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States should work to be ready to distribute COVID-19 vaccines by November 15, according to a target date released by the Centers for Disease Control and Prevention on Friday.
It’s an ambitious date so far – there is still no vaccine approved for use, and there may not be until later this year or beyond. But, in preparation for that day, the CDC’s Advisory Committee on Immunization Practices, a group made up primarily of physicians and public health experts outside the CDC, met virtually Friday and debated the best how to distribute such a vaccine when it becomes available, weighing who would. be online to get it first.
Once a COVID-19 vaccine is cleared by the Food and Drug Administration, ACIP will make recommendations on how the vaccine should be used. Its guidelines will trigger the start of the vaccine distribution process, according to Paul Mango, a senior official at the Department of Health and Human Services.
“[The government] intends to distribute vaccines within 24 hours of final ACIP approval, ”Mango told reporters during a press call on October 23.
At ACIP On Friday, members reviewed what is known about vaccine candidates currently in clinical trials and laid the groundwork so they can make quick decisions once a vaccine is cleared.
In a presentation to the committee, Dr. Mary Chamberland, representing the CDC, said ACIP has agreed to follow the principles of maximizing benefits and minimizing harm, promoting justice, and mitigating inequalities in health care when determining early allocation groups.
ACIP discussed four overlapping groups at high risk of contracting COVID-19 who may be prioritized to get the vaccine. The timing of groups receiving the vaccine when will depend on the characteristics of the vaccine and the quantities available, the advisers said.
Still, a consensus has formed that health workers should be the first to get vaccinated, given their high risk of exposure. Healthcare workers are defined by ACIP as “paid and unpaid people working in healthcare settings who may be exposed directly or indirectly to patients or infectious materials”. This population is estimated at 21 million.
A second group described by ACIP would be much larger – 87 million. This would include workers in other critical areas, defined as people who “carry out operations vital to the continuity of critical infrastructure, such as food, agriculture, transport, education and law enforcement. “.
A third group, of around 100 million people, would be made up of those with health conditions that put people at a higher risk of serious illness from COVID-19. These are adults who have one or more high-risk medical conditions, such as obesity, diabetes, and cardiovascular disease.
A fourth group that would be considered for priority vaccination are adults 65 years of age and older (53 million people) who have no other health problems, but who are at risk of serious illness due to their age. This includes adults living at home and adults living in long-term care facilities (3 million), according to the CDC.
ACIP’s goals are to use a vaccine to reduce transmission, disease and death from COVID-19, and different strategies are being considered to achieve this.
To that end, a modeling study presented by CDC epidemiologist Matthew Biggerstaff showed that vaccinating all adults 65 and older first (after healthcare workers) might have the greatest effect on reducing of the total number of deaths in the United States.
Biggerstaff’s presentation also suggested that vaccination of high-risk adults of any age who have underlying medical conditions – such as lung disease, heart disease, diabetes, kidney disease or obesity – might have the greatest effect on reducing the number of infections, and thus limit the spread. of the coronavirus.
Biggerstaff cautioned that these were theoretical scenarios and actual results could differ, depending on the characteristics of the vaccines available.
CDC physician Dr Janell Routh told the committee that states and territories are working on a Nov. 15 “readiness date” for vaccine distribution. “We want to make sure, before the product is launched, that everything is in place to accept and administer the vaccine,” she said.
There are 64 jurisdictions, including states, territories, and some major cities, that have submitted preliminary plans to the CDC for vaccine distribution. The CDC provided feedback on the plans this week and expects states to recruit providers, set up data systems to track who gets vaccines and work with community leaders, so states are ready. to distribute vaccines as soon as one is cleared by the FDA.
Plans are also being developed to increase the state’s capacity to distribute the vaccine to long-term care facilities “through federal pharmaceutical partnerships,” according to Routh. A revised “playbook” for states to use in developing plans was released on Friday and notes that these partners could include national chains, large regional chains or independent drugstore networks. Routh said 55% of eligible U.S. pharmacies have already signed up to dispense COVID-19 injections.
Once a vaccine is approved, the CDC plans a nationwide “Vaccinate with Confidence” campaign with extensive outreach from health care providers and various communities to encourage people to get it. Dr Amanda Cohn, CDC’s acting chief medical officer for vaccine policy, said the public health campaign will be based on “evidence-based content to amplify messages enabling an individual to make the decision to vaccinate.” .
The panel also heard data from two candidate vaccine manufacturers, Novavax and Janssen, on the progress of their studies, which are still recruiting volunteers. It is not certain that these two vaccines are among the first to be launched.
It is up to the FDA to approve or give emergency clearance for any vaccine. There are currently four vaccine candidates in the final phase of clinical study in the United States. None of the companies have so far applied for FDA clearance or approval.