CDC panel recommends healthcare workers, long-term care residents and staff be first to get COVID-19 vaccine

A key federal panel has recommended healthcare workers as well as residents and staff in long-term care facilities get the first doses of COVID-19 vaccines.

The Centers for Disease Control and Prevention’s (CDC's) Advisory Committee on Immunization Practices (ACIP) voted Tuesday to approve recommendations on the initial allocation of a COVID-19 vaccine that could be approved in the next few weeks. The recommendations will aid states that are going to be tasked with distributing their first batches of the doses.

The recommendation says the first phase should be devoted to healthcare personnel in hospitals, pharmacies, outpatient clinics, home health businesses, emergency medical services and public health roles.

Personnel and residents in long-term care facilities should also be prioritized, with nursing homes taking priority ahead of assisted living and similar residential care facilities.

CDC estimates there are around 21 million healthcare personnel in the U.S. and about 3 million long-term care residents, with the most in nursing homes at 1.3 million.

The recommendations come as the federal government gets close to approving a COVID-19 vaccine. A Food and Drug Administration (FDA) advisory panel is expected to review data for a vaccine manufactured by Pfizer on Dec. 10, and emergency approval from the agency could come soon after.

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An advisory panel will evaluate a vaccine from Moderna during a Dec. 17 meeting.

ACIP will also have to evaluate whether to recommend use of a vaccine candidate.

Operation Warp Speed, a joint venture of the departments of Health and Human Services (HHS) and Defense, hopes to ship out 6.4 million doses of a vaccine 24 hours after emergency approval is granted. Warp Speed Chief Operating Officer Gen. Gustave Perna is optimistic the government can distribute 40 million doses by the end of December, which is enough to vaccinate 20 million people as two doses are required for full protection.

But state governors will decide who gets the initial doses, HHS Secretary Alex Azar said in a call with reporters recently.

It will be vital for healthcare facilities to sub-prioritize who gets the vaccine doses in the initial shipments, CDC officials said.

“Sub-prioritization of healthcare personnel is needed to consider individuals with direct patient contact who are unable to telework,” said Sarah Oliver, M.D., a member of the CDC’s Epidemic Intelligence Service, during the meeting.

Some members of the panel said they shouldn’t forget about smaller doctors' offices.

“I am greatly concerned about the ability for the small and private practice to get appropriate vaccination,” said Jason Goldman, M.D., who represented the American College of Physicians at the meeting.

Healthcare facilities need to also consider the chances of adverse symptoms from taking the vaccine. Some of the symptoms listed by Pfizer and Moderna include mild fevers and headaches.

“Consider planning that personnel can have time away from clinical care if they experience symptoms post vaccination,” Oliver said.

The chances of symptoms should also factor into which departments get the vaccine. CDC officials said facilities should stagger vaccinations among a clinical unit so the entire unit doesn't get the vaccine at the same time.

This will help ensure workers in the unit can step in if their colleagues come down with symptoms.

The panel will likely decide at a later meeting who else will get vaccines in the first phase of allocation, including essential workers and seniors, after workers and long-term care residents are vaccinated.