December 21, 2020Client Alert

CDC's Advisory Committee on Immunization Practices Recommends to CDC Who Should Get Vaccine Next—States To Have Final Say

On Sunday, vaccine advisors to the Center for Disease Control and Prevention (CDC) voted to recommend that both older adults, ages 75 and older, and "frontline essential workers" including first responders be next in line to receive Covid-19 vaccines which will now go to the CDC for final approval.

The CDC's Advisory Committee on Immunization Practices (ACIP) held a vote Sunday to determine the order of high-risk priority groups for Phase 1 of COVID-19 vaccine distribution, which encompasses the first months of vaccine distribution. Sunday's vote passed with 13 in favor and 1 against. It established the group's recommendation for the remainder of Phase 1 — Phases 1b and 1c. The group recommends in early December that health care workers and residents of long-term care facilities be the first people to get the vaccine, in Phase 1a. ACIP said that in determining who should get the vaccine next they took into account input/advice from a wide variety of scientist, ethicists, vaccination expert and from the public. Phases 1b, 1c and 2 are broken down as followed:

Phase 1b: Expected to start in January

  • Persons aged 75 years and older
  • Frontline Worker:
  • First Responders (Firefighters, Police)
  • ´╗┐Education (teachers, support staff, daycare)
  • Food & Agriculture
  • Manufacturing
  • Corrections workers
  • U.S. Postal service workers
  • Public transit workers
  • Grocery store workers

Phase 1c: Expected to start in February

  • Persons aged 65 -74 years
  • Persons aged 16-64 with high risk conditions
  • Essential workers not recommended in Phase 1b:
  • Transportation and Logistics
  • Food Service
  • Shelter & Housing (construction)
  • Finance
  • IT & Communication
  • Energy
  • Media
  • Legal
  • Public Safety (Engineers)
  • Water & Wastewater

Phase 2

  • All people aged 16 years and older not in Phase 1, who are recommended for vaccination

The reason the committee needed to recommend specific groups to specific phases of rollout is simple: There is not enough vaccine yet for everyone who needs one.

Given the limitations, "difficult choices have to be made," Dr. Kathleen Dooling, an ACIP member, said during the meeting Sunday. "Members of the working group strongly support vaccination being offered to every person in the United States as soon as possible," calling the committee's proposal "a road map for how we can get there together."

Vaccine rollout phases are also expected to overlap. "It is not necessary to fully complete vaccination in one phase before moving to the next phase," said the CDC's Sara Oliver. She suggested that state and local health departments could decide to widen the pool of vaccine recipients if vaccine appointments for the current phase are going unfilled or if vaccine supply grows more quickly than expected.

Federal health officials have estimated that there could be enough vaccine supply to inoculate 100 million people before the end of February, including the nation’s 21 million health care workers and three million residents of long-term care facilities. The C.D.C. reported on Sunday that more than 556,000 people had received an initial shot over the last week; both the Pfizer and Moderna vaccines require a second dose several weeks later.

Once the advisory group's recommendations are accepted by CDC Director Robert Redfield, they are expected to be published in the CDC's "Morbidity and Mortality Weekly" later this week and will be shared as official CDC guidance.

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