(CN) — Health care workers and residents of long-term care facilities should receive the first vaccinations for Covid-19 when they are available, a U.S. Centers for Disease Control panel voted on Tuesday.
The Advisory Committee on Immunization Practices held the vote after three hours of debate on who should receive the first round of vaccinations, some of which could be available by mid-December.
Health care personnel on the frontlines of the coronavirus pandemic are obvious contenders for the first vaccines, but some panelists were divided over including residents of long-term care facilities in the first phase. They noted possible problems with reporting how patients reacted to the shots.
Although long-term care facility patients only make up 6% of those infected with the coronavirus, according to the committee, they have suffered 40% of the fatalities.
Two companies, Pfizer and Moderna, could have vaccines available this month. Pfizer already asked the U.S. Food and Drug Administration for emergency approval of its vaccine in November, while Moderna submitted its request on Monday.
Roughly 20 million vaccines will be available by the end of December with FDA approval, according to CDC officials, with 5-10 million available each subsequent week.
“We expect a constrained environment for phase one,” said Dr. Sara Oliver, a CDC officer. “[The vaccines] won’t all be available right away,”
Quickly and efficiently vaccinating the nation’s 21 million health care workers could prove challenging. While hospitals are a likely place for mass vaccinations, some of the panelists warned that outpatient doctor’s offices sometimes encounter Covid-19 patients long before the hospitals.
“The outpatient community is truly the backbone of the health care system,” said Dr. Jason Goldman of the American College of Physicians. “We need to really look at the outpatient offices at risk. The office staff is critical to running these outpatient offices.”
In addition, panelists worried about how to prioritize the different types of health care workers. How will institutions weigh an individual worker’s risk versus the overall operation of hospitals, some panelists asked. Doctors and nurses working directly with patients should receive the first doses, most agree, but what about support services like cleaning personnel?
“How do you balance those risks?” asked Dr. Yvonne Maldonado of the American Academy of Pediatrics. “These are really entangled concepts.”
There are also challenges surrounding long-term care facilities. The turnover in these institutions could make it difficult to fully vaccinate patients, since both the leading vaccines require a follow-up shot a month after the first dose. Some panelists also worried about properly monitoring those who receive the vaccine to respond and report adverse reactions to the shots.
“We don’t have a good safety surveillance network in place,” said Dr. Helen Talbot.
The committee also held a brief public comment period.
Aly Hargrave, a nurse from Minnesota, criticized the panel for not studying potential health effects from the proposed vaccines before approving the recommendations.
“It’s questionable how you can label it safe,” said Hargrave. “Is it possible we would be risking widespread injury in our essential health care workers?”
Sia Anagnostou, a board member for the group Why We Vax, pushed back against those remarks.
“There’s an influx of people and groups that continue to spread misinformation,” said Anagnostou. “We haven’t usually taken it seriously, but we’re starting to see it’s deleterious effects.”
In the end, the panel voted to approve the recommended phase one rollout with only one dissenter.
The Advisory Committee on Immunization Practices is a 15-member panel, but there is a vacant seat right now so only 14 members voted. Their recommendations are not binding; CDC director Robert Redfield will give the final approval. Then, states will be tasked with distributing the first round of vaccines. State health officials are not required to follow the recommendations.
The committee will hold another vote to decide the next groups who should receive vaccines, such as police officers and those working in the transportation sector, like bus drivers.
More than 13.6 million Americans have contracted the coronavirus over the last eight months, according to Johns Hopkins University. Close to 270,000 have died from the respiratory disease.
Health experts worry those numbers could surge over the next couple months as cold weather forces more people inside and people hold holiday gatherings.
“We’re averaging one Covid death a minute,” said Beth Bell, director of the CDC’s National Center for Emerging and Zoonotic Infectious Diseases. “In the time it takes us to have this meeting, 180 people will have died of Covid-19. We are acting none too soon.”