Many states have prioritized COVID-19 vaccines for people over 75 and then switched to those over 65, but they are not expected to continue quitting by age, an advisory committee of people said on Monday. Centers for Disease Control and Prevention.
The approach is inherently unfair to minorities, committee members said, because they have a lower life expectancy and because people of color die from COVID-19 at a younger age than white Americans – even in the thirties, forties and fifties.
“I am not in favor of any part of an age group under 65,” said Dr. José Romero, pediatric infectious disease specialist at the University of Arkansas for Medical Sciences at Little Rock and Chairman of the Advisory Committee on Immunization Practices. .
The committee disagreed with plans by some states to require people to show proof that they have two health conditions on a pre-specified list before they are allowed to be vaccinated.
People with two well-controlled medical conditions may have a lower risk of severe COVID-19 than those with an uncontrollable condition or less common illness that was not common enough.
For example, although type 2 diabetes is considered a higher risk disease, type 1 is not always, even though people with this less common autoimmune version are at the same risk, noted Dr Katherine Poehling, professor of pediatrics at Wake. Winston-Salem School of Forest Medicine, North Carolina.
Yes, there will be people who lie about their medical conditions, admitted Dr. Helen Talbot, an infectious disease specialist at Vanderbilt University Medical Center in Nashville, Tennessee. “There is always someone who finds a way to cheat.”
But it’s better to let in a few cheaters than to deny the vaccine to people who really need it, she said.
According to committee members, the other category of people that should be given priority is those who care for other people who may not be able to be vaccinated.
Dr Grace Lee, professor of pediatric infectious diseases at Lucile Packard Children’s Hospital and Stanford University School of Medicine in Stanford, Calif., Cited parents of children who have received stem cell transplants.
“Being able to protect these people in the absence of any high-risk medical conditions, I think in itself is important, in part because we can’t immunize young children at the moment,” he said. she declared.
Each state is developing its own vaccine allocation plan, so there are a lot of conflicting messages about who should be prioritized in the coming months as vaccine supply remains tight, committee members said.
For this reason, committee members said the Johnson & Johnson vaccine, released over the weekend, should be added to the general pool of available vaccines, rather than targeted at a particular group or population.
They reaffirmed their commitment to equitable distribution of vaccines, even if they are distributed to as many people as possible.
“I feel very challenged to ensure that we continue to maintain equity as a goal of implementing the COVID-19 vaccination program,” Lee said.
Many vaccine distribution facilities are so worried about getting precisely the right people vaccinated that they are refusing too many, she continued.
“Since our intention is to vaccinate everyone anyway except the most serious situations whether or not I get a correct high risk A vs. B condition, I think that’s less important.” than just making sure we provide access, ”she said.
About 50 million Americans have received at least one dose of a COVID-19 vaccine. By the end of this month, Pfizer-BioNTech will have delivered a total of 120 million doses of its vaccine, enough to immunize 60 million people; Moderna will have provided 100 million doses to vaccinate 50 million people; and J&J will provide 20 million doses of its single-injection vaccine. That’s enough to cover more than half of the 210 million adults in the United States.
At its second four-hour meeting in two days, the committee considered whether to extend the recommended period between two doses of Pfizer-BioNTech or Moderna vaccines.
Some suggested that a delay would allow more vaccine to be distributed, but committee members said they did not think there was enough data to justify postponing the second dose of either. other vaccine.
Opinions were more divided on whether people who had symptomatic COVID-19 would need the two doses of the two-dose vaccines.
Basic immunology suggests the disease would act as a primary dose and the first shot as a booster, Talbot said. “I no longer need the data. We have all been following the immunology,” she said.
Others have raised the question of whether the risks of vaccination for people who have had COVID-19 would outweigh the benefits, especially from a second vaccine. CDC officials said there was not enough information to answer this question.
Implementing such a policy would be difficult, as it is not known how long the protection lasts and how sick a person must be to develop adequate natural protection.
Contact Karen Weintraub at kweintraub @ usatoday.
Patient health and safety coverage at USA TODAY is made possible in part by a grant from the Masimo Foundation for Ethics, Innovation and Competition in Healthcare. The Masimo Foundation does not provide editorial contributions.