, the team at the Johns Hopkins Center for Health Security recommends.
“The primary reason for including these candidate groups within Tier 1 is that their prioritization would likely avert the greatest overall harm,” the Center’s report reads.
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 whether one or more of them works safely by the end of the year and hope to start distribution sometime at the beginning of next year. But while companies are already ramping up production in case a vaccine does work, there will not be enough to vaccinate everyone right away.
“It may take many months before most US residents have access to vaccination; bottlenecks at various stages of the vaccine manufacturing process (eg, supply of vials or syringes, fill and finish process) could cause further delays in vaccine availability,” the report reads.
The US Centers for Disease Control and Prevention’s Advisory Committee 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 security experts, vaccine researchers, bioethicists and specialists in patient safety and vaccine access, wanted to inform the discussion.
“It is important to emphasize that we are not providing a set of definitive recommendations about who should be prioritized for vaccination,” they cautioned. But they said their candidate groups should be given serious consideration.
Even within priority groups, there will have to be rankings. “There will likely not be enough vaccine supply for all members of Tier 1 candidate groups to be offered vaccines concurrently,” the report reads.
First in line: “Those most essential in sustaining the ongoing COVID-19 response,” they suggested. After that would come those most essential to maintaining “core societal functions,” such as teachers, public transportation workers and food supply workers.
Also at the front: people most at risk of severe illness or death and their caregivers. It might be more important to vaccinate caregivers, they said, because some at-risk people might not be able to safely get a vaccine, or might not develop a robust immune response.
In the second tier should come health workers not directly involved in the coronavirus response; pharmacy staff; people living far away from health care; electricity, sanitation and other key workers; delivery staff; deployed military; and police.
“Vaccination will not eradicate 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 occasional outbreaks,” the report cautions.