Healthcare Workers to Be First in Line for a COVID Vaccine

As the vaccines for coronavirus disease 2019 (COVID-19) move closer to becoming reality, with the products developed by Pfizer/BioNTech and Moderna both up for approval in the United States, the question remains: Who should get it first? Answer: You. That is, infection preventionists and other healthcare professionals, as well as residents and workers at long-term care facilities.

So voted a special advisory committee to the Centers for Disease Control and Prevention (CDC) yesterday. That committee, the Advisory Committee on Immunization Practices, voted 13 to 1 to put healthcare providers and long-term care facilities first in line. The recommendation was approved by CDC Director Robert Redfield, MD.

The term healthcare provider covers a lot of professional territory by this panel’s definition. It includes employees at hospitals and outpatient clinics and long-term care facilities. But also public health workers, home healthcare workers, pharmacy workers, and emergency medical service workers. That comes to about 24 million Americans in all.

The vote came as Great Britain granted emergency use authorization for the Pfizer/BioNTech vaccine, becoming the first country in the world to approve a vaccine for wide distribution.

Both Pfizer/BioNTech, and Moderna have asked the US Food and Drug Administration (FDA) to grant emergency use authorization for their products. Operation Warp Speed, the special panel created by the White House to oversee the vaccines’ speedy development and distribution, says the Pfizer vaccine could be ready for distribution by December 15; the Moderna vaccine by December 22. States must order the vaccines through Operation Warp Speed.

As healthcare officials have been saying for some time, the arrival of a COVID-19 vaccine will not amount to doing away with social distancing, hand hygiene, and masking.

Anthony Fauci, MD, the director of the National Institute of Allergy and Infectious Diseases (NIAID) and a member of the White House coronavirus task force, co-wrote a viewpoint in October in JAMA Network in which he argues that these “‘low-tech’ tools to prevent the spread of SARS-CoV-2 are essential, and it must be emphasized that these interventions will still be needed after a vaccine is initially available.”

The one vote on the CDC advisory panel against the recommendation concerning vaccine distribution was by Helen Talbot, MD, a vaccine researcher at Vanderbilt University. She argues that there just aren’t enough data to prove that the vaccine should be used on elderly residents at long-term care facilities.

“I have spent my career studying vaccines in older adults,” Talbot said, as reported by STAT. “We have traditionally tried a vaccine in a young, healthy population and then hoped it worked in our frail, older adults. And so we enter this realm of ‘We hope it works and we hope it’s safe.’ And that concerns me on many levels.”

Kevin Kavanagh, MD, also has some misgivings about the coming COVID vaccines. “I’m worried that they are going to cause a significant immune response, not one that’s dangerous, but one which may discourage people from getting the vaccine,” Kavanagh tells Infection Control Today® in a Q&A. “We see this with the shingles vaccine. People take the first dose. They don’t want to take the second dose, because they had a fever and were sick.”

Kavanagh also fears that SARS-CoV-TWO will mutate. And that means that another vaccine will need to be developed to tackle that mutation. “Now, the good news on that front is that with the new technology of mRNA, it looks like these vaccines may be able to be printed in a matter of weeks,” Kavanagh said. “So that you’ll have very rapid response.”

Still, when you consider that according to a Gallup poll in October, 42% of Americans say that they will not get the COVID vaccine, the concerns raised by Doctors Kavanagh and Talbot give pause.