Will healthcare workers be among the first in line once a COVID-19 vaccine is available? Will disease outbreaks be taken into account as vaccines are distributed?
Exactly how will they be paid for to ensure they are available and accessible?
Those are among the questions raised as America's Health Insurance Plans (AHIP) sent recommendations this week to the National Academies of Sciences, Engineering, and Medicine, which is working on a preliminary framework for the equitable allocation of COVID-19 vaccines.
"There has been significant federal government investment to accelerate the development of vaccines," Matthew Eyles, AHIP's president and CEO, said in the letter. "However, no matter how many of the vaccine candidates are ultimately successful, there will be a limited supply of the vaccine available initially. Therefore, there must be a plan to phase the allocation of COVID vaccines over time as the supply increases until they are widely available for the entire population."
Among the top issues of concern for AHIP: What role will health insurers play in the allocation of the vaccine?
Already, Eyles said, payers conduct outreach such as reminders to ensure patients receive the vaccines they need, and they work with provider networks and coordinate across partners such as public health officials for data sharing regarding members’ vaccine statuses, he said.
"Following the release of a vaccine for COVID-19, some insurance providers could play a collaborative role in the postmarket safety surveillance system by contributing real-world data on safety and efficacy of the vaccine to the Food and Drug Administration (FDA), the Centers for Disease Control and Prevention (CDC), and other authorities," he wrote. "Most relevant to this framework, insurance providers can use their member data to help identify which people may meet the criteria to be eligible for the vaccine, according to the best available evidence."
AHIP suggested healthcare professionals who regularly interact with patients, whether in hospitals, clinics or doctors' offices, should be included in early distribution. The organization also asked for additional guidance on how to prioritize populations within each of the phases of distribution and said local trends in COVID-19 cases should be considered as a factor to help guide prioritization of allocation of the vaccine across all phases.
Their letter comes as leaders increasingly question how vaccines will be divvied out to Americans if and when a vaccine is available.
There are competing viewpoints about the best way to divvy out immunizations. For instance, distributing the initial doses of COVID-19 vaccine to front-line healthcare workers may not be the best approach, said health policy expert and professor Ezekiel Emanuel.